This guide provides an overview of the Indiana Health Insurance Exchange including the history of the Exchange, how the Exchange will operate, and Exchange information for consumers and professionals.
Beginning in 2014, as part of the Affordable Care Act (ACA), health insurance coverage for individuals and small businesses will become available through new state Health Insurance Exchanges. Most importantly, the key tax credits (e.g. the small business healthcare tax credits) and tax subsidies (e.g. individual health insurance tax subsidies) will only be available for coverage purchased through a state Health Insurance Exchange.
All states have three options for setting up a state Health Insurance Exchange for 2014:
Build a State-Based Exchange
Enter into a State-Federal Partnership Exchange
Default to a Federally-Facilitated Exchange
In November 2012, Indiana announced they would default to a federally-facilitated Health Insurance Exchange. The Indiana Health Insurance Exchange will open October 1, 2013, for coverage beginning January 1, 2014.
Indiana Health Insurance Exchange - History
Originally, Indiana explored creating a state-based Health Insurance Exchange. In 2011, Former Governor Mitch Daniels signed Executive Order #11-01 to conditionally establish the Indiana Insurance Market, Inc., a nonprofit corporation to serve as the Indiana Health Insurance Exchange. As part of this planning, an inter-agency group including the Department of Insurance, the Family and Social Services Administration, and the Office of Medicaid Policy and Planning worked to plan for the state-based exchange.
However, the state-based Exchange did not receive legislative backing. The draft exchange legislation was not proposed during the 2012 legislative session which ended in March 2012, and efforts stalled.
In November 2012, then Governor-elect Mike Pence announced that he would not move forward with setting up a state-based health insurance exchange when he took office in 2013. Therefore, Indiana will default to a federally-facilitated Health Insurance Exchange in 2014.
Indiana Health Insurance Exchange - What is It?
The Indiana Health Insurance Exchange will be operated through a federally-run Health Insurance Exchange (branded as the "Marketplace"). According to healthcare.gov, starting in October 2013 Indiana residents will be able to access information about insurance plans available through the Marketplace. The SHOP Exchange will be available to small businesses in Indiana for businesses with 100 or fewer employees. Coverage starts January 1, 2014.
According to healthcare.gov, 909,600 or 16% of Indiana's non-elderly residents are uninsured. Through the Exchange, Indiana residents can shop for and compare insurance plans, access insurance premium tax credits, and be screened for eligibility in public assistance programs such as Medicaid and CHIP. More information on the federally-run Health Insurance Marketplace can be found here.
Indiana Health Insurance Exchange - What Plans Will be Available?
All plans offered through the Indiana Health Insurance Exchange will meet the federal ACA definition of a Qualified Health Plan (QHP). The plans will be offered by level of coverage for essential health benefits (EHB), to allow consumers to compare plans on an "apples to apples" basis. The four "metal" levels are: Bronze (plan pays 60%), Silver (plan pays 70%), Gold (plan pays 80%) and Platinum (plan pays 90%). More information on the types of plans that will be available, and the carriers offering plans in Indiana, is expected by late summer 2013.
Indiana Health Insurance Exchange - Role of Insurance Professionals & Navigators
The Indiana Health Insurance Exchange will follow federal guidelines for insurance professionals selling policies through the Exchange, and for Navigators assisting consumers and small businesses.
Insurance professionals will be able to register with the Indiana Health Insurance Exchange and receive commissions directly from the carriers (using their Exchange ID number and NPN to track sales). For more information see: Role of Agents in Health Insurance Marketplaces.
The Indiana Health Insurance Exchange Navigator program will assist consumers in making choices about their health care options and accessing their new health care coverage, including access to premium tax credits for some consumers. The federal government will run the navigator program in Indiana.