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Answers 2025
Starting in January 2014, can you be denied health insurance for a pre- existing condition? - CORRECT ANSWERS ✔✔No What is a pre-existing condition? - CORRECT ANSWERS ✔✔It is something that was wrong with you before you tried to get insurance. If you do not get insurance in 2014, will you have to pay a penalty? - CORRECT ANSWERS ✔✔Yes If you did not have insurance in 2013, did you have to pay a penalty? - CORRECT ANSWERS ✔✔No What are Certified Enrollment Assistance Personnel? - CORRECT ANSWERS ✔✔CEAPs are Agents and Counselors who can help you find out what covereage you can get. Does your income level change the kind of insurance you may get? - CORRECT ANSWERS ✔✔Yes Can people with lower incomes qualify for Medi-Cal? - CORRECT ANSWERS ✔✔Yes
Answers 2025
Will some people qualify for coverage at lower rates because they have a low income? - CORRECT ANSWERS ✔✔Yes What are the names for the different levels (metallic tiers) of coverage?
- CORRECT ANSWERS ✔✔Bronze, Silver, Gold, Platinum What are tiers? - CORRECT ANSWERS ✔✔They are like levels or grades. Like grade 1, grade 2, grade 3. Or like a bronze medal, silver medal, gold medal. What is a premium? - CORRECT ANSWERS ✔✔It is the amount of money you have to pay for your insurance? It is like the amount of your bill. If your premium is higher, will you pay more for your insurance? - CORRECT ANSWERS ✔✔Yes. Because your premium was higher, your insurance bill will be higher. If your premium is higher, will you pay more for office visits? - CORRECT ANSWERS ✔✔No. Because your premium was higher, your office visits will cost less.
Answers 2025
What percentage of your medical bill will be covered by the insurance company if you have a Platinum plan? - CORRECT ANSWERS ✔✔90% on average. You will pay 10% on average. If I already have insurance at my job, can I try to get insurance with Covered California for cheaper? - CORRECT ANSWERS ✔✔Yes. If your insurance costs 10% of your income, is it affordable? - CORRECT ANSWERS ✔✔No, your insurance should be 8% or less than your income to be affordable. If your insurance costs 6% of your income, is it affordable? - CORRECT ANSWERS ✔✔Yes because if your your insurance is 8% or higher that your income it is affordable. When was the Affordable Care Act signed into law? - CORRECT ANSWERS ✔✔March 2010 Is the "Affordable Care Act" the same as "The Patient Protection and Affordable Care Act"? - CORRECT ANSWERS ✔✔Yes
Answers 2025
In what year will most of the Affordable Care Act take full effect? - CORRECT ANSWERS ✔✔ 2014 Can health plans put a dollar limit on their plans? - CORRECT ANSWERS ✔✔No Can health plans put a lifetime dollar limit on their plans? - CORRECT ANSWERS ✔✔No Can health plans put an annual limit on their plans? - CORRECT ANSWERS ✔✔No Is a Basic Coverage Plan the same as a Catastrophic Plan? - CORRECT ANSWERS ✔✔Yes Are some people not required to have insurance? - CORRECT ANSWERS ✔✔Yes If your religion does not believe in health care, are you required to have health insurance? - CORRECT ANSWERS ✔✔No
Answers 2025
Who can use Covered California? - CORRECT ANSWERS ✔✔Anyone from California ages 18 to 64. If you are in jail, can you have insurance from Covered California? - CORRECT ANSWERS ✔✔No Will Latinos be the largest group of people eligible for premium assistance? - CORRECT ANSWERS ✔✔Yes, 46% Is California a multi-lingual state? (A place where people speak different languages?) - CORRECT ANSWERS ✔✔Yes What are the 13 most common languages spoken in California? - CORRECT ANSWERS ✔✔English Spanish Vietnamese Chinese Korean Tagalog Russian
Answers 2025
Farsi Armenian Khmer (Cambodian) Laotian Arabic Hmong What are the top two uninsured populations? - CORRECT ANSWERS ✔✔Latino, White What does SHOP mean? - CORRECT ANSWERS ✔✔Small Business Health Options Program What else is the Small Business Health Options Program called? - CORRECT ANSWERS ✔✔SHOP Who can use California's SHOP market? - CORRECT ANSWERS ✔✔1. 1- 50 employees
- Offer Covered California to all employees
- Have most of their employees live in California
Answers 2025
If a news reporter asks you questions about Covered California, can you talk to them? - CORRECT ANSWERS ✔✔No What are the 8 steps to be a successful CEC? - CORRECT ANSWERS ✔✔1. Follow up with people
- Find uninsured people who need coverage
- Set a time for an appointment for people
- Walk through the enrollment process with people
- Be sensitive and be confidential
- Provide information and comply with the ADA (American's with Disabilities Act)
- Comply with State and Federal regulations
- Help people with annual renewals What is Minimum Essential Coverage (MEC)? - CORRECT ANSWERS ✔✔It is affordable. Your job pays for at least 60% of the cost. Are people required to tell Covered California if big things change in their life? - CORRECT ANSWERS ✔✔Yes If they have a baby
Answers 2025
If someone moves away If someone goes to jail If you make more money at your job etc. What is an HMO? - CORRECT ANSWERS ✔✔Health Maintenance Organization What is a Health Maintenance Organization (HMO)? - CORRECT ANSWERS ✔✔An HMO is like Kaiser. Members see a primary care provider. You have to see the primary care provider before you can see a specialist. What is an PPO? - CORRECT ANSWERS ✔✔Preferred Provider Organization What is a Preferred Provider Organization (PPO)? - CORRECT ANSWERS ✔✔A PPO is like Blue Cross. You go to the doctor you want. You do not need a referral. You can see a doctor outside your network (but at a higher cost).
Answers 2025
What is Evidence of Coverage (EOC)? - CORRECT ANSWERS ✔✔It is a legal document that shows that you have health coverage. What is EOB? - CORRECT ANSWERS ✔✔Explanation of Benefits What is Explanation of Benefits (EOB)? - CORRECT ANSWERS ✔✔It explains how your insurance paid the doctor. It is NOT a bill. Is an Explanation of Benefits (EOB) a bill? - CORRECT ANSWERS ✔✔No Where do you go to get a replacement ID card for your insurance? - CORRECT ANSWERS ✔✔Contact your health insurance company Will people who stay on their Medi-Cal plan have to do annual redetermination? - CORRECT ANSWERS ✔✔No What is annual redetermination? - CORRECT ANSWERS ✔✔It is when Covered California checks to make sure you are still eligible for coverage.
Answers 2025
If you do not pay your health care premium (bill), will your coverage be terminated (cancelled)? - CORRECT ANSWERS ✔✔Yes What is compliance? - CORRECT ANSWERS ✔✔1. Maintain privacy and security
- Avoid conflicts of interest
- Help prevent fraud, waste, and abuse What are the 5 parts of the Code of Conduct? - CORRECT ANSWERS ✔✔1. Protect confidentiality
- Take personal responsibility
- Make ethical decisions
- Follow the law
- Be polite, respectful, honest and fair What is a Conflict of Interest? - CORRECT ANSWERS ✔✔It is a situation, not an action. You do not have to do something bad to have a Conflict of Interest. Is a Conflict of Interest unlawful if the person does not do anything about it? - CORRECT ANSWERS ✔✔Yes
Answers 2025
What is Personally Identifiable Information (PII)? - CORRECT ANSWERS ✔✔Things like Full name, Birthplace, email address, credit card numbers, etc. What is FTI? - CORRECT ANSWERS ✔✔Federal Tax Information Is a Drivers License Personally Identifiable Information (PII)? - CORRECT ANSWERS ✔✔Yes Is a Social Security Number Personally Identifiable Information (PII)? - CORRECT ANSWERS ✔✔Yes What is "Minimum Necessary" Use and Disclosure? - CORRECT ANSWERS ✔✔You are responsible for only sharing the minimum amount of information needed to get something done. What is PHI? - CORRECT ANSWERS ✔✔Personal Health Information What is Personal Health Information (PHI)? - CORRECT ANSWERS ✔✔Any information about a persons health history, their treatment history, health documents, etc.
Answers 2025
Do Covered Entities have to follow the Privacy and Security rules? - CORRECT ANSWERS ✔✔Yes What is HIPPA? - CORRECT ANSWERS ✔✔Health Insurance Portability and Accountability Act What is the Health Insurance Portability and Accountability Act (HIPPA)?
- CORRECT ANSWERS ✔✔They are the Privacy Rule and the Security Rule that protect Personally Identifiable Information (PII).
