Page 1 of 69
Indiana Navigator EXAM COMPLETE NEWEST 300
QUESTIONS AND VERIFIED SOLUTIONS LATEST
UPDATE THIS YEAR
QUESTION: FFM in IN & OH observe ___________ guidelines but maintain oversight of
____________ regulated insurance products. - ANSWER-federal, state
QUESTION: What does SEP mean? - ANSWER-Special Enrollment Period
QUESTION: The 3 types of Cost share Reductions (CSR) - ANSWER-Deductible, Copayment,
Coinsurance
QUESTION: Changes in household (married/divorced/birth/adoption), income, and location, as
well as, a loss of health coverage are all examples of what? - ANSWER-Exceptions for Special
Enrollment Period (SEP)
QUESTION: When was the ACA passed? - ANSWER-2010
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QUESTION: It's goal was to increase the number of individuals with health insurance coverage.
Cannot be denied coverage for pre-existing conditions
Insurance policies are guaranteed to be available and renewable - ANSWER-Affordable Care Act
(ACA)
QUESTION: This is what helps limit out of pocket cost for health benefits. - ANSWER-Cost
Sharing Reductions (CSR)
QUESTION: - meet all requirements for PTC (Premium Tax Credit)
- enroll in Silver Plan (70% AV) on FFM
- Household income 100% - 250% FPL
OR Household income 100% - 300% FPL for Native Americans
All of these are eligibility requirements for what? - ANSWER-Cost Sharing Reductions (CSR)
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QUESTION: In-network healthcare providers may only charge cost sharing up to an ___ __
______ _______ amount. This amount is the maximum cost sharing a plan may charge in a
year. - ANSWER-OUT-OF-POCKET Maximum
QUESTION: The average % of medical cost expected to be paid by health plan over all enrollees
is called. ______ _____ (__), - ANSWER-Actuarial Value (AV)
QUESTION: Plans with a higher AV will have ________ premiums and ___________ cost sharing
- ANSWER-higher, reduced
QUESTION: Anthem, CareSource, MDWise, and Managed Health Services are referred to as
what? - ANSWER-Managed Care Entities (MCE)
QUESTION: Which health plan contains the following:
- Qualifies as MEC (Minimum Essential Coverage)
- covers IN residents aged 19-64
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- Income below 138% FPL
- who are NOT eligible for Medicare or another Medicaid category? - ANSWER-Healthy Indiana
Plan (HIP)
Q; What does FFM stand for? - ANSWER-Federally-facilitated Marketplace
QUESTION: The name of the federal agency within the US Dept of Health and Human Services
(HHS) that administers Medicare, works in partnership with state governments to administer
Medicaid and the Children's Health Insurance Program (CHIP) and oversees the federally
Marketplace (FFM)/www.healthcare.gov - ANSWER-Centers for Medicare & Medicaid Services
(CMS)
QUESTION: How many metal levels are there on the FFM and what are they? - ANSWER-4 -
Bronze, Silver, Gold, Platinum
QUESTION: 60/40 - ANSWER-Bronze Level
4
Indiana Navigator EXAM COMPLETE NEWEST 300
QUESTIONS AND VERIFIED SOLUTIONS LATEST
UPDATE THIS YEAR
QUESTION: FFM in IN & OH observe ___________ guidelines but maintain oversight of
____________ regulated insurance products. - ANSWER-federal, state
QUESTION: What does SEP mean? - ANSWER-Special Enrollment Period
QUESTION: The 3 types of Cost share Reductions (CSR) - ANSWER-Deductible, Copayment,
Coinsurance
QUESTION: Changes in household (married/divorced/birth/adoption), income, and location, as
well as, a loss of health coverage are all examples of what? - ANSWER-Exceptions for Special
Enrollment Period (SEP)
QUESTION: When was the ACA passed? - ANSWER-2010
1
, Page 2 of 69
QUESTION: It's goal was to increase the number of individuals with health insurance coverage.
Cannot be denied coverage for pre-existing conditions
Insurance policies are guaranteed to be available and renewable - ANSWER-Affordable Care Act
(ACA)
QUESTION: This is what helps limit out of pocket cost for health benefits. - ANSWER-Cost
Sharing Reductions (CSR)
QUESTION: - meet all requirements for PTC (Premium Tax Credit)
- enroll in Silver Plan (70% AV) on FFM
- Household income 100% - 250% FPL
OR Household income 100% - 300% FPL for Native Americans
All of these are eligibility requirements for what? - ANSWER-Cost Sharing Reductions (CSR)
2
, Page 3 of 69
QUESTION: In-network healthcare providers may only charge cost sharing up to an ___ __
______ _______ amount. This amount is the maximum cost sharing a plan may charge in a
year. - ANSWER-OUT-OF-POCKET Maximum
QUESTION: The average % of medical cost expected to be paid by health plan over all enrollees
is called. ______ _____ (__), - ANSWER-Actuarial Value (AV)
QUESTION: Plans with a higher AV will have ________ premiums and ___________ cost sharing
- ANSWER-higher, reduced
QUESTION: Anthem, CareSource, MDWise, and Managed Health Services are referred to as
what? - ANSWER-Managed Care Entities (MCE)
QUESTION: Which health plan contains the following:
- Qualifies as MEC (Minimum Essential Coverage)
- covers IN residents aged 19-64
3
, Page 4 of 69
- Income below 138% FPL
- who are NOT eligible for Medicare or another Medicaid category? - ANSWER-Healthy Indiana
Plan (HIP)
Q; What does FFM stand for? - ANSWER-Federally-facilitated Marketplace
QUESTION: The name of the federal agency within the US Dept of Health and Human Services
(HHS) that administers Medicare, works in partnership with state governments to administer
Medicaid and the Children's Health Insurance Program (CHIP) and oversees the federally
Marketplace (FFM)/www.healthcare.gov - ANSWER-Centers for Medicare & Medicaid Services
(CMS)
QUESTION: How many metal levels are there on the FFM and what are they? - ANSWER-4 -
Bronze, Silver, Gold, Platinum
QUESTION: 60/40 - ANSWER-Bronze Level
4
