Covered California Certified Enroller Practice Exam

During the 90-day period after an appeal is submitted, what assistance is Covered CA expected to provide?

1. Formal mediation only

2. Informal resolution assistance

3. Immediate approval of benefits

4. Support for dependent coverage options

The correct answer is: Informal resolution assistance

Covered California is expected to provide informal resolution assistance during the 90-day period after an appeal is submitted. This means that while the appeal is being processed, Covered California aims to help consumers in navigating the appeal process and resolving any issues informally without entering into more formal or legal mediation. This support often includes guiding the appellant through the necessary steps, answering questions about the appeal status, and helping to clarify any issues that may be involved in their case. The focus is on facilitating communication and assisting applicants to understand their options and potential next steps. This informal approach helps ensure that claimants have support and access to necessary information while waiting for a more formal decision regarding their appeal. The other options listed do not reflect the primary role of Covered California during this period. Immediate approval of benefits would not be applicable since the appeal process involves timing and cannot guarantee instant decisions. Formal mediation typically occurs after informal options are exhausted or if both parties agree to it, and support for dependent coverage options isn't specifically within the scope of what is provided during the appeal process unless directly related to the appeal itself.