Wondering what your move should be for providing health insurance options for your small business employees? As a small business owner or human resources director of a smaller company, you are likely overwhelmed with healthcare options and the price tag that accompanies them. Fortunately, there are quick and easy ways to weigh your options today. One of those options is to use your health insurance marketplace to compare plans and prices.
- 1 Some background on health insurance marketplaces
- 2 Contrasting the Different Types of State-run Health Insurance Marketplaces
- 3 Purely State-run Health Insurance Marketplace
- 4 State-run Marketplaces that Use the HealthCare.gov Platform
- 5 Marketplaces run by a partnership between state and federal governments
- 6 Marketplaces Where a State Runs the Small Business Marketplace and the Federal Government Runs the Marketplace for Individual Plans
- 7 Federally-facilitated Marketplaces, Where the State Government Conducts Plan Management
Some background on health insurance marketplaces
Since the implementation of the Affordable Care Act, health insurance marketplaces were established nation-wide to make finding and comparing coverage simpler. At their most basic, these marketplaces are price comparison websites where individuals can enroll in health insurance to meet minimum essential coverage obligations. According to each state’s specific guidelines, consumers can also use the marketplace to receive federal subsidies.
For people who do not receive benefits from an employer, under their spouse’s or parents’ coverage, or are otherwise left to enroll for a healthcare plan individually, many use state-run health insurance marketplaces to determine what plan will best fit their needs and budget. There are currently, as of early May 2017, six different types of state-run health insurance marketplaces:
- State-run marketplace
- State-run marketplace using the federal website platform
- State-federal partnership marketplace
- Marketplace where a state runs the marketplace for small business, and the federal government runs the individual marketplace
- Federally-facilitated marketplace, where the state runs plan management
- Federally-facilitated marketplace
Contrasting the Different Types of State-run Health Insurance Marketplaces
Depending on in which state you work and live, your marketplace will look and operate differently. Leaving out the federally-facilitated marketplaces (19 states total), here’s a brief breakdown of what to expect from each type of state-run health insurance marketplace.
Purely State-run Health Insurance Marketplace
States: California, Colorado, Connecticut, Idaho, Maryland, Massachusetts, Minnesota, New Mexico, New York, Rhode Island, Vermont, Washington, Washington D.C.
Twelve states and Washington D.C. have opted to house health insurance markets on their own websites. Opting out of using healthcare.gov as the market platform, these states have branded their own marketplace and are creating laws for regulation and aid at the state-level to supplement federal laws already in place. A prime example of a state-run health insurance marketplace is Washington D.C.’s marketplace, DC Health Link.
DC Health Link
In 2017, DC Health Link has made a number of updates to the platform, including increasing storage and reducing fallibility by switching to a cloud-based memory system. Similarly to many other non-federally-facilitated marketplaces, a DC Health Link insurance broker is required to be certified by the state-run marketplace to be able to help employers select plans and understand details. Yes – it’s a district, and not a state – but the assigned governing body of the marketplace works to make sure all the participants on the provider side are compliant with laws at the state and federal levels.
Health insurance marketplaces that are solely state-run have taken recent actions to anticipate the possible overturn in legislature surrounding federal health care guidelines. Minnesota’s marketplace, MNsure, has seen an uptick in enrollments since the start of 2017. The state government has since enacted a bill to provide upwards of $300 million in insurance premium relief to those who miss the eligibility cut-off for advanced premium tax credits.
State-run Marketplaces that Use the HealthCare.gov Platform
States: Arkansas, Kentucky, Nevada, Oregon
These five states that have chosen to establish their own exchange have decided to use HealthCare.gov to apply for coverage. Arkansas, for example, provides information on their website, Arkansas Health Connector, but all of the plan comparisons and information from providers resides on the federal platform.
In contrast to DC Health Link, where the information is managed by the state entity, Arkansas Health Connector utilizes the federally-facilitated platform to manage the information from the providers.
Marketplaces run by a partnership between state and federal governments
States: Delaware, Illinois, Iowa, Michigan, New Hampshire, West Virginia
These six states have opted for a partnership between the state and federal governments where the state conducts the plan management and consumer assistance. However, consumers in these states use HealthCare.gov to apply for coverage and apply for cost assistance.
For example, Choose Health Delaware partners with the U.S. Department of Health and Human Services to provide for state residents. Enrollment was 11% higher in 2016 than the year prior, and although there was a significant rate hike in 2016, premium subsidies have offset the difference by a huge margin. For comparison, DC Health Link saw a 19% rise in new enrollments in 2017 over 2016.
Marketplaces Where a State Runs the Small Business Marketplace and the Federal Government Runs the Marketplace for Individual Plans
States: Mississippi, Utah
Both Mississippi and Utah use the federally-run exchange for market plans for individuals’ enrollment, but that state government runs an exchange for small businesses.
One Mississippi is the exchange used by small businesses, run by the state of Mississippi. DC Health Link has options for small businesses, too, but individuals use the state-run platform as well as company owners.
Federally-facilitated Marketplaces, Where the State Government Conducts Plan Management
States: Kansas, Maine, Montana, Nebraska, Ohio, South Dakota, Virginia
Mostly deferring to the federal facilitation of health insurance marketplaces as a default, these seven states maintain some responsibility in overseeing plans that are sold in the federal exchange.
The Maine health insurance marketplace has been whittled down to only three providers for on-exchange plans in 2017. DC Health Link for 2017 has three major providers as well, but houses 20 plans in the individual market: four PPOs and 16 HMOs.
If you live and operate in the Washington D.C. area, DC Health Link is a great place to start your search for affordable healthcare plans for your small business employees. After you get a little further along in your research, we encourage you to reach out to us at Business Benefits Group to get a free informational benefits consultation. Legislation on federal healthcare regulations is subject to change, so we can help you stay abreast of the changes and options available to you.