Which statement correctly defines a qualified health plan (QHP)?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
A qualified health plan (QHP) is a health plan that is certified by an exchange (in California, Covered California) as meeting the ACA's standards for coverage. A QHP must cover the essential health benefits, comply with cost-sharing and actuarial-value limits, and be offered through the marketplace. Certification is what makes the plan 'qualified' and eligible to receive premium tax credits on behalf of enrollees. QHPs may be offered at the Bronze, Silver, Gold, or Platinum metal levels. A QHP must also comply with the exchange's network adequacy, marketing, and transparency requirements, and only enrollees in a QHP may receive premium tax credits and cost-sharing reductions.
Why the other options are wrong
- B) Merely being employer-sponsored does not make a plan a QHP; the plan must meet the exchange certification standards.
- C) A plan covering only catastrophic expenses is a separate, limited category of coverage; it does not define a QHP.
- D) QHPs are private insurance products offered through the exchange, not government-administered Medicare plans.
Memory hook
QHP = the exchange's stamp of approval. Certified, comprehensive, and marketplace-offered.