Wednesday, June 15, 2022

Does Illinois Have Its Own Health Insurance Exchange

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Florida Health Insurance Exchange Enrollment

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The experience with the regional call center for Florida was good. Because the state doesnt have its own marketplace, health insurance enrollment is hosted by the federal exchange. The representative we spoke with was knowledgeable, helpful, and patient. Our questions on health insurance features and neighborhood assistors and navigators were answered satisfactorily. Representatives suggest allotting one hour to the online enrollment process to account for the website’s delays and slow download times.

Federal Health Insurance Exchange: 318-2596

Healthcaregov Plus 18 State

States had the option of creating their own exchanges or relying on the federal government to create an exchange for them. Some states have hybrid exchanges that are either a partnership between the state and federal government or a state-run exchange that uses the federal enrollment platform . As of 2021, there are 15 fully state-run exchanges, six state-run exchanges that use HealthCare.gov for enrollment, six state-federal partnership exchanges, and 24 federally-run exchanges.

The largest health insurance exchange, HealthCare.gov, is run by the federal government, serving health insurance shoppers in 36 states in 2021 . The other 14 states and the District of Columbia each run their own exchanges .

Three of the states that use HealthCare.gov in 2021Maine, Kentucky, and New Mexicoare transitioning to fully state-run exchanges in the fall of 2021, and will no longer use HealthCare.gov for coverage effective in 2022 and beyond. So as of the 2022 plan year, DC and 17 states will have their own exchange platforms, while the other 33 states will continue to use HealthCare.gov.

Some other states are considering a similar transition within the next few years, so the number of states relying on the federally-run exchange platform is expected to decline over time.

Enrollment Is Now Open Through Jan 15 2022

Looking for health care plans on the Marketplace? UnitedHealthcare Individual and Family Marketplace plans offer affordable, reliable coverage options for you and your family. As part of the American Rescue Plan Act , many individuals and families are now eligible for lower or in some cases $0 monthly premiums for Marketplace health coverage.

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Number Of Insurers On Exchange

In July 2017, the Centers for Medicare and Medicaid Services issued a press release stating that fewer health insurers had applied to offer plans on the health insurance exchanges for 2018, 141 compared to 227 applying to offer plans for 2017. The press release followed announcements from Humana and Aetna that they would not offer any health plans on any state exchange in 2018. In addition, in 2016, UnitedHealthcare had announced that it would exit all but three exchanges in 2017. The insurers said their decisions to exit the markets were based on financial losses and regulatory uncertainty regarding the cost-sharing reduction reimbursements.

Nationwide, an average of 4.3 insurers per state offered plans on the exchanges, compared to five insurers in 2014 and six in 2015. In Illinois, five insurers offered plans on the state’s health insurance exchange in 2017, compared to seven insurers in 2016, eight in 2015, and five in 2014. The table below displays the number of health insurers that offered plans on each state’s exchange for each year between 2014 and 2017. This information is provided for Illinois and three of its neighboring states.

Number of health insurers offering plans on the ACA exchanges
State
: Kaiser Family Foundation, “Number of Issuers Participating in the Individual Health Insurance Marketplaces”

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ObamaCare is using a provision in the bill that allows them to charge insurers a 3.5% fee to sell insurance on the Federal Run Health Insurance Exchange.

This is a response to the GOP standing lockstep against setting up state-run exchanges this, along with opting-out of Medicaid expansion, is part of a plan to break ObamaCare .

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How Has Management Of The Marketplaces Changed Over Time

The exchanges/marketplaces debuted in the fall of 2013, providing coverage for the 2014 plan year. Since then, several states have made changes to their marketplace management. Some have opted to move away from HealthCare.gov and operate their own exchange, while others have taken the opposite course, abandoning a state-run enrollment platform in favor of using HealthCare.gov.

For the 2015 plan year:

  • Idaho used HealthCare.gov for enrollment in 2014, but switched to being a fully state-run exchange prior to the 2015 open enrollment period.
  • Nevada and Oregon both had state-run exchanges in 2014, but due to technical difficulties, they both opted to become federally-supported state-based exchanges prior to the 2015 open enrollment period .

For the 2016 plan year:

  • Hawaii opted to transition to an SBM-FP, abandoning its state-run enrollment platform .

For the 2017 plan year:

  • Arkansas switched from having a state-federal partnership exchange to an SBM-FP .
  • Hawaii switched from an SBM-FP to the federally-run exchange .
  • Kentucky switched from a state-based exchange to an SBM-FP .

For the 2020 plan year:

Exchange management stayed unchanged for a few years. But several changes took effect in the fall of 2019, for the 2020 plan year:

For the 2021 plan year:

The following changes occurred in the fall of 2020:

For the 2022 plan year:

Anticipated changes for future years:

Virginia plans to have a fully state-run exchange by the 2024 plan year.

Illinois Health Insurance Marketplace

The Marketplace is an alternate way to find health coverage that allows you to research a range of provider options, plan designs, and costs to find coverage that best meets your needs. With one application, you can see all your options and enroll. The Health Insurance Marketplace is also known as the Health Insurance Exchange.

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Illinois Health Insurance Exchange

Illinois operates a partnership exchange with the federal government the state runs Get Covered Illinois, as well as a website, in-person assistance, and a help desk, and the federal government provides the IT platform Healthcare.gov that Illinois people use to enroll in coverage or make changes to their plan.Starting in August 2015, the Illinois Department of Insurance started administering Get Covered Illinois, and 15 staff positions were removed in the move to streamline program processes, improve efficiency, and align services resulting in increased access to health coverage for Illinoisans.

To get Covered Illinois has a small team at this point, and the Trump Administration announced in mid-2017 that they would no longer fund community enrollment assistance programs in 18 cities across the United States, including Chicago. The federal government also radically reduced the advertising budget for HealthCare.gov. All of this has left consumer advocates in Illinois scrambling to attempt to fill in the gaps and ensure that there is enough outreach and enrollment assistance available to customers.

Applying On The Phone For An Exchange Plan

Health Insurance Exchanges Explained

Another option currently is to apply for a plan on the federal marketplace through the national call center at 318-2596. This telephone number is staffed by a combination of service center employees and contractors from Maximus, a government services outsourcing company. Agents essentially walk consumers through the enrollment process and can answer any questions or help to explain plan coverage in further detail.

Enrolling over the telephone method still has its issues and kinks though. Our hypothesis that online enrollment would be more efficient than online proved incorrect. Agents don’t use a more streamlined and direct internal system to enroll consumers, as we expected. They’re oftentimes using the same system and website as consumers, so the same constraints and delays may be faced. We tested a sample of representatives at call centers for Idaho, New York, Illinois, and Florida health insurance plans, and came across widely differing experiences. Our findings are reported below.

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Exchanges Are Enrollment Portalsthey’re Not Your Insurer

It’s important to understand that the exchanges are just a platform for purchasing coverage. If you buy health insurance via Covered California, for example , Covered California is not your insurance company. Instead, your insurance company will be Health Net, or Blue Shield, or Anthem, or any of the other private insurers that offer coverage via Covered California.

And to clarify one other point that sometimes creates confusion, the terms “exchange” and “marketplace” are used interchangeably. But the term “market” is used more generally.

So while a health insurance exchange or marketplace refers specifically to the portal in each state that people can use to compare the various options and enroll, the term “health insurance market” applies much more broadly, and can include plans sold outside the exchange and employer-sponsored plans as well as grandmothered and grandfathered plans .

Medicare Enrollment And Coverage Options In Illinois

Illinois has the seventh-highest number of Medicare beneficiaries of any state. More than 2.2 million residents enrolled as of 2020. Approximately 73% are Original Medicare enrollees. The rest signed up for Medicare Advantage plans sold by private insurance companies.6

Some residents also get Medicare Advantage through group retiree programs. For instance, members of Illinois Teachers Retirement Insurance Program have access to Medicare benefits through Total Retiree Advantage Illinois . TRAIL is a Medicare Advantage plan that offers medical and prescription drug coverage to eligible members and their dependents.

If youre an Original Medicare member, you can enroll in Medicare Supplement to help pay out-of-pocket expenses, such as copays and deductibles. In Illinois, Medicare beneficiaries under 65 receive the same open enrollment rights as seniors. Illinois law also mandates that insurers cant charge people under 65 more for a policy than they would a senior.

Because Original Medicare doesnt cover most prescription drugs, many beneficiaries also add a separate Medicare Part D drug plan. In 2018, more than 1.1 million Illinois beneficiaries enrolled in these plans.

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About Obamacares Optional 35% Fee For Selling Insurance

ObamaCare gives states and the federal government the option of charging insurance companies a 3.5% fee on the cost of the premium to sell insurance on the exchange. States have the option of using grants and other forms of assistance from the federal government however, states that refuse to set up a state-run exchange will not get the subsides , therefore their constituents may see the results of this tax passed along to them in the form of higher premiums.

Despite the cost, insurance companies have a big incentive to sell their plans on the exchange since it gives them access to millions of Americans who will only be able to apply their tax credits and subsidies on the exchanges.

How the 3.5% fee will affect States of who are opting out of setting up an exchange and how it will affect the price of insurance premiums remains to be seen. There are a lot of factors that go into which plans are offered in which regions and by which insurers, so pinpointing the results of the 3.5% fee isnt easy. On our site, we will attempt to cover the results of each states choices moving forward in more detail.

Bright Health Will Start Offering Individual Market Plans In Chicago Area In 2021

Our Model

Open enrollment for 2021 health plans will start November 1, 2020, in Illinois, and continue through December 15, 2020. Outside of that window, people with qualifying events can enroll or make changes to their coverage for 2020.

For 2021, Bright Health plans to start providing individual market plans in the Chicago area . Insurers had to file proposed rates and health insurance plans for 2021 in late May, but they are not publicly available as of July.

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Quick Answer: Does Illinois Have A State Health Insurance Exchange

Illinois operates a partnership exchange with the federal government. That means the state runs Get Covered Illinois which provides a website, in-person assistance, and a help desk while Illinois residents use HealthCare.gov to enroll in health coverage and make changes to their plan.

Signing Up For The Health Insurance Marketplace

State marketplaces offer 24/7 assistance to help you sign-up, enroll, or switch plans. Simply scroll down the page until you find your states marketplace to get started. Many states set up their own marketplaces, but the majority have not . If your state hasnt set up its own marketplace, youll use HealthCare.Gov instead.

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Getting Cost Assistance On The Marketplace

Americans making under 400% of the Federal Poverty Level may qualify for cost assistance through the marketplace. Cost assistance includes: reduced premiums via tax credits for those making between 100% 400% FPL, out-of-pocket cost assistance for those making between 100% 250% FPL, and Medicaid for those making under 138% FPL .

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Illinois operates a partnership exchange with the federal government the state department of insurance runs Get Covered Illinois, including a website, in-person assistance, and a help desk, and the federal government provides the IT platform Healthcare.gov that Illinois residents use to enroll in coverage or make changes to their plan.

Former Gov. Pat Quinns administration announced in July 2012 that the Illinois marketplace would operate as a state-federal partnership. Quinn had hoped to leverage the partnership model as an interim step toward a state-run marketplace for the 2015 coverage year. However, a state exchange bill passed in the Senate in 2013 didnt get a vote in the House. There was some hope that exchange legislation would be considered during the fall 2014 session. However, the House did not take up the issue, and Illinois continues to have a partnership exchange .

Rep. Robyn Gabel had hoped the issue would gain traction in 2015, given that the U.S. Supreme Court was considering whether premium subsidies could be lawfully provided in states that dont run their own health insurance exchange. By transitioning to a state-run exchange, Illinois would have secured ongoing subsidies for its residents regardless of how the Court ruled. But the Court ultimately deemed subsidies to be legal in every state, regardless of whether the federal government is running the exchange or not.

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How Much Does Health Insurance Cost In Illinois

The Health Insurance Marketplace uses metal names to classify on-exchange health plans. Checking a plans tier makes it easier to estimate your total out-of-pocket costs for health coverage.

Plan details are prominent when you shop for a plan via the Health Insurance Marketplace. You can estimate your total out-of-pocket costs just by glancing at the plan summary. You can also download plan documents with more detailed information inside.

Average premiums in Illinois
$478$464

Illinois Health Insurance Marketplace Enrollment

Illinois operates a Health Insurance Marketplace in partnership with the federal government called Get Covered Illinois.3You can apply for individual or family health insurance through the Marketplace, over the phone, by mail, or in-person at consumer assistance centers located statewide. This also applies if youre a self-employed entrepreneur with no employees.

Open enrollment for health insurance in Illinois generally runs from . After this date, you can only enroll in Obamacare if you have a qualifying life event.

Illinois Marketplace enrollment has declined every year since 2016. More than 388,000 residents were enrolled back then compared to about 291,000 in 2021.4

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You Can Get There Via Healthcaregov

Although the District of Columbia and 17 states run their own exchanges, HealthCare.gov is a no wrong door platform. Even if youre in a state that doesnt use HealthCare.gov, you can still start there and youll end up in the right place.

The screener page allows you to check your zip code or create an account. If you are in a state that has its own state-run exchange, youll see a message explaining that youll use a different marketplace and a link to it.

Do I Have To Use The Healthcare Marketplace In Illinois

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If you want to get an Advanced Premium Tax Credit to help pay your premiums, you have to apply for coverage via the Health Insurance Marketplace. Otherwise, you can purchase a health plan directly from an insurance company that offers coverage in Illinois. Individuals, families, and small business owners who do not qualify for a tax credit may benefit from purchasing a plan directly from an off-exchange insurance company.

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Can You Buy Health Insurance Without A Job

The good news is you can get health insurance without a job. While group health insurance is not an option for those without an employer, you can still qualify for individual or family plans. Individual health insurance offers all the same coverage options as you may find from employer-sponsored plans.

How Do I Enroll In Illinois’s Health Insurance Marketplace

Visit HealthCare.gov and set up an account if you dont already have one to use the Health Insurance Marketplace. Make sure you have the full name, birth date, and Social Security number of every person in your family who needs coverage before you start the application process.

The application includes several questions related to your income and family, including the following:

  • Are you single or married?
  • How many tax dependents will you claim on your current return?
  • How much income will your household make this year?
  • Do you want to see if you can get help paying for coverage?

Youll need to provide your name, contact information, and details about your income to determine if you qualify for an Advance Premium Tax Credit. The Advance Premium Tax Credit is paid to you in advance to make your health premiums more affordable. Be sure to estimate your annual income as accurately as possible. If you underestimate, you may receive more credit than you would otherwise be eligible to receive. Youll have to pay back the excess in back premiums when you file your taxes.

The following insurance companies offer health insurance plans to Illinois residents in the marketplace:

  • Ambetter of Illinois
  • Individual vs. family deductibles

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