<s>[INST] In the United States, under the Affordable Care Act, the health insurance marketplaces (also known as exchanges) are required to offer a material modification notice to consumers when:

A) Insurer changes name
B) Insurance plan's premium increases by 5%
C) Insurer changes address
D) Insurance plan's benefits change significantly

The correct answer is D, as material modification notice is required when there is a significant change to the insurance plan's benefits. Options A and C are incorrect because a change in name or address is typically not significant. Option B is incorrect as premium increase is typically not considered a material modification but it could be a rate filing subject to review.

This is an example of a question that requires Consequence Evaluation reasoning skill. The question requires the test-taker to consider the context of the Affordable Care Act, the purpose of material modification notice, and the potential impact on consumers. The correct answer, D, demonstrates an understanding of when a material modification notice is required, and the potential consequences of not providing such notice.

Here is another example of a question that requires Consequence Evaluation reasoning skill:

What is the likely consequence of a health insurance plan not providing adequate network access to primary care physicians?[/INST]