エピソード

  • [Health Insurance] 56, HIPAA Portability and Privacy Rules

    [Health Insurance] 56, HIPAA Portability and Privacy Rules
    2026/05/22
    This podcast is made by Ran Chen, who holds an EA license, Insurance and Securities licenses (Series 6, 63, 65), and the CFP® designation. He is passionate about opening access to high-quality exam preparation resources and helping learners prepare more effectively for professional certification exams. In this episode you will learn: - How HIPAA limits pre-existing condition exclusions using a 6-month look-back period and a maximum 12-month exclusion. - The role of creditable coverage in reducing or eliminating pre-existing condition exclusion periods. - What qualifying life events trigger a special enrollment period outside of open enrollment. - The key components of the HIPAA Privacy Rule and its protection of Protected Health Information (PHI). - The differences between the Privacy Rule and the Security Rule, which safeguards electronic PHI (ePHI). For more free exam prep tools, practice questions, and AI-powered explanations, visit https://open-exam-prep.com/ or YouTube Channel: https://www.youtube.com/@Open-exam-prep
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    4 分
  • [Health Insurance] 55, COBRA Qualifying Events and Election Timelines

    [Health Insurance] 55, COBRA Qualifying Events and Election Timelines
    2026/05/21
    This podcast is made by Ran Chen, who holds an EA license, Insurance and Securities licenses (Series 6, 63, 65), and the CFP® designation. He is passionate about opening access to high-quality exam preparation resources and helping learners prepare more effectively for professional certification exams. In this episode you will learn: - The employer has 30 days to notify the plan administrator of qualifying events like termination or reduction in hours. - The employee or beneficiary has 60 days to notify the plan administrator of qualifying events like divorce or a child losing dependent status. - A qualified beneficiary has a 60-day period to elect to continue their COBRA coverage after receiving the election notice. - The initial COBRA premium payment is due within 45 days of electing coverage. - Subsequent monthly premium payments have a 30-day grace period. For more free exam prep tools, practice questions, and AI-powered explanations, visit https://open-exam-prep.com/ or YouTube Channel: https://www.youtube.com/@Open-exam-prep
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    3 分
  • [Health Insurance] 54, COBRA Continuation Coverage

    [Health Insurance] 54, COBRA Continuation Coverage
    2026/05/20
    This podcast is made by Ran Chen, who holds an EA license, Insurance and Securities licenses (Series 6, 63, 65), and the CFP® designation. He is passionate about opening access to high-quality exam preparation resources and helping learners prepare more effectively for professional certification exams. In this episode you will learn: - That COBRA is a federal law applying to employers with 20 or more employees. - The difference in qualifying events for employees (termination, reduced hours) versus dependents (death, divorce, Medicare eligibility). - The standard continuation period is 18 months for termination or reduction in hours. - Dependents are eligible for a longer, 36-month continuation period for events like death of the employee or divorce. - Beneficiaries must pay up to 102% of the premium, which includes the full cost plus a 2% administrative fee. For more free exam prep tools, practice questions, and AI-powered explanations, visit https://open-exam-prep.com/ or YouTube Channel: https://www.youtube.com/@Open-exam-prep
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    3 分
  • [Health Insurance] 53, Group Health Insurance Fundamentals

    [Health Insurance] 53, Group Health Insurance Fundamentals
    2026/05/19
    This podcast is made by Ran Chen, who holds an EA license, Insurance and Securities licenses (Series 6, 63, 65), and the CFP® designation. He is passionate about opening access to high-quality exam preparation resources and helping learners prepare more effectively for professional certification exams. In this episode you will learn: - The distinction between the master contract held by the employer and the certificate of insurance provided to employees. - Common eligibility requirements for group coverage, including waiting periods for new hires. - The key differences between contributory and noncontributory plans, including their required participation percentages. - The function and importance of the annual open enrollment period for making coverage changes. - How experience rating is used for large groups to determine premiums based on their specific claims history. For more free exam prep tools, practice questions, and AI-powered explanations, visit https://open-exam-prep.com/ or YouTube Channel: https://www.youtube.com/@Open-exam-prep
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    3 分
  • [Health Insurance] 52, ACA Consumer Protections and No Surprises Act

    [Health Insurance] 52, ACA Consumer Protections and No Surprises Act
    2026/05/18
    This podcast is made by Ran Chen, who holds an EA license, Insurance and Securities licenses (Series 6, 63, 65), and the CFP® designation. He is passionate about opening access to high-quality exam preparation resources and helping learners prepare more effectively for professional certification exams. In this episode you will learn: - That the ACA's guaranteed issue and renewability rules prohibit insurers from denying coverage based on health status. - Why health plans can no longer impose lifetime or annual dollar limits on essential health benefits. - How the Medical Loss Ratio (MLR) requires insurers to spend at least 80% (individual/small group) or 85% (large group) of premiums on healthcare, or else issue rebates. - How the No Surprises Act protects consumers from unexpected bills for emergency care and from out-of-network providers at in-network facilities. - The critical exception to the No Surprises Act that is often tested: it does not apply to ground ambulance services. For more free exam prep tools, practice questions, and AI-powered explanations, visit https://open-exam-prep.com/ or YouTube Channel: https://www.youtube.com/@Open-exam-prep
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    3 分
  • [Health Insurance] 51, Marketplace and Metal Tier Plans

    [Health Insurance] 51, Marketplace and Metal Tier Plans
    2026/05/17
    This podcast is made by Ran Chen, who holds an EA license, Insurance and Securities licenses (Series 6, 63, 65), and the CFP® designation. He is passionate about opening access to high-quality exam preparation resources and helping learners prepare more effectively for professional certification exams. In this episode you will learn: - The four metal tier plans (Bronze, Silver, Gold, Platinum) and their specific actuarial values. - Eligibility requirements for Catastrophic health plans. - The 2026 update making Bronze and Catastrophic plans automatically eligible for Health Savings Accounts (HSAs). - The difference between Premium Tax Credits and Cost-Sharing Reductions, and why Silver plans are key. - A mnemonic to easily remember the metal tiers and their corresponding cost-sharing percentages. For more free exam prep tools, practice questions, and AI-powered explanations, visit https://open-exam-prep.com/ or YouTube Channel: https://www.youtube.com/@Open-exam-prep
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    3 分
  • [Health Insurance] 50, Essential Health Benefits Under the ACA

    [Health Insurance] 50, Essential Health Benefits Under the ACA
    2026/05/16
    This podcast is made by Ran Chen, who holds an EA license, Insurance and Securities licenses (Series 6, 63, 65), and the CFP® designation. He is passionate about opening access to high-quality exam preparation resources and helping learners prepare more effectively for professional certification exams. In this episode you will learn: - The ten Essential Health Benefits (EHBs) are mandatory for all new individual and small group health plans under the ACA. - EHBs do not automatically apply to large group plans, self-funded plans, or grandfathered plans. - While EHBs must be covered, cost-sharing still applies, with the major exception of certain preventive services which have no cost-sharing. - States define the specific services required within each of the ten EHB categories by selecting a state-specific "benchmark plan". - Exam questions focus on applying EHB rules, such as identifying if a denied service falls into a mandatory category or understanding the limits of the requirements. For more free exam prep tools, practice questions, and AI-powered explanations, visit https://open-exam-prep.com/ or YouTube Channel: https://www.youtube.com/@Open-exam-prep
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    3 分
  • [Health Insurance] 49, Affordable Care Act Overview and Key Provisions

    [Health Insurance] 49, Affordable Care Act Overview and Key Provisions
    2026/05/15
    This podcast is made by Ran Chen, who holds an EA license, Insurance and Securities licenses (Series 6, 63, 65), and the CFP® designation. He is passionate about opening access to high-quality exam preparation resources and helping learners prepare more effectively for professional certification exams. In this episode you will learn: - That insurers must offer coverage to all applicants regardless of health status under the guaranteed issue provision. - That premiums can only be rated based on age, location, family size, and tobacco use, not health history. - That dependents can remain on a parent's plan until age 26, irrespective of marital, student, or financial status. - Key 2026 updates, including the expiration of enhanced premium tax credits on Dec 31, 2025, and the new 9.96% employer affordability threshold. - That all compliant plans must cover ten Essential Health Benefits, such as hospitalization and prescription drugs. For more free exam prep tools, practice questions, and AI-powered explanations, visit https://open-exam-prep.com/ or YouTube Channel: https://www.youtube.com/@Open-exam-prep
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    3 分