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What is a health insurance exchange? A health insurance exchange is an organized marketplace for customers to shop for health insurance based on price.

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Presentation on theme: "What is a health insurance exchange? A health insurance exchange is an organized marketplace for customers to shop for health insurance based on price."— Presentation transcript:

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2 What is a health insurance exchange? A health insurance exchange is an organized marketplace for customers to shop for health insurance based on price and quality. Like aorfor health insurance.

3 The cereal aisle Why do we need to organize this marketplace?

4 Income Eligibility for Medicaid or Exchange Subsidies People in this income bracket will receive help with premiums. People in this income bracket, enrolled in the Exchange, will receive help with premiums and out-of- pocket expenses. Family Income as % of Federal Poverty Line (FPL)

5 Who qualifies for aid? Persons in Family100% FPL*133% FPL250% FPL400% FPL 1$10,890$14,484$27,225$43,560 2$14,710$19,564$36,775$58,840 3$18,530$24,645$46,325$74,120 4$22,350$29,726$55,875$89,400 5$26,170$34,806$65,425$104,680 6$29,990$39,887$74,975$119,960 7$33,810$44,967$84,525$135,240 8$37,630$50,048$94,075$150,520 An individual earning up to $43,560 a year or a family of four earning up to $89,400 Lower earners may also be eligible for additional aid for out-of-pocket expenses. a year will be eligible for subsidies to help pay premiums. *2011 Federal Poverty Level as determined by annual income; will change when Exchange opens in late 2013

6 How the Tax Credits Work Tax credits can be used by individuals and families making between 100% and 400% of the federal poverty level (a family of 4 earning $22,350 to $89,400 a year) Eligible individuals and families who use the Exchange will pay a percentage of their income for insurance, ranging from 2% to 9.5% (contribution goes up as income goes up) Older Americans who face higher premium costs will receive higher tax credit Individuals and families who choose a less expensive plan will pay less Tax credit is paid up-front to insurers – so Americans benefit right away

7 Tax Credit Examples * 1. Family of Four with Income of $50,000, Purchases Benchmark Plan Income as a Percentage of FPL 224% Premium Cost for Benchmark Plan: $9,000 Tax Credit: $5,430 Premium Cost for Plan Family Chooses: $9,000 What Family Pays: $3, Family of Four with Income of $50,000, Purchases Less Expensive Plan Income as a Percentage of FPL 224% Premium Cost for Benchmark Plan: $9,000 Tax Credit: $5,430 Premium Cost for Plan Family Chooses: $7,500 What Family Pays: $2,070 * Source: U.S. Department of Treasury Aug announcement

8 Tax Credit Examples * 3. Family of Four with Income of $50,000, Parents are between ages 55 and 64 Income as a Percentage of FPL 224% Premium Cost for Benchmark Plan: $14,000 Tax Credit: $10,430 Premium Cost for Plan Family Chooses: $14,000 What Family Pays: $3,570 * Source: U.S. Department of Treasury Aug announcement

9 Helping Small Businesses Qualifying small businesses with up to 25 full-time employees can receive tax credits to help pay employee premiums. The tax credit will be up to 50 percent of the premium cost in 2014.

10 Exchange will provide world-class customer experience 1 Web portal to shop and compare choices 2 Call center for assistance with eligibility and subsidies 3 Navigators for face-to-face customer support

11 Wisconsin’s Exchange Website

12 Massachusetts and Utah have active Exchanges

13 SB200: The Colorado Health Benefit Exchange Act of 2011 The Colorado General Assembly passed Senate Bill 200 in May SB 200 establishes the framework for the Colorado Health Benefit Exchange. The Exchange will be governed by a Board of Directors. A legislative implementation review committee will also monitor Exchange operations.

14 2011 Exchange Milestones Colorado receives planning grant Initial workgroups formed Enabling legislation passed (SB200) Board of directors selected Operations grant proposal submitted Board determines staffing and governance policies

15 2011 Workgroups EVE Eligibility, Verification, and Enrollment How can we create a “no wrong door” approach in the exchange? DAWG Data Advisory Work Group How do we use data and economic modeling to determine who are the potential customers in the exchange? MEOW Marketing Education and Outreach Work Group How do we find and enroll our customers into the exchange? SEWG Small Employer Work Group How can we best serve small businesses in the exchange?

16 Exchange Timeline Create policies for finance, audit, and prevention of fraud Certify benefits and health plans Develop web portal and customer service functions Develop Navigator program Test all systems 2014 Launch

17 Contact Information Colorado Health Insurance Exchange Live in November:


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