Covered California Certified Enroller Practice Exam

What responsibility do Certified Enrollment Counselors (CECs) have regarding consumer complaints?

1. They must resolve all complaints personally

2. They can ignore complaints unless they are severe

3. They refer consumers to applicable state agencies

4. They escalate all issues to the CEO

The correct answer is: They refer consumers to applicable state agencies

Certified Enrollment Counselors (CECs) play a crucial role in assisting consumers with their healthcare coverage options through Covered California. When it comes to consumer complaints, CECs are responsible for referring consumers to the applicable state agencies. This is essential as it ensures that complaints are handled by the appropriate authorities who have the resources and jurisdiction to address the issues effectively. Referring complaints helps maintain a systematic approach to consumer concerns and allows consumers to receive expert assistance specific to their issues. This practice ensures that complaints are not overlooked and instead directed to where they can be properly processed and resolved, which upholds the integrity of the enrollment process and consumer rights. Other responsibilities for complaints may involve providing necessary information or guidance, but the primary expectation is to facilitate the appropriate connections to state agencies equipped to handle such situations. This helps streamline the complaint handling process and ensures consumer satisfaction within the healthcare system.