It's long been said that what you don't know won't hurt you.

Whoever said that clearly had no knowledge of the Patient Protection and Affordable Care Act. Since its enactment in March 2010, PPACA and its impact on health plans, wellness programs,long-term care and even adoption benefits can definitely harm benefits pros who aren't on top of its provisions.

To help professionals get a better grasp on the law ' and to have a little fun ' EBA has created the PPACA Challenge: a 30-question quiz designed to test practitioners' health care reform knowledge. Feeling confident about how much you know?

Go ahead, get started! No cheating, but if you need some hints, you'll fi nd plenty on EBA's health care reform timeline at Click Health Reform >PPACA Timeline in the lefthand navigation bar for clues.

Test your knowledge of the Patient Protection and Affordable Care Act. Are you a PPACA prodigy? Or, do you need health care reform remediation? Take EBA's PPACA Challenge to find out.

1. The 'Cadillac Plan Test' required under the Patient Protection and Affordable Care Act takes effect in:

A. 2012

B. 2014

C. 2016

D. 2018

2. True or false: The PPACA's rules regarding wellness programs do not apply to grandfathered plans?

A. True

B. False

3. Fully insured plans must include a 'essential health benefits package.' Which of these is not an 'essential health benefit' under the law?

A. Emergency services

B. Maternity and newborn care

C. Chiropractic services

D. Rehab services

4. The PPACA increased non-taxable adoption assistance to $13,170. This provision expires when?

A. 2011

B. 2012

C. 2013

D. 2014

5. Under the PPACA, employers must provide reasonable break time to allow nursing mothers to express milk for a child up to the age of one. True or false: This break time is unpaid.

A. True

B. False

6. Health plans begun on or after Sept. 23, 2010 must have an internal and external claims appeal process, unless grandfathered. An employer's internal appeals process must follow which body's appeals process?

A. The Department of Health and Human Services

B. The Department of Labor

C. The Federal Trade Commission

D. State law process

7. Health plans that offer dependent coverage are required to cover dependents up to what age?

A. 23

B. 25

C. 26

D. 28

8. Which of the following statements is not true?

A. Lifetime limits are allowed on nonessential benefits

B. Lifetime limits on benefits are not allowed under the PPACA

C. Some lower lifetime limits may violate the ADA

D. State laws may prohibit certain lifetime benefits

9. Under the PPACA, a non-grandfathered group plan may:

A. Require a referral for OB-GYN care

B. Allow a pediatrician to be a designated primary care provider

C. Require higher cost-sharing amounts for out-of-network emergency care

D. All of the above

10. Starting with plans beginning Jan. 1, 2014, no one can be excluded for a pre-existing condition. Until then, though, when may a health plan exclude a dependent with a pre-existing condition?

A. At any time

B. When the dependent is older than age 26

C. When the dependent is older than age 19

D. When the dependent has been refused coverage in the past

11. True or false: The law's requirements on preventive care do not apply to grandfathered plans.

A. True

B. False

12. Who is eligible for the PPACA's small employer tax credit?

A. Employers with fewer than 10 full-time equivalent employees

B. Employers with fewer than 25 full-time equivalent employees

C. Employers with fewer than 50 full-time equivalent employees

D. Employers with fewer than 100 full-time equivalent employees

13. Who is required to automatically enroll all new employees in a health plan?

A. All employers

B. Employers with more than 100 full-time employees

C. Employers with more than 200 full-time employees

D. Employers with more than 1,000 full-time employees

14. When must an employer provide an 'opt-out notice' to employees?

A. When the employee declines health care benefits during open enrollment

B. When the employee changes from one plan to another

C. When dependents are no longer eligible for coverage

D. When the company automatically enrolls employees in its health plan

15. An employer may establish a cafeteria plan under the PPACA if

A. The company currently employs 200 or fewer employees

B. The company employed 200 or fewer employees in the preceding year

C. The company employed 200 or fewer employees for either of the two preceding years

D. The company employed 200 or fewer employees on average over the past five years

16. The Class Act provision of the PPACA deals with

A. Network vs. non-network coverage

B. Best-in-class provider identification

C. Long-term care insurance

D. State exchanges

17. Which provision of the PPACA does not take effect this year (2011)?

A. The Uniform Explanation of Coverage provision

B. Class Act provision

C. The W-2 Reporting provision

D. The Qualified Medical Expenses provision

18. Who is eligible to receive federal grant money for a workplace wellness program?

A. Any employer

B. Companies with fewer than 500 employees

C. Companies that had no workplace wellness program prior to enactment of the PPACA

D. Companies that can document prior success with workplace wellness initiatives

19. The majority of future changes required by the PPACA will take place in

A. 2012

B. 2013

C. 2014

D. 2018

20. Beginning Jan. 1, 2013, annual employee contributions to FSAs will be

A. Capped at $2,000

B. Capped at $2,500

C. Capped at $3,500

D. Tied to the Consumer Price Index

21. The requirement that there be no annual limits in health plans except for per beneficiary annual limits on specific covered, non-essential benefits take effect in

A. 2011

B. 2012

C. 2013

D. 20104

22. True or false: For plans beginning Jan. 1, 2014, the PPACA requires that limits on the annual out-of-pocket maximum imposed by group health plans be the same as those imposed on HSA-compatible HDHPs.

A. True

B. False

23. Employers with plans beginning Jan. 1, 2014 must offer affordable coverage to employees working how many hours per week?

A. 25

B. 30

C. 35

D. 40

24. True or false: The PPACA states that insurers must accept every employer that applies for coverage in the state where the insurer writes policies for health coverage. However, an insurer is not required to continue such coverage if the plan becomes unaffordable.

A. True

B. False

25. Effective for plans starting Jan. 1, 2014, waiting periods for coverage may be no longer than

A. 30 days

B. 60 days

C. 90 days

D. 120 days

26. True or false: Under the current law, large employers will not be allowed to offer insurance through state health exchanges.

A. True

B. False

27. True or false: States will be free to limit which employers are allowed to purchase insurance though state health insurance exchanges.

A. True

B. False

28. Which of the following would not cause a non-collectively bargained health plan to lose grandfathered status under the PPACA?

A. Change in insurance carriers

B. Change in the scope of benefits

C. Increase in cost-sharing

D. Change in third-party administrator

29. The PPACA's Claims Review Rules do not apply to:

A. Health plans that are grandfathered plans

B. Plans with less than two current employees participating in the plan on the first day of the plan year (e.g., stand-alone retiree-only plans)

C. Non-health plans, such as disability and retirement plans

D. All of the above

30. The PPACA will require an excise tax on so-called 'Cadillac Plans.' Who is responsible for calculating this tax?

A. Employers

B. Insurers

C. Brokers

D. Third-party administrators


1) D 2) A 3) C 4) A 5) A 6) B 7) C 8) B 9) B 10) C 11) A 12) A 13) C 14) D 15) C 16) C 17) A 18) C 19) C 20) B 21) D 22) A 23) B 24) B 25) C 26) B 27) A 28) D 29) D 30) A

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