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PY 2025 Pennie Individual Marketplace
Training for New Agents and Brokers
To be eligible to enroll in coverage through Pennie, a customer must be a US
citizen, US national, or have a qualifying immigration status. In addition they must:
a) hold citizenship or lawful present immigration status for the duration in which
they are seeking coverage b) be a resident of Pennsylvania c) not be incarcerated
(unless pending disposition of charges) d) all of the above-correct-answer-d) all of
the above
In PA, customers who are not US citizens must be lawfully present in the US for
five continuous years to be eligible for Medicare or MA/CHIP ("five-year bar"). This
applies to coverage through Pennie as well a) true b) false-correct-answer-b) false
Immigrants who have an individual tax identification number (ITIN) are permitted
to use that instead of an SSN on their Pennie application. a) true b) false-correct-
answer-b) false
Which of the following should you attempt to do when assisting households with
mixed immigration statuses? a) help all the customers of the household b) provide
resources in different formats, preferably in their preferred language c) only ask
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questions and collect information for eligible Pennie applicants who are seeking
coverage d) all of the above-correct-answer-d) all of the above
If Pennie is unable to verify a customers in immigration information, the customer
will be asked to provide additional documentation. If asked, how long does the
customer have to provide such documentation? a) 30 days b) 45 days c) 60 days d)
90 days-correct-answer-d) 90 days
For Pennie to forward a customer's application to DHS for a MA/CHIP eligibility
determination, their annual household income must fall at or below what
percentage of the FPL? a) 100% b) 138% c) 189% d) 215%-correct-answer-b) 138%
When will Pennie transition from using the 2023 FPL levels to 2024 levels? a)
November 1st b) December 1st c) January 1st-correct-answer-a) November 1st
If a customer qualifies for APTC but elects to not take the entire estimated amount
available to them, what happens to the remaining PTC? a) it gains interest b) it is
forfeited c) it will be issued as a tax return-correct-answer-c) it will be issued as a
tax return
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If the cost of the SLCS plan in a customer's area increases, but the household
income remains the same, the amount of APTC will: a) increase b) not change c)
decrease-correct-answer-a) increase
Since the APTC calculation is based on the cost of the second lowest cost silver
SLCS plan, customers can only enroll in the SLCS plan if they want to receive APTC.
true or false-correct-answer-false
When calculating household income, only family members who are seeking
coverage should be included. true or false-correct-answer-false
What is the likely consequence of under reporting income? a) IRS penalty of $100
b) IRS penalty of 10% of the aptc granted c) repayment of all access aptc to the
IRS-correct-answer-c) repayment of all access aptc to the IRS
If a customer fails to reconcile the APTC received on their annual tax return for 2
years in a row Pennie will: a) remove their financial assistance for the upcoming
year b) terminate their coverage for the upcoming year c) impose a financial
penalty-correct-answer-a) remove their financial assistance for the upcoming year
PY 2025 Pennie Individual Marketplace
Training for New Agents and Brokers
To be eligible to enroll in coverage through Pennie, a customer must be a US
citizen, US national, or have a qualifying immigration status. In addition they must:
a) hold citizenship or lawful present immigration status for the duration in which
they are seeking coverage b) be a resident of Pennsylvania c) not be incarcerated
(unless pending disposition of charges) d) all of the above-correct-answer-d) all of
the above
In PA, customers who are not US citizens must be lawfully present in the US for
five continuous years to be eligible for Medicare or MA/CHIP ("five-year bar"). This
applies to coverage through Pennie as well a) true b) false-correct-answer-b) false
Immigrants who have an individual tax identification number (ITIN) are permitted
to use that instead of an SSN on their Pennie application. a) true b) false-correct-
answer-b) false
Which of the following should you attempt to do when assisting households with
mixed immigration statuses? a) help all the customers of the household b) provide
resources in different formats, preferably in their preferred language c) only ask
,2|Page
questions and collect information for eligible Pennie applicants who are seeking
coverage d) all of the above-correct-answer-d) all of the above
If Pennie is unable to verify a customers in immigration information, the customer
will be asked to provide additional documentation. If asked, how long does the
customer have to provide such documentation? a) 30 days b) 45 days c) 60 days d)
90 days-correct-answer-d) 90 days
For Pennie to forward a customer's application to DHS for a MA/CHIP eligibility
determination, their annual household income must fall at or below what
percentage of the FPL? a) 100% b) 138% c) 189% d) 215%-correct-answer-b) 138%
When will Pennie transition from using the 2023 FPL levels to 2024 levels? a)
November 1st b) December 1st c) January 1st-correct-answer-a) November 1st
If a customer qualifies for APTC but elects to not take the entire estimated amount
available to them, what happens to the remaining PTC? a) it gains interest b) it is
forfeited c) it will be issued as a tax return-correct-answer-c) it will be issued as a
tax return
, 3|Page
If the cost of the SLCS plan in a customer's area increases, but the household
income remains the same, the amount of APTC will: a) increase b) not change c)
decrease-correct-answer-a) increase
Since the APTC calculation is based on the cost of the second lowest cost silver
SLCS plan, customers can only enroll in the SLCS plan if they want to receive APTC.
true or false-correct-answer-false
When calculating household income, only family members who are seeking
coverage should be included. true or false-correct-answer-false
What is the likely consequence of under reporting income? a) IRS penalty of $100
b) IRS penalty of 10% of the aptc granted c) repayment of all access aptc to the
IRS-correct-answer-c) repayment of all access aptc to the IRS
If a customer fails to reconcile the APTC received on their annual tax return for 2
years in a row Pennie will: a) remove their financial assistance for the upcoming
year b) terminate their coverage for the upcoming year c) impose a financial
penalty-correct-answer-a) remove their financial assistance for the upcoming year
