Page 1 of 130
INDIANA NAVIGATOR EXAM WITH COMPLETE
QUESTIONS AND CORRECT VERIFIED ANS WERS
LATEST UPDATE JUST RELEASED THIS YEAR
What is Cobra Insurance also known as?
Consolidated Omnibus Budget Reconciliation Act
COBRA Insurance
a type of temporary health insurance coverage authorized under federal law that may allow an
individual to elect to keep their insurance coverage if the individual's employment ends, loses
coverage as a dependent of the covered employee, or another qualifying event occurs.
What happens if an individual elects COBRA coverage?
the individual pays 100% of the premiums, including the share the employer used to pay, plus a
small administrative fee.
Coinsurance
is a consumer's share/percentage of the cost of a healthcare service, paid in addition to the
deductible amount
Auto Assignment
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the process by which an individual who does not select a Hoosier Healthwise (HHW) or HIP
Managed Care Entity (MCE) at the time of the HHW or HIP application, or within 14 days of the
submission of the application, is automatically assigned to a Managed Care Entity (MCE)
Certificate of Coverage
a list of benefits, services, cost sharing, exclusions, and limits applied by a particular health
insurance policy.
.
Consumer Directed Health Plan (CDHP)
a health plan that has a high deductible cost but often lower premiums. An individual with this
plan is eligible for a health savings account (HSA) to which the individual can contribute pre-tax
dollars for qualified healthcare expenses, which employers may also contribute to.
Dependent
a child up to 26 years old under the Affordable Care Act (ACA).
The ACA requires plans and issuers that offer dependent coverage, to make the coverage
available until a child reaches 26 years old. What plans does this rule apply to?
plans in the individual market and to new employer plans. It also applies to existing employer
plans unless the adult child has another offer of employer-based coverage (such as through the
adult child's job).
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Division of Family Resources (DFR)
a division of the Indiana Family and Social Services Administration (FSSA), which establishes
eligibility for Medicaid, HIP, the Supplemental Nutrition Assistance Program (SNAP - food
assistance), and the Temporary Assistance for Needy Families (TANF - cash assistance).
Explanation of Benefits (EOB)
is a document that describes what an insurer paid for a health service accessed by a consumer
enrolled in one of the insurer's health insurance policies, what the consumer paid and/or owes
for the service, and a summary of the consumer's remaining deductible and out-of-pocket
maximum amounts. Each time a health service is accessed by a consumer, the consumer will
receive one of these from their insurer.
Financial Interest
is for purposes of the IDOI Conflict of Interest Policy for Indiana Navigators and AOs, when an
Indiana Navigator or AO will receive, or may receive, any compensation or other financial
arrangement or benefit, either directly or indirectly, from a third party.
Flexible Spending Account (FSA)
is a medical savings account that allows an individual and the individual's employer to
contribute pre-tax dollars towards future medical costs. Funds in this account will expire at the
end of the year.
Health Maintenance Organization (HMO)
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is a designation given to health insurers offering products or services in any market segment
(individual, small group, large group, or self-insured) in order to also provide or arrange for the
delivery of health care services to enrollees on a prepaid basis. Individuals covered under this
organization will have a prescribed set of providers that may provide covered services. Except
for certain services, including emergency services.
Health Savings Account (HSA)
is a medical savings account that allows the individual and the individual's employer to
contribute pre-tax dollars towards the cost of future health costs. Dollars in this account do not
expire and belong solely to the individual (including the employer contribution)
What happens to an individual if they use the HSA funds for anything other than qualified
health care expenses?
they must pay a penalty
Navigator Designation Form
is a form developed by the IDOI that may be completed by insurance producers or consultants
licensed in Indiana as part of the initial Indiana Navigator certification application process, in
place of the online new or renewal application for Indiana Navigators.
Individual Market
is the market for health insurance coverage offered to individuals other than in connection with
a group health plan.
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SUCCESS!
INDIANA NAVIGATOR EXAM WITH COMPLETE
QUESTIONS AND CORRECT VERIFIED ANS WERS
LATEST UPDATE JUST RELEASED THIS YEAR
What is Cobra Insurance also known as?
Consolidated Omnibus Budget Reconciliation Act
COBRA Insurance
a type of temporary health insurance coverage authorized under federal law that may allow an
individual to elect to keep their insurance coverage if the individual's employment ends, loses
coverage as a dependent of the covered employee, or another qualifying event occurs.
What happens if an individual elects COBRA coverage?
the individual pays 100% of the premiums, including the share the employer used to pay, plus a
small administrative fee.
Coinsurance
is a consumer's share/percentage of the cost of a healthcare service, paid in addition to the
deductible amount
Auto Assignment
1
SUCCESS!
,Page 2 of 130
the process by which an individual who does not select a Hoosier Healthwise (HHW) or HIP
Managed Care Entity (MCE) at the time of the HHW or HIP application, or within 14 days of the
submission of the application, is automatically assigned to a Managed Care Entity (MCE)
Certificate of Coverage
a list of benefits, services, cost sharing, exclusions, and limits applied by a particular health
insurance policy.
.
Consumer Directed Health Plan (CDHP)
a health plan that has a high deductible cost but often lower premiums. An individual with this
plan is eligible for a health savings account (HSA) to which the individual can contribute pre-tax
dollars for qualified healthcare expenses, which employers may also contribute to.
Dependent
a child up to 26 years old under the Affordable Care Act (ACA).
The ACA requires plans and issuers that offer dependent coverage, to make the coverage
available until a child reaches 26 years old. What plans does this rule apply to?
plans in the individual market and to new employer plans. It also applies to existing employer
plans unless the adult child has another offer of employer-based coverage (such as through the
adult child's job).
2
SUCCESS!
,Page 3 of 130
Division of Family Resources (DFR)
a division of the Indiana Family and Social Services Administration (FSSA), which establishes
eligibility for Medicaid, HIP, the Supplemental Nutrition Assistance Program (SNAP - food
assistance), and the Temporary Assistance for Needy Families (TANF - cash assistance).
Explanation of Benefits (EOB)
is a document that describes what an insurer paid for a health service accessed by a consumer
enrolled in one of the insurer's health insurance policies, what the consumer paid and/or owes
for the service, and a summary of the consumer's remaining deductible and out-of-pocket
maximum amounts. Each time a health service is accessed by a consumer, the consumer will
receive one of these from their insurer.
Financial Interest
is for purposes of the IDOI Conflict of Interest Policy for Indiana Navigators and AOs, when an
Indiana Navigator or AO will receive, or may receive, any compensation or other financial
arrangement or benefit, either directly or indirectly, from a third party.
Flexible Spending Account (FSA)
is a medical savings account that allows an individual and the individual's employer to
contribute pre-tax dollars towards future medical costs. Funds in this account will expire at the
end of the year.
Health Maintenance Organization (HMO)
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is a designation given to health insurers offering products or services in any market segment
(individual, small group, large group, or self-insured) in order to also provide or arrange for the
delivery of health care services to enrollees on a prepaid basis. Individuals covered under this
organization will have a prescribed set of providers that may provide covered services. Except
for certain services, including emergency services.
Health Savings Account (HSA)
is a medical savings account that allows the individual and the individual's employer to
contribute pre-tax dollars towards the cost of future health costs. Dollars in this account do not
expire and belong solely to the individual (including the employer contribution)
What happens to an individual if they use the HSA funds for anything other than qualified
health care expenses?
they must pay a penalty
Navigator Designation Form
is a form developed by the IDOI that may be completed by insurance producers or consultants
licensed in Indiana as part of the initial Indiana Navigator certification application process, in
place of the online new or renewal application for Indiana Navigators.
Individual Market
is the market for health insurance coverage offered to individuals other than in connection with
a group health plan.
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