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Obamacare Marketplace Profile: Idaho's Health Insurance Exchange

Obamacare Marketplace Profile: Idaho's Health Insurance Exchange

Posted Sep 11, 2013 by Jenifer Dorsey

Exchange name: Your Health Idaho

Website: www.yourhealthidaho.org  

State-based or federally run: Your Health Idaho is among the 17 declared state-based health insurance exchanges, which include Washington, D.C. The exchange structure is quasi-governmental, which means it is an independent public agency.

Plans: Earlier this month, Your Health Idaho announced it would offer 161 health insurance plans from eight Idaho insurance companies for coverage beginning January 2014. This includes 76 health plans for individuals and families, 55 small group health plans, 13 dental plans and 17 small group dental plans

These plans, as with all plans sold through the new online marketplace, will meet Obamacare’s four metal level requirements—bronze, silver, gold and platinum—and include benefits in the 10 categories of essential health benefits and preventive care at no additional cost. Some catastrophic plans will also be available to those who qualify.

More information about the approved health and dental plans will be available Oct. 1, when open enrollment begins. In the meantime, the yourhealthidaho.org website guides consumers to contact the participating carriers directly for more information. The carriers selling through Idaho’s online marketplace include the following:

Your Health Idaho will operate under the clearinghouse model, which means that all plans meeting minimum federal requirements for qualified health plans are sold on the exchange.

As in all states, Idahoans may also purchase health insurance plans that fulfill the Affordable Care Act’s individual mandate off the exchange. To be considered qualified coverage, they must meet the Affordable Care Act’s minimum requirements and will also be categorized by metal level. Plans purchased in the private marketplace do not qualify for tax credits or subsidies.

When planning for 2014 health coverage, individuals and families nationwide are wise to consider additional protection through supplemental coverage. For instance, a bundled gap plan that includes coverages such as accident medical expense insurance and accident disability income insurance pays lump-sum cash benefits when a qualifying event occurs and can help create more comprehensive benefits like those offered through an employer. A critical illness insurance plan pays out lump-sum cash benefits upon diagnosis of certain illnesses that can be used for everything from medical bills to childcare. Supplemental insurance is not available through state-based or federally operated health insurance exchanges; however, they are easy to obtain directly from the plan’s carrier or a licensed agent or broker.

Rates: Last week, Idaho released health insurance exchange sample rate information for individual and family coverage. Premium examples were provided for a 31-year-old and family of four in a news release. The monthly rates were broken down by ZIP code and showed the range from bronze level to the highest priced metal plan offered in the region. The monthly premium for a 31-year-old ranged from $159.80 to $336. Family rates ranged from $529.52 to $1,110.

Premium rates will be established based on age, geography, family size and tobacco use. Under the Affordable Care Act, Americans cannot be denied coverage or charged more due to preexisting conditions. These provisions apply whether plans are purchased via the marketplace or not.

Consumers who purchase health insurance plans from state-based and federally operated exchanges may qualify for tax credits and subsidies, depending on their income. The healthedeals.com Health Care Reform Calculator, which was listed among The Financial Times “Best Online Tools for the Toughest Health Questions,” can help those planning to buy from an exchange calculate their Obamacare health insurance cost and tax credit.

Consumer assistance: Your Health Idaho is training Consumer Connectors to assist its residents shopping for health insurance online and offline. Consumer Connectors include agents and brokers as well as In-Person assistors, which are employees and volunteers from nonprofit organizations statewide.

To find a licensed agent or broker, Idahoans may visit the Idaho Department of Insurance for a full listing. Information about In-Person assistors is not yet available, although the selection process is complete; consumers have been instructed to check yourhealthidaho.org for updates or contact the Consumer Connector program at connect@yourhealthidaho.org.

Idahoans may also contact Your Health Idaho’s consumer assistance hotline at 855-YHIdaho (855-944-3246) with questions.

In the news: Reports were swirling this summer that Idaho would be handing over its exchange to federal operation in 2014. In August, it was announced that the state’s marketplace will be up and running by open enrollment on Oct. 1. 

Need coverage now?

If you need health insurance to get you by until January 1, 2014, a temporary insurance plan can provide coverage for as few as 30 days. Start shopping on healthedeals.com or contact a healthedeals.com sales consultant for more information on short-term health insurance and supplemental plans.

Jenifer Dorsey is a freelance writer whose specialties include health and fitness, wellness, sports and recreation. She is a competitive amateur track cyclist who also enjoys mountain biking, hiking, camping and other outdoor adventure. Jenifer received a B.A. in journalism from Columbia College Chicago and is an MFA candidate at Naropa University. She lives in Colorado.