CLAHS California Life, Accident and Health or Sickness Examination - Set 3 - Part 2

Test your knowledge of technical writing concepts with these practice questions. Each question includes detailed explanations to help you understand the correct answers.

Question 21: Cal-COBRA provides group continuation rights primarily to employees of California employers of what size, which fall below the federal COBRA threshold?

Fifty to one hundred employees

Two hundred or more employees

Two to nineteen eligible employees

Exactly one thousand employees

Question 22: Under the Family and Medical Leave Act, an eligible employee of a covered employer may take up to twelve weeks of leave, during which the employer must do which of the following?

Maintain the employee's group health coverage

Pay the employee full wages

Terminate the group coverage

Convert the plan to an individual policy

Question 23: The Mental Health Parity and Addiction Equity Act requires that, when a group plan offers mental health and substance use benefits, those benefits be treated in what way?

With higher deductibles than medical care

With a separate annual visit cap

As fully optional and uncovered

No more restrictive than medical limits

Question 24: Which of the following is a primary function of the Health Insurance Portability and Accountability Act?

Setting insurer premium rates

Protecting the privacy of health information

Requiring twelve weeks of leave

Calculating marketplace subsidies

Question 25: When the children of married parents are covered under two group plans, the birthday rule designates which parent's plan as primary?

The plan of the older parent

The plan of the higher earner

The parent with the earliest birthday

The plan with the lower deductible

Question 26: Under the Affordable Care Act, how may a health plan treat an applicant's pre-existing medical condition?

It may not exclude the condition

It may exclude the condition permanently

It may deny the application outright

It may charge double premiums for it

Question 27: Under the Affordable Care Act, guaranteed issue requires a health insurer to do which of the following?

Offer coverage only to healthy applicants

Reject applicants with chronic conditions

Sell coverage at any time of year

Accept eligible applicants regardless of health

Question 28: Under the Affordable Care Act, a cost-sharing reduction subsidy lowers which of the following for an eligible enrollee?

The monthly premium

The federal income tax rate

Out-of-pocket costs like deductibles and copays

The provider's contracted fees

Question 29: Under the Affordable Care Act, a cost-sharing reduction is available only to an eligible enrollee who selects a plan in which metal tier?

Bronze

Silver

Gold

Platinum

Question 30: Under the Affordable Care Act, the advance premium tax credit is a subsidy designed to lower which of the following for an eligible household?

The hospital's charges

The annual deductible only

The prescription copay only

The monthly premium

Question 31: How is the advance premium tax credit typically delivered for a marketplace enrollee?

Paid in advance directly to the insurer

As a year-end refund check

Deposited into a health savings account

Paid to the enrollee's employer

Question 32: To receive a premium tax credit or cost-sharing reduction, where must a California consumer purchase a qualified health plan?

Directly from any insurer off-exchange

From an out-of-state marketplace

Through Covered California, the Exchange

Through any licensed bank

Question 33: When a consumer applies through Covered California, which entity verifies income and calculates the amount of any premium subsidy?

The consumer's employer

The insurance producer alone

The county tax assessor

Covered California, the Exchange

Question 34: The annual window during which any eligible person may enroll in or change a marketplace plan without needing a qualifying event is known as which of the following?

The grace period

The open enrollment period

The elimination period

The probationary period

Question 35: Outside of open enrollment, a person may enroll in or change marketplace coverage during a special enrollment period only after experiencing which of the following?

A qualifying life event

A premium rate increase

A change of mind about coverage

A provider leaving the network

Question 36: Which of the following events would NOT open a special enrollment period for marketplace coverage?

Marriage of the applicant

Birth of a child

Voluntarily dropping prior coverage

Involuntary loss of job-based coverage

Question 37: A health plan that is certified by and sold on the Exchange, covers the essential health benefits, and is the only plan that can carry subsidies is known as which of the following?

A grandfathered plan

An excepted-benefit plan

A self-funded plan

A qualified health plan

Question 38: Under the Affordable Care Act, the set of service categories that every individual and small-group plan must cover is known as which of the following?

Essential health benefits

Supplemental benefits

Excepted benefits

Discretionary benefits

Question 39: Which of the following is NOT one of the essential health benefits that an individual or small-group plan must cover?

Emergency services

Prescription drugs

Routine adult dental care

Maternity and newborn care

Question 40: Under the Affordable Care Act, pediatric services that must be covered as an essential health benefit include which of the following?

Adult cosmetic surgery

Oral and vision care

Long-term care

Routine adult dental

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