Oneexchange Access Quiz 1

The Patient Protection and Affordable Care Act (PPACA) is a law that expands Medicaid, offers a one-stop place to compare and enroll into healthcare plans, provides cost-sharing reductions, and premium-lowering aid to individuals who qualify. It is not a tax or a way for everyone to get free medical care, nor is it a play by Andrew Lloyd Weber.

The maximum deductible available for plans in the Marketplace is $5000 for an individual and $10,000 for a family. This means that individuals or families would have to pay up to this amount out of pocket before their insurance coverage starts to cover expenses.

The "Advanced Premium Tax Credit" is a subsidy provided by the government that has two options for utilization. It can immediately lower your healthcare premiums if desired, or it can be received as a credit on your tax return, thereby increasing the amount of your tax return.

A "Silver" plan refers to a health insurance plan that covers 70% of services. This means that when an individual with a Silver plan seeks medical services, the insurance company will pay for 70% of the cost, while the individual is responsible for the remaining 30%. It is important to note that the term "Silver" is used to categorize health insurance plans based on their actuarial value, which represents the percentage of healthcare costs covered by the plan.

There are five levels of plans on the Public Marketplace, including Catastrophic Plans. These levels are Bronze, Silver, Gold, Platinum, and Catastrophic. Each level represents a different level of coverage and cost-sharing. Bronze plans have the lowest premiums but higher out-of-pocket costs, while Platinum plans have the highest premiums but lower out-of-pocket costs. Catastrophic plans are available for individuals under 30 or those with hardship exemptions and provide coverage for essential health benefits after a high deductible is met.

The Private Marketplace refers to an unsubsidized Marketplace where individuals and families can compare and purchase health insurance. It is not a governmental one-stop shop or an underground market. Additionally, it is specifically for health insurance and not for other types of insurance like life, dental, auto, or travel.

The "FFM" refers to the Federally Facilitated Marketplace. This is a marketplace established by the federal government where individuals and small businesses can shop for and purchase health insurance plans. It is designed to provide access to affordable healthcare coverage options for those who do not have access to employer-sponsored plans or other government programs.

The "SBM" refers to a State-Based Marketplace. This is a platform or exchange where individuals and small businesses can shop for and purchase health insurance plans. In a State-Based Marketplace, the state government takes the lead in running and managing the marketplace, including determining the eligibility criteria, plan options, and subsidies available to individuals and businesses. This is different from a Subsidy-Based Marketplace, State-Broker Marketplace, or Subsidy-Broker Marketplace, which may have different structures and mechanisms for providing health insurance options and subsidies.

An HRA is an account set up by an employer that provides reimbursement to the participant for qualified services set by that employer. It can also refer to a health reimbursement account. Therefore, the correct answer is both a and c.

Medicaid is a program that provides healthcare coverage for low-income individuals who meet certain eligibility criteria. It is specifically designed for individuals with limited financial resources, and the income threshold for eligibility is up to 133% of the Federal Poverty Limit (FPL). This program aims to ensure that those who cannot afford private health insurance have access to necessary medical services and treatments.

In 2014, it does make a difference if you are an Alaskan Native (AN) or an American Indian (AI) and want to purchase health insurance in the Public Marketplace. AN/AI's will not be penalized for not buying or having health coverage, and they will not pay any coinsurance for coverage if their incomes are within certain limits. This means that they are exempt from the penalty for not having health insurance and they receive additional financial assistance for their coverage.

The Initial Enrollment Period for the Marketplaces began on November 15th.

The first available effective date for those who use the Marketplaces is January 1, 2015.

The Initial Enrollment Period for the Marketplaces ends on February 15, 2015. This means that individuals must enroll in a health insurance plan through the Marketplaces by this date in order to have coverage for the upcoming year. After February 15, individuals may still be able to enroll in a plan if they qualify for a Special Enrollment Period or if they qualify for Medicaid or the Children's Health Insurance Program.

Catastrophic plans are high-deductible plans designed for low-income individuals under the age of 30. These plans have lower monthly premiums but higher deductibles, meaning individuals must pay a significant amount out of pocket before the insurance coverage kicks in. Catastrophic plans are meant to provide coverage for major medical expenses, such as hospital stays or emergency room visits, rather than routine healthcare services. These plans offer a safety net for young individuals who may be healthy and not require frequent medical care, but still want protection against unforeseen and costly medical events.

The names of the plans on the Public Marketplace are Bronze, Silver, Gold, Platinum, and Catastrophic.

Individuals can change plans once their plan has started during two specific times: when their contract with the plan ends and during the Annual Enrollment Period of each year. This means that individuals have the opportunity to make changes to their plans on a monthly basis if they are an AI/AN (American Indian/Alaska Native) and during the designated annual enrollment period.

The correct answer is November 15 - February 15, 2014. This is the specific time period during which individuals can make changes to their healthcare plans for the year 2014. It is called the Annual Enrollment Period (AEP) and it is a limited window of time for individuals to review and modify their healthcare coverage options.

The correct answer is A and B. Incarceration and being an illegal resident of the United States will restrict you from being able to purchase insurance from the Marketplaces.

You can change plans purchased from the Marketplace when you have a baby or when you are moving out of your service area. These life events may require different healthcare needs or coverage options, so it is important to have the flexibility to switch plans to better suit your circumstances.

California has its own State-Based Marketplace. This means that California operates its own health insurance exchange where individuals and small businesses can purchase health insurance plans. This is in contrast to states that use the federal marketplace, also known as Healthcare.gov. Having its own State-Based Marketplace allows California to have more control and flexibility in designing and implementing its health insurance programs to meet the specific needs of its residents.

Florida (FL) uses the Federally-Facilitated Marketplace. This means that the state relies on the federal government to run its health insurance marketplace, rather than operating its own state-based marketplace.

The correct answer is OneExchange Access. This is the name of the segment that the person is working with.

The correct answer is www.healthcare.gov. This is the website for the FFM, which stands for Federally Facilitated Marketplace. It is the online platform where individuals can enroll in health insurance plans offered through the Affordable Care Act.

A copay is a set charge that you pay for a service. It is a fixed amount that you are required to pay out of pocket each time you receive a specific healthcare service. Unlike coinsurance, which is a percentage of the total cost of the service, a copay is a predetermined fee. It is commonly used in health insurance plans to help share the cost of medical expenses between the insurance company and the insured individual.

A "Platinum" plan is a type of insurance plan that provides coverage for 90% of services. This means that the plan will pay for 90% of the cost of covered services, while the remaining 10% will be the responsibility of the insured individual.

A "Bronze" plan is a type of health insurance plan that covers 60% of services. This means that the planholder is responsible for paying 40% of the cost of services out of pocket. Bronze plans typically have lower monthly premiums but higher deductibles and out-of-pocket costs compared to other types of plans.

A "Gold" plan is a type of health insurance plan that covers 80% of services. This means that the insurance company will pay for 80% of the cost of covered services, while the individual is responsible for paying the remaining 20%.

To qualify for a Premium Tax Credit, the household income must be within a certain range. This range is based on the federal poverty level and varies depending on the size of the household. The purpose of the Premium Tax Credit is to help individuals and families with low to moderate incomes afford health insurance coverage through the Health Insurance Marketplace. By providing a tax credit, the government aims to make insurance more affordable and accessible to those who may not be able to afford it otherwise.

To qualify for a Cost Sharing Reduction (CSR), the household income must be within a certain range. This range is based on the federal poverty level (FPL) and varies depending on the size of the household. The purpose of CSR is to help lower-income individuals and families afford healthcare coverage by reducing their out-of-pocket costs, such as deductibles, copayments, and coinsurance. By limiting eligibility to those with a specific income level, the government ensures that the assistance is targeted towards those who need it the most.

In 2014, there was a requirement for all plans to offer a standardized set of services known as Essential Health Benefits. These benefits included healthcare services and prescription drugs. This ensured that individuals had access to necessary medical services and medications regardless of the specific plan they had.

Private health plans are required to include prescription drugs as one of the benefits. This is because prescription drugs are an essential component of healthcare and are often necessary for treating various medical conditions. Including prescription drugs in private health plans ensures that individuals have access to the medications they need to manage their health and well-being.

Vision is not required to be included in health plans because it is considered a separate type of coverage that is not essential for overall health and well-being. While hospitalization, emergency services, and laboratory services are necessary for medical treatment and diagnosis, vision services are typically considered optional and can be obtained through separate vision insurance plans.

CHIP stands for Children's Health Insurance Program. This program provides health insurance coverage to low-income children and pregnant women who do not qualify for Medicaid. It is a government-funded program that ensures access to healthcare services for vulnerable populations.

Covered California is the correct answer because it is the name of the health insurance Marketplace specifically for California. It is a state-based exchange where individuals and families can compare and purchase health insurance plans. MediCAL is a separate program that provides free or low-cost health coverage for low-income individuals and families in California. California Health Exchange and Healthcare California are not the correct names for the health insurance Marketplace in California.

The correct answer is Texas uses the FFM, HealthCare.gov. This means that Texas utilizes the Federally Facilitated Marketplace (FFM) and the HealthCare.gov website for its health insurance marketplace. This indicates that Texas does not have its own state-run marketplace, but instead relies on the federal government's platform for individuals and families to enroll in health insurance plans.

The correct answer is Florida uses the FFM, HealthCare.gov. This means that in Florida, the health insurance Marketplace is operated by the federal government through the HealthCare.gov website. This allows residents of Florida to shop for and enroll in health insurance plans offered by private insurance companies.

The correct answer is Marketplace and Non-Marketplace. Marketplaces refer to platforms or environments where goods, services, or information are exchanged between buyers and sellers. They can be physical locations or online platforms. Non-Marketplaces, on the other hand, do not involve any exchange of goods, services, or information between buyers and sellers. This could include areas or platforms where there is no commercial activity taking place.

The acronym "SHOP" stands for Small Business Health Options Program. This program is designed to help small businesses provide health insurance coverage to their employees. It allows employers to compare and choose from a variety of health insurance plans that are available in their area, making it easier for small businesses to offer affordable healthcare options to their employees.

If the employer offers health insurance to an individual that does not meet the minimum essential coverage standards, the individual will be able to go to the Public Marketplace and receive governmental aid. This is because individuals who have health insurance that does not meet the minimum essential coverage standards are eligible for governmental aid through the Public Marketplace.

An individual can determine if they qualify to receive aid by completing a subsidy application on the SBM or FFM websites. These websites provide a platform for individuals to input their information and determine their eligibility for aid based on the criteria set by the program. By completing the application, individuals can provide the necessary information for evaluation and receive a determination on whether they qualify for aid or not.

If your income makes health insurance unaffordable or if you are an American Indian or Alaskan Native, you will not be penalized for not having coverage in 2014. Additionally, if your religion is opposed to healthcare insurance, you will also not be penalized.

Starting in 2014, insurance companies will no longer be able to put yearly or lifetime limits on essential health benefits. This means that individuals will have access to necessary medical treatments and services without worrying about reaching a maximum limit on coverage. This change aims to provide better healthcare access and financial protection for individuals.

A "Catastrophic" plan includes a high deductible, essential health benefits, and three primary care visits per year at no cost. This means that the plan requires the insured to pay a significant amount out-of-pocket before the insurance coverage kicks in. Despite the high deductible, the plan still covers essential health benefits, which are a set of services that all insurance plans must cover under the Affordable Care Act. Additionally, the plan provides three primary care visits per year at no cost, allowing the insured to receive preventive care and basic medical services without any additional charges.

In 2014, there will be no pre-existing condition that will be declinable. This means that insurance companies will not be able to deny coverage or charge higher premiums based on any pre-existing condition. This is due to the implementation of the Affordable Care Act, which prohibits discrimination against individuals with pre-existing conditions. Therefore, individuals with conditions such as End-Stage Renal Disease, Cancer, and AIDS/ARC will not be denied coverage or face higher costs in 2014.

In 2014, pregnancy was not considered a declinable condition. This means that insurance companies could not deny coverage or charge higher premiums based solely on an individual's pregnancy status.

If someone doesn't have health coverage in 2014, they may have to pay a fee and they may have to pay for all of their care. This means that not having health coverage can result in financial consequences, as individuals may be required to pay a penalty fee and also be responsible for covering the costs of their medical care out of pocket.

In 2014, the fee for a child who is uninsured is $47.5 or 0.5% of their income. This means that if the child's income is $9,500 or less, they will have to pay a fee of $47.5. If their income is more than $9,500, they will have to pay 0.5% of their income as the fee.

Under the Affordable Care Act (ACA), young adults can stay on their parents' health insurance plan until they reach the age of 26. This provision was implemented to ensure that young adults have access to affordable healthcare coverage as they transition into adulthood and potentially face challenges in obtaining their own insurance. By allowing them to remain on their parents' plan, it helps to bridge the gap and provide continuous coverage during this period of their lives.

Children can join or remain on their parents' coverage even if they are eligible to enroll in their employer's plan or if they are married. This means that even if they have the option to get coverage through their own employer or through their spouse's plan, they can still choose to stay on their parents' coverage if they prefer.