A Qualified Health Plan (QHP) is best defined as a health plan that:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Under the ACA, a Qualified Health Plan is a health insurance plan that is certified by an exchange (in California, Covered California) and provides the essential health benefits. A QHP must also meet standards for marketing, network adequacy, and quality reporting. Plans certified as QHPs are the products eligible to be sold on the exchange and the plans for which premium tax credits are available. This is the definitional core of the exchange marketplace. Only QHPs may be sold through Covered California, and only enrollees in QHPs are eligible for premium tax credits and cost-sharing reductions. The certification process reviews benefits, cost-sharing, network adequacy, and rate reasonableness before a plan reaches consumers.
Why the other options are wrong
- B) QHPs are exchange-certified products for individuals and small groups, not employer-only plans for large employers.
- C) QHP enrollees pay premiums, though eligible individuals may receive premium tax credits to reduce the cost.
- D) QHPs cover comprehensive essential health benefits, not just catastrophic events; catastrophic coverage is a separate limited category.
Memory hook
QHP = the exchange's certified seal of approval; no certification, no marketplace shelf.