Free Daily Headlines :

  • COVID-19
  • Vaccine Info
  • Money
  • Politics
  • Education
  • Health
  • Justice
  • More
    • Environment
    • Economic Development
    • Gaming
    • Investigations
    • Social Services
    • TRANSPORTATION
  • Opinion
    • CT Viewpoints
    • CT Artpoints
DONATE
Reflecting Connecticut’s Reality.
    COVID-19
    Vaccine Info
    Money
    Politics
    Education
    Health
    Justice
    More
    Environment
    Economic Development
    Gaming
    Investigations
    Social Services
    TRANSPORTATION
    Opinion
    CT Viewpoints
    CT Artpoints

LET�S GET SOCIAL

Show your love for great stories and out standing journalism

So, what’s an exchange?

  • by Arielle Levin Becker
  • December 6, 2012
  • View as "Clean Read" "Exit Clean Read"

It’s a major piece of “Obamacare,” and set to debut in just under 10 months. But unless you’ve been paying close attention, you might not be totally clear on exactly what a health insurance exchange is. Here’s a primer.

What is an exchange?

An exchange is a store for selling health insurance. Every state is supposed to have one as part of federal health reform. Connecticut’s is expected to begin selling coverage in October; the plans will take effect Jan. 1, 2014.

Connecticut Health Insurance Exchange CEO Kevin Counihan said it’s intended to be a simpler, more transparent way to buy coverage than the market that exists now.

Who will use it?

If you buy coverage for yourself, you will have the option of buying it through the exchange. So will small businesses. Anyone who gets subsidies through the federal reform law to buy coverage (more on those later) will have to buy their coverage through the exchange.

The exchange is not intended to replace Medicare or Medicaid. People who qualify for those programs will continue to receive that coverage separate from the exchange. Similarly, people who get their coverage through their jobs won’t be using the exchange. And people will still have the option of buying insurance through the state’s existing individual and small group insurance markets, outside the exchange.

What will the exchange sell?

The exchange will sell health plans offered by private insurance carriers, like Aetna, Anthem Blue Cross and Blue Shield and ConnectiCare. (Insurers can decide whether to sell plans on the exchange or not, so it’s not clear which ones will or won’t yet.) In addition, Counihan said two new nonprofits are coming to the state and could sell plans on the exchange: a new plan called Healthy CT that’s being launched with federal funds, and Harvard Pilgrim Health Care, a nonprofit Massachusetts insurer.

Each insurer will be required to offer standardized plans with four variations. Those variations, referred to as bronze, silver, gold and platinum, have to do with how much of a person’s medical costs the plan will pay for. A bronze plan, for example, will pay for 60 percent of the enrollee’s covered medical costs, while the enrollee will have to pay out-of-pocket for the other 40 percent. A silver plan will cover 70 percent, a gold plan will cover 80 percent and a platinum plan will cover 90 percent. Plans that cover more will generally have higher premiums.

Insurers will also be allowed to sell additional plans that have different types of designs. Counihan said those could include plans with limited networks, tiered networks or designs aimed at encouraging wellness.

The idea is to make sure that the insurers offer standardized plans that customers can easily compare while also letting the insurers try different methods for achieving more affordable or innovative coverage.

How will shopping at this “store” work?

The exchange will have a website that people can use to buy coverage. Customers will be able to enter information about themselves, and it will tell them what options are available, presented in a way that lets them can compare plans and select one. Counihan, who worked for the exchange set up under Massachusetts’ health reform law, said that in that state, it typically took people 15 to 20 minutes to buy insurance through that state’s exchange.

There will also be a toll-free call center for people who have questions or want to discuss the process with a person. Counihan said the representatives will be trained in the health reform law, the benefits and plans offered, and will be trained to expect to spend a long time on the phone with callers. He said they’ll be sensitive to the fact that many people calling will be getting insurance for the first time, or getting covered again after a long gap.

In addition, the exchange will have “navigators,” people who can offer help — in person, potentially — to those looking to buy coverage. The exchange will also certify insurance brokers who can sign people up for coverage.

What will it cost?

Plan costs — whether they’ll be affordable — is a major concern of many supporters and critics of health reform. It won’t be clear exactly what insurance plans in the exchange will cost until carriers have had a chance to submit their proposals and get the rates approved by the state insurance department next year. Some experts expect that prices for plans both inside and outside the exchange will be higher than what many people pay now because of new requirements in the health reform law.

But for many people, there will be limits on what they pay, regardless of what the plans cost.

For people earning below 400 percent of the poverty level, premium costs will be capped at 9 percent of their income. That means that if you have a family of four and earn $92,200, you won’t have to pay more than $692 a month for health insurance. (The federal government will pick up the rest of the cost.)

You can get an estimate of whether you qualify for premium subsidies, and how much they’d be, here.

“Even with these subsidies, this is a lot of money,” Counihan said. “But it’s clearly intended with these subsidies to make a very expensive product more affordable.”

People earning below 250 percent of the poverty level will also be eligible for federal subsidies to reduce the copayments and deductibles they have to pay.

Follow Arielle Levin Becker on Twitter.

Sign up for CT Mirror's free daily news summary.

Free to Read. Not Free to Produce.

The Connecticut Mirror is a nonprofit newsroom. 90% of our revenue comes from people like you. If you value our reporting please consider making a donation. You'll enjoy reading CT Mirror even more knowing you helped make it happen.

YES, I'LL DONATE TODAY

ABOUT THE AUTHOR

Arielle Levin Becker

SEE WHAT READERS SAID

RELATED STORIES
‘It’s a nightmare:’ A growing number of seniors are unable to book vaccine appointments as problems mount
by Dave Altimari and Jenna Carlesso

The state acknowledged Friday in an email to local health workers that some residents are waiting days for a callback.

Panel recommends small, inflationary pay hike for state officials
by Keith M. Phaneuf

Connecticut's part-time legislature hasn't received a pay hike since 2001. The annual base-pay for senators and representatives is $28,000.

Police task force seeks wider applicant pool for watchdog role
by Kelan Lyons

The task force sent four recommendations — and two that didn't get unanimous approval— to lawmakers for the 2021 session.

Miguel Cardona, who are you?
by Ann Policelli Cronin

When I ask Connecticut teachers about Miguel Cardona, those who know him or have worked with him say that he is really nice guy who knows what the challenges in our classrooms are, knows how to help teachers to improve their teaching, and respects public schools. All good. But what is his vision for teaching and learning that he will bring to the U.S. Department of Education?

Connecticut needs a strong two-party system, this Democrat says
by Edward Marcus

J.R. Romano’s recent resignation as the state’s Republican Party chair has brought into focus the need for a viable opposition party in Connecticut. It is not healthy politics when everything is totally controlled by one party:  the legislature, the governorship, and most of the major municipalities in our state.

Support Our Work

Show your love for great stories and outstanding journalism.

$
Select One
  • Monthly
  • Yearly
  • Once
Artpoint painter
CT ViewpointsCT Artpoints
Opinion Miguel Cardona, who are you?
by Ann Policelli Cronin

When I ask Connecticut teachers about Miguel Cardona, those who know him or have worked with him say that he is really nice guy who knows what the challenges in our classrooms are, knows how to help teachers to improve their teaching, and respects public schools. All good. But what is his vision for teaching and learning that he will bring to the U.S. Department of Education?

Opinion Connecticut needs a strong two-party system, this Democrat says
by Edward Marcus

J.R. Romano’s recent resignation as the state’s Republican Party chair has brought into focus the need for a viable opposition party in Connecticut. It is not healthy politics when everything is totally controlled by one party:  the legislature, the governorship, and most of the major municipalities in our state.

Opinion Connecticut’s $100 million college shell game
by Stephen Adair

The plan to consolidate the 12 community colleges in Connecticut into one college with 12 campuses is called “Students First,” which is ironic because it does not fund students first.  It funds a new administration in a new, statewide bureaucracy. The Board of Regents (BOR) and the Connecticut State Colleges and Universities (CSCU) system office […]

Opinion Inconsistent television captioning is a barrier to equal access
by Jeffrey Bravin and Barbara Cassin

Our world long ago entered the age of the 24-hour news cycle, and a full understanding of the “who, what, when, where and why” of the news is critical for deaf, deafblind and hard of hearing citizens. Yet, Connecticut’s inconsistent quality of television captioning locks our community out of the complete sense of what is happening.

Artwork Grand guidance
by Anne:Gogh

In a world of systemic oppression aimed towards those of darker skintones – representation matters. We are more than our equity elusive environments, more than numbers in a prison and much more than victims of societal dispositions. This piece depicts a melanated young man draped in a cape ascending high above multiple forms of oppression. […]

Artwork Shea
by Anthony Valentine

Shea is a story about race and social inequalities that plague America. It is a narrative that prompts the question, “Do you know what it’s like to wake up in new skin?”

Artwork The Declaration of Human Rights
by Andres Chaparro

Through my artwork I strive to create an example of ideas that reflect my desire to raise social consciousness, and cultural awareness. Jazz music is the catalyst to all my work, and plays a major influence in each piece of work.”

Artwork ‘A thing of beauty. Destroy it forever’
by Richard DiCarlo | Derby

During times like these it’s often fun to revisit something familiar and approach things with a different slant. I have been taking some Pop culture and Art masterpieces and applying the vintage 1960’s and 70’s classic figures (Fisher Price, little people) to the make an amusing pieces. Here is my homage to Fisher -Price, Yellow […]

Twitter Feed
A Twitter List by CTMirror

Engage

  • Reflections Tickets & Sponsorships
  • Events
  • Donate
  • Newsletter Sign-Up
  • Submit to Viewpoints
  • Submit to ArtPoints
  • Economic Indicator Dashboard
  • Speaking Engagements
  • Commenting Guidelines
  • Legal Notices
  • Contact Us

About

  • About CT Mirror
  • Announcements
  • Board
  • Staff
  • Sponsors and Funders
  • Donors
  • Friends of CT Mirror
  • History
  • Financial
  • Policies
  • Strategic Plan

Opportunity

  • Advertising and Sponsorship
  • Speaking Engagements
  • Use of Photography
  • Work for Us

Go Deeper

  • Steady Habits Podcast
  • Economic Indicator Dashboard
  • Five Things

The Connecticut News Project, Inc. 1049 Asylum Avenue, Hartford, CT 06105. Phone: 860-218-6380

© Copyright 2021, The Connecticut News Project. All Rights Reserved. Website by Web Publisher PRO