A Qualified Health Plan (QHP) is best defined as a health plan that:

Why D is correct

A Qualified Health Plan is a plan certified by an exchange, in California by Covered California, as meeting the standards required for sale on the exchange, including covering the essential health benefits, meeting actuarial value and cost-sharing requirements, and complying with licensure and solvency rules. QHPs are the vehicles through which premium tax credits and cost-sharing reductions are delivered. Certification is the defining feature that distinguishes a QHP from other coverage sold outside the exchange. Exchange certification is what makes a plan a QHP: the exchange verifies that the plan covers the essential health benefits, meets an actuarial value tier, complies with cost-sharing limits, and is offered by a licensed issuer in good standing. Off-exchange plans may be comparable, but certification is the legal marker of QHP status.

Why the other options are wrong

• A) QHP certification is performed by the exchange, and plans are state-licensed; no single federal approval authorizes nationwide sale. QHP certification is performed by the state exchange, not the federal government, and it does not authorize a plan to operate in every state.
• B) Catastrophic plans are a special QHP category for young adults, but most QHPs provide comprehensive coverage with cost sharing. A catastrophic-only product is a separate market category; QHPs must meet specified actuarial value and cost-sharing standards that catastrophic plans do not satisfy.
• C) QHPs are subject to state and exchange regulation; being employer-sponsored does not make a plan a QHP. Employer plans sold through the SHOP exchange can be QHPs, but QHPs are not exempt from state regulation, and certification by the exchange is the defining feature.

Memory hook

QHP = exchange-certified stamp of quality, EHB coverage and real actuarial value.