1. I don't know.
2. If the engine has always had synthetic oil, probably not. If no or unknown, it may be time. The classical symptom of a stretched timing chain is hard starting, but normal running; but that's with carburetors and distributors. With EFI and computers adjusting the timing dynamically, the engine computer may compensate until it just flat can't.
3. The usual biggest hassle is removing and replacing the harmonic balancer and/or the hub behind it, which are usually a press fit on the crank nose. With the right special tools, it only adds an hour or two to a water pump job.