Federally Facilitated Marketplace (FFM) Practice Exam

These questions are part of the practice quiz. Start practicing

• What is the primary function of the SLCSP in subsidy calculations?
• Navigators and certified application counselors are permitted to make plan selection recommendations.
• Outside the Open Enrollment Period, enrollment generally requires what?
• What is the recommended action when you identify a series of fraudulent calls from someone posing as a member of your agency?
• Applicants who permanently move to a new county and attest to having qualifying coverage in the last 60 days are:
• Which statement is true regarding SSN on the Marketplace application?
• Which actuarial value is associated with the Silver metal level?
• Which statement best describes CSRs in relation to plan selection for eligible individuals?
• A premium tax credit is not allowed for a consumer's Marketplace coverage if the individual chooses to be covered by an ICHRA. The statement is:
• Which scenario results in a retroactive coverage date?
• Why does the Gold plan have a much higher premium than the Bronze plan, given both are HMO plans from the same issuer product?
• What is a Qualified Health Plan (QHP)?
• Where do consumers remain during the entire application process when assisted by an agent or broker?
• An applicant submits an application on January 17 and is not SEP-eligible. What is their enrollment status in a QHP?
• What is a verification mismatch and how is it resolved?
• If a consumer is eligible for CSRs, which plan level typically offers the most savings and potentially the lowest monthly premium?
• Scenario: A consumer moved to a new state last week. Select the correct coverage effective date following plan selection.
• What documentation does Amanda need to obtain from Noel prior to submitting an updated eligibility application for Noel after a move?
• Plan selection recommendations by navigators and CACs are sometimes encouraged.
• Are there fixed enrollment period dates consumers should know?
• What is Form 1095-A used for in relation to SLCSP data and APTC paid?
• Which statement about newborn coverage is true?
• Scenario: A consumer had a child last month. Select the correct coverage effective date following plan selection.
• What is the Second Lowest Cost Silver Plan (SLCSP) and its role in subsidy calculation?
• Which statement is true about the annual renewal process?
• Your client has an annual income DMI. What guidance should you provide?
• Sonya and Jamar live together as domestic partners with a daughter. Jamar files a tax return while Sonya files a separate tax return and claims Gabrielle as their dependent. Since the three live together, is this one tax household?
• Which statement best describes how accuracy of eligibility determinations across states is achieved?
• Are capital gains from selling property or investments included on Marketplace applications?
• Which of the following is NOT a listed reporting channel for a privacy incident involving a potential PII breach?
• What are the Essential Health Benefits (EHBs) that all QHPs must cover?
• If a consumer voluntarily terminated QHP coverage outside Open Enrollment, the consumer may have to wait until the next OE to choose a new plan, unless they qualify for a special enrollment period.
• If a plan is discontinued or a consumer loses eligibility, how may they switch plans during the year?
• If the household contact is transitioning to Medicare but the spouse wants to remain on Marketplace, which contact center should you use?
• What is the difference between Premium Tax Credit (PTC) and Premium Tax Credit Reconciliation?
• Is it possible to select a Marketplace plan after December 15, 2024 but before the end of the Open Enrollment Period?
• What happens if a consumer fails to pay their premium?
• What should agents and brokers do to prevent data matching issues on Marketplace applications and prevent consumers from potentially losing their Marketplace coverage and/or financial assistance?
• What is the role of the Second Lowest Cost Silver Plan (SLCSP) in subsidy calculations?
• Which form is used to reconcile any advance premium tax credits (APTC) with the actual premium tax credit?
• What is the primary purpose of the Federally Facilitated Marketplace (FFM)?
• If a consumer makes a QHP change to a different QHP issuer before the coverage effective date, but after making their initial binder payment, which issuer is responsible for refunding the January premium?
• How does a move affect enrollment in the Marketplace?
• When might additional identity checks be triggered during the verification process?
• Which statement best aligns with preventing data matching issues on Marketplace applications?
• A Special Enrollment Period (SEP) allows enrollment outside the Open Enrollment Period due to qualifying life events. Which statement is true?
• If the information on Form 1095-A is wrong, what should a consumer do?
• What does it mean if an application is marked 'verification required'?
• What is Form 1095-B and when is it used?
• What is the purpose of eligibility redetermination by the Marketplace?
• Jane received an email from CMS alerting her that she has three business days to explain irregular search activity detected on her CMS Enterprise Portal account. If she does not respond to this most recent notice, what will happen?
• What is Plan A's out-of-pocket maximum in the example?
• If Medicaid eligibility is determined, what may happen automatically?
• What is the role of the annual renewal process for marketplace coverage?
• Given Plan A and Plan B with the same actuarial value (73%), but different deductibles and out-of-pocket maximums, which statement is true?
• What does MAGI stand for and how is it used in marketplace determinations?
• Which statement about QHPs is NOT true?
• Which form is used to reconcile APTC and PTC with premiums?
• A consumer who terminates QHP coverage outside Open Enrollment will always need to wait for the next Open Enrollment to enroll in a new plan.
• How can a consumer file an appeal online with the Marketplace if they disagree with an eligibility determination?
• Which metal level generally has the lowest premium but highest cost-sharing?
• As you assist clients during Open Enrollment, you want to remind them to make binder payments by the earliest possible deadline. What is the earliest possible payment deadline date to include in your reminder?
• Navigators and CACs can make plan selection recommendations with no restrictions.
• If a consumer terminates coverage outside Open Enrollment, they may be eligible for a Special Enrollment Period.
• What is the purpose of Form 8962 in tax filing and how is it used?
• CSR discounts apply only to which plan tier?
• Which option describes a process where an agent or broker can facilitate eligibility without the consumer visiting HealthCare.gov?
• What is the typical role of a Navigator or Certified Application Counselor (CAC) in the FFM?
• How is MAGI-based household size determined for subsidy eligibility?
• How should consumers handle changes in income or household during the coverage year?
• MAGI determines eligibility for premium subsidies; which factors influence whether MAGI qualifies you for subsidies?
• An applicant who attests to being recently married with one spouse having qualifying coverage in the last 60 days is:
• Which income components are included when calculating MAGI?
• Scenario: A consumer will be losing minimum essential coverage (MEC) next month. What is the correct coverage effective date following plan selection?
• Before submitting a new Marketplace application for Elizabeth, must a broker verify whether there is an active application?
• True or False: If HHS suspects that an agent, broker, or web-broker may have engaged in fraud or abusive conduct that could cause imminent or ongoing harm using a consumer's PII, CMS may temporarily suspend the affected entity's Marketplace Agreement(s).
• Which statement correctly describes Medicaid/CHIP Denial SEP eligibility?
• During Open Enrollment, completing an application typically makes an applicant eligible to enroll if other criteria are met. Which statement best describes this eligibility?
• If Jianxin's premium is $100, which would be an allowable premium for Aiping?
• How does a change in income affect premium subsidies during the year?
• What is the Open Enrollment Period (OEP) and why is it important?
• Should you actively update and submit a Plan Year 2025 Marketplace application after a MOEN is issued?
• Which statement describes what would occur next when Keisha creates a new OE application without your NPN, while auto-enrollment remains for the prior plan?
• Who is eligible to enroll in a Qualified Health Plan (QHP) through the FFM?
• Which statement is true about APTC or PTC and tax filing?
• When is CSR available and what is a key limitation?
• If two consumers are not in the same tax household, are they automatically eligible for APTC or CSR?
• Which of the following is NOT a factor in determining APTC eligibility?
• Which metal level is described as having the highest premium but the lowest cost-sharing?
• Which of the following represents the correct requirement before plan changes or application updates?
• Is worker's compensation included on Marketplace applications?
• Elizabeth’s consent example indicates CMS must have what before assisting with enrollment, if the consumer has provided consent via email?
• What is Plan A's deductible in the example?
• Which enrollment process involves agents visiting both a DE partner site and HealthCare.gov while completing the application?
• Which factor could lead to a higher premium?
• If an applicant moves from a foreign country, what is their eligibility status for enrolling in a Qualified Health Plan (QHP)?
• Qualifying for a Special Enrollment Period can allow enrollment in a new plan outside Open Enrollment.
• Which statement best completes the sentence: To prevent data matching issues, agents and brokers should do all of the following?
• In a married couple where the wife does not have eligible immigration status but the husband does, who is eligible for Marketplace coverage?
• Eduardo explains that a person claiming to work with your agency contacted him about a payment issue and asked for personal and financial information over the phone to effectuate his Marketplace coverage. Since Eduardo did not provide any information, should this incident be reported?
• How does the marketplace address fraud and abuse prevention?
• What is the purpose of 1095-A data when completing Form 8962?
• Paula wants to post an online advertisement to help enroll in Marketplace coverage. Which type of ad could CMS consider misleading?
• What is a Catastrophic plan and who is typically eligible?
• Which entity can provide an eligibility determination to the consumer during enrollment?
• Premium Tax Credits are administered by which entity for states without a state-based marketplace?
• How does employer-sponsored insurance affect eligibility for APTC?
• When does the Open Enrollment Period end?
• Two plans with the same actuarial value can differ in cost-sharing features such as deductibles and copays.
• You identify an unknown login to your EDE partner site, and you believe that someone has gained unauthorized access to your EDE account. To which agency or party should you report this privacy incident?
• How does the FFM ensure accuracy of eligibility determinations across state lines?
• If Aiping is a tobacco user, how would that affect his premium?
• Which statement about premium and out-of-pocket costs is true?
• Which steps contribute to preventing data matching issues and protecting consumer coverage?
• How does having access to affordable employer coverage affect eligibility for Marketplace subsidies?
• Where can a consumer check Medicaid or CHIP eligibility determination?
• How is a dependent defined for MAGI purposes in the marketplace?
• What does it mean to be ineligible for subsidies?
• What is APTC used for in marketplace subsidies?
• Navigators and CACs are allowed to make plan recommendations in all circumstances.
• A consumer who loses QHP coverage due to voluntary termination outside OE can enroll in a new plan immediately if they request it.
• If a consumer gains a dependent due to birth or adoption in the last 60 days, their eligibility to enroll in a QHP is:
• Is Social Security Income included on Marketplace applications?
• An applicant who permanently moves within the same county and does not gain access to new QHPs as a result of the move is:
• What is eligibility redetermination and when does it occur?
• Are CSR benefits available on Bronze, Gold, or Platinum plans?
• A current Marketplace enrollee makes an active plan selection after December 15, 2024 but before the Open Enrollment Period ends. What is the typical effective date of that late selection?
• If a consumer's PII is suspected to be used in a fraud incident involving a change in plan selection, what is the required action?
• MEC stands for which term in Marketplace coverage?
• To prevent data matching issues on Marketplace applications, which actions are appropriate?
• How do APTC payments interact with the monthly premium payments to the QHP issuer?
• Is there information that will help a consumer review both the cost and quality of Marketplace plans?
• What should Jose do to ensure he is compensated for the enrollment when his NPN was not included?
• Are Temporary Assistance for Needy Families (TANF) payments included on Marketplace applications?
• If the Marketplace determines you are Medicaid-eligible, which of the following is true?
• In the scenario where Dominic updated Joel's income on an existing application without recording the calls, are Dominic's actions compliant?
• A client aged 65 with 10 years of Medicare taxes is trying to enroll in a Marketplace plan. What will happen?
• How does a qualifying life event affect enrollment eligibility?
• How does incarceration affect eligibility for Marketplace coverage?
• What does SLCSP stand for and what is its role in premium subsidy calculations?
• In a scenario where Marcus is searching for Elizabeth's existing application before submitting a new one, does Marcus need Elizabeth's consent before searching for her application, even if he has not submitted an application yet?
• What is the difference between Premium Tax Credit (PTC) and Cost-Sharing Reductions (CSR)?
• Open Enrollment generally occurs during which window?
• Is adult dental coverage an essential health benefit in the individual market?
• A Special Enrollment Period can be triggered by qualifying life events such as loss of coverage.
• Which statement about a Qualified Health Plan (QHP) is accurate?
• What is the relationship between Medicaid eligibility and Marketplace eligibility?
• What does 'minimum essential coverage' (MEC) denote?
• Which income documentation is commonly used to verify income for marketplace eligibility?
• Which statement best describes which plan levels CSR can apply to?
• Does Eun need Leda to review and attest to the accuracy of her application if Eun entered the income exactly as Leda sent it?
• How does the Marketplace verify a consumer's identity?
• How is affordability used to determine APTC?
• Can you purchase a stand-alone adult dental plan through the Marketplace if you also enroll in a qualified health plan?
• Which statement best describes Premium Tax Credit (PTC) in relation to monthly premiums?
• What are the privacy and security obligations when handling marketplace consumer information?
• Are state tax refunds included on Marketplace applications?
• What does DMI indicate in the context of Marketplace enrollment?
• If a consumer receives a Medicaid/CHIP PDM notice and takes no action, what happens to financial assistance?
• Which statement best describes Classic DE?
• Which statement best describes the relationship between MAGI, subsidies, and employer coverage?
• Which statement about Form 1095-A is correct?
• Which of the following is a factor used to determine eligibility for premium tax credits (APTC)?
• Which plan type did Jianxin and Aiping select as best fit, given they share many doctors and chose the Silver plan?
• Tips and gratuities – should these be included on Marketplace applications?
• Which scenario would make an applicant eligible to enroll in a QHP, provided all other criteria are met?
• What could have prevented Tyler's father's and sister's coverage termination when Tyler enrolled on his own plan?
• If you have access to other affordable coverage, what is likely regarding APTC?
• How do metal levels relate to costs and cost-sharing?
• Which action is appropriate when someone impersonates your agency to obtain information?
• During a loss of MEC SEP, how long do you have to help submit documents, and can the consumer access coverage during this period?
• Which term refers to the annual process of comparing the APTC that was paid to the actual credit due on Form 8962?
• For a married couple filing jointly with one daughter claimed as a dependent, is this one tax household on the Marketplace application?
• Which entity receives the APTC payment to reduce the monthly premium?
• What information does Form 1095-A provide?
• You receive a voicemail about a HealthCare.gov application from someone claiming to represent Affordable Health Care Agency for George Smith. What should you instruct your client to do?
• How many days after birth, adoption, or foster care do consumers have to select a plan through an SEP?
• If the consumer selects a plan with a premium higher than the SLCSP, how is APTC applied?