Certified Enroller Covered California Midterm Exam Prep
2025/2026 – Study Guide
Certified Enroller Covered California Midterm Exam Prep 2025/2026
Section 1: Eligibility & Enrollment Fundamentals
1. To be eligible for a Covered California health plan, an individual must be:
a) A U.S. Citizen only
b) A resident of California and a U.S. Citizen or Lawfully Present immigrant
c) Any person living in the United States
d) A resident of any state that has a state-based exchange
✓ b) A resident of California and a U.S. Citizen or Lawfully Present immigrant
2. The Annual Open Enrollment Period for 2026 coverage typically runs:
a) July 1 - August 31
b) January 1 - March 31
c) November 1 - January 31 ✓
d) October 15 - December 7
✓ c) November 1 - January 31
3. A Qualifying Life Event (QLE) is required to:
a) Renew coverage automatically every year
b) Get a Special Enrollment Period (SEP) outside of Open Enrollment ✓
c) Apply for Medi-Cal at any time
d) Change plans during the Open Enrollment Period
✓ b) Get a Special Enrollment Period (SEP) outside of Open Enrollment
4. Which of the following is NOT a common QLE?
a) Getting married
b) Having a baby
c) Losing minimum essential coverage
d) Getting a new job with a higher salary ✓
✓ d) Getting a new job with a higher salary
5. The effective date of coverage for a new enrollment during Open Enrollment (e.g.,
January) is typically:
a) The day the application is submitted
b) The first of the month after the plan is selected ✓
, c) The 15th of the following month
d) The first of the next calendar year
✓ b) The first of the month after the plan is selected
6. Minimum Essential Coverage (MEC) includes all of the following EXCEPT:
a) A Covered California health plan
b) Employer-sponsored health insurance
c) Medi-Cal
d) Short-term, limited-duration health insurance ✓
✓ d) Short-term, limited-duration health insurance
7. A consumer who moves to California from another state and has no coverage qualifies
for a Special Enrollment Period. How long do they have to enroll?
a) 30 days
b) 60 days ✓
c) 90 days
d) 120 days
✓ b) 60 days
8. The "residency" requirement for Covered California means the individual:
a) Owns a home in California
b) Intends to reside in California, with or without a fixed address ✓
c) Has a California driver's license
d) Has lived in California for at least 5 years
✓ b) Intends to reside in California, with or without a fixed address
9. An individual is eligible for Medi-Cal if their household income is at or below:
a) 100% of the Federal Poverty Level (FPL)
b) 138% of the Federal Poverty Level (FPL) ✓
c) 200% of the Federal Poverty Level (FPL)
d) 400% of the Federal Poverty Level (FPL)
✓ b) 138% of the Federal Poverty Level (FPL)
10. Incarcerated individuals (in jail or prison) are:
a) Eligible for Covered California plans with a premium tax credit
b) Eligible for Medi-Cal
c) Not eligible for enrollment in a Covered California Qualified Health Plan ✓
d) Automatically enrolled in a health plan
✓ c) Not eligible for enrollment in a Covered California Qualified Health Plan
, Section 2: Financial Assistance & Advanced Premium Tax Credit (APTC)
11. The Advanced Premium Tax Credit (APTC) is a:
a) Loan that must be repaid to the IRS
b) Discount on out-of-pocket costs like deductibles
c) Federal tax credit that lowers monthly health insurance premiums ✓
d) State-funded grant for low-income individuals
✓ c) Federal tax credit that lowers monthly health insurance premiums
12. Eligibility for APTC is based on all of the following EXCEPT:
a) Household Income as a percentage of the Federal Poverty Level (FPL)
b) Not being eligible for other qualifying coverage like Medicare or an affordable
employer plan
c) The cost of the benchmark plan (second-lowest-cost Silver plan) in their area
d) The number of pre-existing medical conditions ✓
✓ d) The number of pre-existing medical conditions
13. What form must a consumer receive from their employer to help determine eligibility
for APTC?
a) W-2 Form
b) Form 1095-A
c) Form 1095-C ✓
d) Form 8962
✓ c) Form 1095-C
14. If a consumer's income increases significantly during the year, what should they do?
a) Do nothing until they file their taxes.
b) Immediately report the change to Covered California to update their APTC ✓
c) Cancel their coverage
d) Switch to a more expensive plan
✓ b) Immediately report the change to Covered California to update their APTC
15. The purpose of Form 8962 is to:
a) Apply for Covered California coverage
b) Report the APTC to the IRS and reconcile it with the final premium tax credit ✓
c) Verify immigration status
d) Enroll in a health plan during Open Enrollment
✓ b) Report the APTC to the IRS and reconcile it with the final premium tax credit
2025/2026 – Study Guide
Certified Enroller Covered California Midterm Exam Prep 2025/2026
Section 1: Eligibility & Enrollment Fundamentals
1. To be eligible for a Covered California health plan, an individual must be:
a) A U.S. Citizen only
b) A resident of California and a U.S. Citizen or Lawfully Present immigrant
c) Any person living in the United States
d) A resident of any state that has a state-based exchange
✓ b) A resident of California and a U.S. Citizen or Lawfully Present immigrant
2. The Annual Open Enrollment Period for 2026 coverage typically runs:
a) July 1 - August 31
b) January 1 - March 31
c) November 1 - January 31 ✓
d) October 15 - December 7
✓ c) November 1 - January 31
3. A Qualifying Life Event (QLE) is required to:
a) Renew coverage automatically every year
b) Get a Special Enrollment Period (SEP) outside of Open Enrollment ✓
c) Apply for Medi-Cal at any time
d) Change plans during the Open Enrollment Period
✓ b) Get a Special Enrollment Period (SEP) outside of Open Enrollment
4. Which of the following is NOT a common QLE?
a) Getting married
b) Having a baby
c) Losing minimum essential coverage
d) Getting a new job with a higher salary ✓
✓ d) Getting a new job with a higher salary
5. The effective date of coverage for a new enrollment during Open Enrollment (e.g.,
January) is typically:
a) The day the application is submitted
b) The first of the month after the plan is selected ✓
, c) The 15th of the following month
d) The first of the next calendar year
✓ b) The first of the month after the plan is selected
6. Minimum Essential Coverage (MEC) includes all of the following EXCEPT:
a) A Covered California health plan
b) Employer-sponsored health insurance
c) Medi-Cal
d) Short-term, limited-duration health insurance ✓
✓ d) Short-term, limited-duration health insurance
7. A consumer who moves to California from another state and has no coverage qualifies
for a Special Enrollment Period. How long do they have to enroll?
a) 30 days
b) 60 days ✓
c) 90 days
d) 120 days
✓ b) 60 days
8. The "residency" requirement for Covered California means the individual:
a) Owns a home in California
b) Intends to reside in California, with or without a fixed address ✓
c) Has a California driver's license
d) Has lived in California for at least 5 years
✓ b) Intends to reside in California, with or without a fixed address
9. An individual is eligible for Medi-Cal if their household income is at or below:
a) 100% of the Federal Poverty Level (FPL)
b) 138% of the Federal Poverty Level (FPL) ✓
c) 200% of the Federal Poverty Level (FPL)
d) 400% of the Federal Poverty Level (FPL)
✓ b) 138% of the Federal Poverty Level (FPL)
10. Incarcerated individuals (in jail or prison) are:
a) Eligible for Covered California plans with a premium tax credit
b) Eligible for Medi-Cal
c) Not eligible for enrollment in a Covered California Qualified Health Plan ✓
d) Automatically enrolled in a health plan
✓ c) Not eligible for enrollment in a Covered California Qualified Health Plan
, Section 2: Financial Assistance & Advanced Premium Tax Credit (APTC)
11. The Advanced Premium Tax Credit (APTC) is a:
a) Loan that must be repaid to the IRS
b) Discount on out-of-pocket costs like deductibles
c) Federal tax credit that lowers monthly health insurance premiums ✓
d) State-funded grant for low-income individuals
✓ c) Federal tax credit that lowers monthly health insurance premiums
12. Eligibility for APTC is based on all of the following EXCEPT:
a) Household Income as a percentage of the Federal Poverty Level (FPL)
b) Not being eligible for other qualifying coverage like Medicare or an affordable
employer plan
c) The cost of the benchmark plan (second-lowest-cost Silver plan) in their area
d) The number of pre-existing medical conditions ✓
✓ d) The number of pre-existing medical conditions
13. What form must a consumer receive from their employer to help determine eligibility
for APTC?
a) W-2 Form
b) Form 1095-A
c) Form 1095-C ✓
d) Form 8962
✓ c) Form 1095-C
14. If a consumer's income increases significantly during the year, what should they do?
a) Do nothing until they file their taxes.
b) Immediately report the change to Covered California to update their APTC ✓
c) Cancel their coverage
d) Switch to a more expensive plan
✓ b) Immediately report the change to Covered California to update their APTC
15. The purpose of Form 8962 is to:
a) Apply for Covered California coverage
b) Report the APTC to the IRS and reconcile it with the final premium tax credit ✓
c) Verify immigration status
d) Enroll in a health plan during Open Enrollment
✓ b) Report the APTC to the IRS and reconcile it with the final premium tax credit
