What You Need to Know About the Government Health Insurance Marketplace

Open enrollment has begun.
You probably already knew that. We’re continuing to develop resources that will help make sense of all of the changes and how they’ll impact you. For now, with all the buzz, we wanted to briefly tell you what you need to know about the health insurance “marketplace” (also called “exchange”) and what it means for you. Here are 6 things you need to know now:

1. There’s no reason to hurry in open enrollment.

First, let’s be clear that there’s no rush here. Given the technical glitches in the new system, it’s not a bad idea to wait a little while to enter the fray. If you enrolled in a new plan today, that plan would become effective on January 1. The final day to enroll for a January 1 effective date is December 15. You will still have an opportunity to enroll for a couple more months after that if you’d like to wait.

2. What is the health insurance marketplace?

The health insurance marketplace is designed to provide consumers with the opportunity to view available health insurance plan and compare plan details and prices from multiple companies. To be really honest, it’s basically the same thing we’ve had available for our clients for years. What’s new has more to do with the rules that govern plan design and the availability of “premium tax credits” (subsidies) to help lower your cost.

3. What’s the difference between the government (public) marketplace and private marketplaces?

Private marketplaces (or “exchanges”) will offer many of the same plans but will also include additional plans and companies that have opted not to participate in the government-run marketplace. So there will be more options. If you want to utilize a premium tax credit (subsidy), however, you will have to purchase a plan on the government marketplace in order to verify eligibility.

4. When do I have to get a plan?

As you know, the Affordable Care Act mandates that everyone have a qualified plan or pay a fine. If you don’t have a plan or will be dropping the plan you have, you’ll need to enroll in a new one during Open Enrollment. If you have a non-grandfathered plan (bought after March 23, 2010), you’ll have a chance to enroll when your current plan renews/expires. If you have a grandfathered plan you’ll be fine to keep it.

5. What about prices?

There’s no question that prices are going to be higher. (Here’s why). If you make between 100-400% of the federal poverty limit, you will be eligible for a premium tax credit that can lower your payment. Get more on premium tax credits here. We are suggesting that many of our clients consider options to renew their current plans prior to December 1, or new clients to purchase coverage by then, in order to lock in 2013 prices for a while longer. You will then be in a stronger position to consider your options. (We can help with that – just contact us if you’re interested).
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6. Can AC Forrest help with any of this?

We’re glad you asked! Yes. AC Forrest is certified to assist consumers on the government’s health insurance marketplace and will additionally have access to several private marketplaces. As always, your prices are no different when you opt to work with us – they are fixed whether you have help or do this on your own. We hope you’ll trust us to continue to serve you as you make the transition into the new health insurance system. We also hope you’ll refer us to your friends and coworkers too!
We’re committed to helping you navigate the new system. If you have other questions or concerns we’d love to hear from you. You can call us or simply reply to this email.
Stay tuned!