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Navigator 133 Exam Questions with 100% Correct Answers | Verified | Updated 2024

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Define Maryland Health Connection - ️️The new marketplace in the state to compare health insurance options and enroll in health coverage. Name the important elements of the Maryland Health Connection - ️️1. New Marketplace to shop and compare health insurance. 2. No Wrong Door 3. Only ...

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  • February 9, 2024
  • 22
  • 2023/2024
  • Exam (elaborations)
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Navigator Exam
Define Maryland Health Connection - ✔ ✔ The new marketplace in the state to compare health
insurance options and enroll in health coverage.



Name the important elements of the Maryland Health Connection - ✔ ✔ 1. New Marketplace to
shop and compare health insurance.

2. No Wrong Door

3. Only place to qualify for Advance Premium Tax Credits and Cost Sharing Reductions

4. Private and Government plans



What are the four ways consumers can apply for health care coverage? - ✔ ✔ 1. Online at
www.marylandhealthconnection.gov

2. In person

3. On the phone

4. By mail



What are the 6 types of consumer assistance workers - ✔ ✔ Navigators

Assisters

Caseworkers

Consolidated Services Center Representatives

Producers

Application Counselors



True or False

If Sally enrolls in Qualified Health Plan and her payment is posted by the 18th of February, Sally can
submit her health bills for services she received for the entire month of February. - ✔ ✔ False

,There are no retroactive enrollment dates for private health insurance



What is the date that a payment must be POSTED for coverage to be effective on the 1st day of the
following month? - ✔ ✔ 18th



When will individuals eligible for Medicaid have coverage effective? - ✔ ✔ On the first day of the
month in which they enroll



What does the acronym FPL stand for? - ✔ ✔ Federal Poverty Level



Define "Affordable" health insurance - ✔ ✔ Health Insurance with premium costs less than a certain
percentage of an individual's income. The percentage is based on the Federal Poverty Level

Up to 133% FPL = 2.00%

134 - 150% = 4.00%

151 - 200% = 6.30%

201 - 250% = 8.05%

251 - 400% = 9.5%



Some people may be exempt from having health insurance. Name the 6 exemptions. - ✔ ✔ 1.
Financial hardship

2. Religious objections

3. Members of a federally recognized Indian tribe

4. Those without coverage for less than three months

5. Incarcerated individuals

6. Consumers with incomes below the tax filing threshold

, Consumers without health insurance coverage will be required to pay a tax penalty. Tax penalties will be
phased in how? - ✔ ✔ 2014 - $95 per adult or 1% of income (whichever is higher)

2015 - $325 or 2% of income (whichever is higher)

2016 - $695 or 2.5% of income (whichever is higher)



What does the acronym SBC stand for - ✔ ✔ Summary of Benefits and Coverage



Insurance companies and group health plans must provide consumers with two things. What are they? -
✔ ✔ Summary of Benefits and Coverage

Uniform Glossary of Terms



True or False

Lifetime and yearly dollar limits on coverage of essential health benefits are no longer permitted. - ✔
✔ True



What does the acronym MAGI stand for? - ✔ ✔ Modified Adjusted Gross Income



What does the acronym QHP stand for? - ✔ ✔ Qualified Health Plan



Define Qualified Health Plan (QHP) - ✔ ✔ A private health benefit plan that has been certified by
Maryland Health Connection to meet requirements for certification under the ACA and Maryland law.



Qualified Health Plans offered on the Maryland Health Connection must meet requirements for what
four areas? - ✔ ✔ Metal Level and Actuarial Values

Essential Health Benefits

Network Design

Cost Sharing Limits

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