This guide provides an overview of the Wyoming Health Insurance Exchange including the history of the exchange, how the exchange will operate, and exchange information for Wyoming residents and small businesses.
Wyoming Health Insurance Exchange Introduction
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 (also called health insurance marketplaces).
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
Wyoming will default to a federally-facilitated health insurance exchange. The Wyoming Health Insurance Exchange will open October 1, 2013, for coverage starting January 1, 2014.
Wyoming Health Insurance Exchange - History
In 2011, Governor Matt Mead established the Wyoming Health Insurance Exchange Steering Committee (HB 0050) to explore a state-based health insurance exchange. The Steering Committee included representatives from the Legislature, businesses, insurers, providers, hospitals, consumers, and state agencies. In March 2012, the Committee voted not to file an extension for federal exchange planning funds, and planning for a state-based exchange was suspended.
On November 14, 2012, Governor Mead announced Wyoming would default to a federally-run Exchange for 2014. Wyoming continues to explore transitioning to a state-run exchange in coming years.
Wyoming Health Insurance Exchange - What is It?
The Wyoming Health Insurance Exchange will be operated through a federally-run health insurance exchange, also referred to as the Health Insurance Marketplace. Starting October 1, 2013 Wyoming residents will be able to access information about all the plans available through the Exchange. All individual plans will be guaranteed-issue, and eligible consumers will receive tax subsidies to reduce the cost of their plan. The tax subsidies are based on family status and household income. The Exchange will also screen for eligibility in Medicaid.
According to an estimate by healthcare.gov, 82,495 or 17% of Wyoming’s non-elderly residents are uninsured, of whom 68,436 (83%) may qualify for either tax credits to purchase coverage in the Marketplace or for Medicaid if Wyoming participates in ACA Medicaid expansion.
For small businesses, the Wyoming SHOP Exchange will be available for employers with 100 or fewer employers.
Wyoming Health Insurance Exchange - What Plans will be Available?
All plans offered through the Wyoming Health Insurance Exchange will meet the 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%).
Carriers had until April 30, 2013 to submit applications. It's expected that plans, carriers, and rates will be released later this summer.
Wyoming Health Insurance Exchange - Role of Insurance Professionals & Navigators
The Wyoming 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 Wyoming Health Insurance Exchange and receive any commissions directly from the carriers (using their Exchange ID number and NPN).
The Wyoming 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 subsidies for eligible consumers. The federal government will run the navigator program in Wyoming.