PUBH 6012 Exam 2 Week 6 Questions and Answers |Complete Solutions Graded
A+ |100% Correct
Waiting Period Coverage waiting period limited to 90 days.
Federal Poverty Level (FPL) Income thresholds determining eligibility for subsidies.
2025 FPL for one $15,060 income for a household of one.
Subsidies Financial assistance for individuals between 133%-400% FPL.
Medical Loss Ratio (MLR) Percentage of premiums spent on medical care: 80% (small) or
85% (large).
Minimum Value Standard Plans must cover at least 60% of medical costs.
Affordability Standard Job-based plans must cost ≤9.12% of income (2023).
Preventive Services Includes screenings and vaccinations with no cost sharing.
Premium Tax Credits Available for incomes between 100%-400% FPL.
Cost-Sharing Reduction Subsidies Limits on out-of-pocket costs for incomes <250% FPL.
Marketplace Challenges Rising costs may deter enrollment and retention.
NFIB v. Sebelius Supreme Court case on ACA's individual mandate legality.
A+ |100% Correct
Waiting Period Coverage waiting period limited to 90 days.
Federal Poverty Level (FPL) Income thresholds determining eligibility for subsidies.
2025 FPL for one $15,060 income for a household of one.
Subsidies Financial assistance for individuals between 133%-400% FPL.
Medical Loss Ratio (MLR) Percentage of premiums spent on medical care: 80% (small) or
85% (large).
Minimum Value Standard Plans must cover at least 60% of medical costs.
Affordability Standard Job-based plans must cost ≤9.12% of income (2023).
Preventive Services Includes screenings and vaccinations with no cost sharing.
Premium Tax Credits Available for incomes between 100%-400% FPL.
Cost-Sharing Reduction Subsidies Limits on out-of-pocket costs for incomes <250% FPL.
Marketplace Challenges Rising costs may deter enrollment and retention.
NFIB v. Sebelius Supreme Court case on ACA's individual mandate legality.
