Description
In 2010, the Affordable Care Act was passed into law. Its primary goal is to ensure that virtually all Americans are able to access, obtain and maintain affordable health insurance coverage. To meet this goal, ACA effected many changes; among the most notable are these:
1. It put into place a number of private insurance consumer protection measures to make sure most individuals have access to quality health insurance, regardless of their health status.
2. It created public health insurance exchanges or marketplaces to give consumers a way to access and purchase health coverage which otherwise they may not have been able to obtain or afford.
Consumer protection measures have been steadily coming into effect since ACA was enacted. Arguably, the bigger step was the creation and implementation of the health insurance exchanges. This is the focus of this course. Few would dispute that health insurance exchanges are the cornerstone of the Affordable Care Act.
This course provides an overview of health insurance exchanges and their basic requirements and objectives as set forth by ACA. It includes the following chapters:
• Exchange Basics
• Exchange Functions and Operations
• Coverage Available Through an Exchange
• Financial Assistance Available Through an Exchange
• Shopping on the Exchanges
Learning Objectives
This course offers a general discussion of the new health insurance exchanges and how they are intended to function under the law. It does not delve into the specifics of any single state exchange nor does it describe the role of licensed producers on anything but a very general level. It is intended for those who want a basic understanding of the new environment in which health insurance is available and can be delivered to millions of Americans. Upon conclusion of the course, students will be able to:
• demonstrate an understanding of the purpose and functions of a health insurance exchange
• cite the types of consumers that exchanges serve
• explain the basics of small business health option programs, or SHOPs
• describe the kinds of health plans and other coverage that exchanges offer
• describe the financial assistance available through an exchange to certain low- and moderate-income individuals and their dependents
• explain how individuals and small businesses can enroll in exchange plans
• demonstrate an understanding of the types of consumer assistance available through the exchanges, and the role the law envisions for agents and brokers in federally facilitated and partnership exchanges
Consumers who seek health insurance coverage through an exchange can receive assistance in a variety of ways. Licensed insurance producers, agents, and brokers are among those who can provide this assistance, to the extent permitted and defined by their state. Producers who want to work with their state exchange are encouraged to take on additional study through the formal training and certification courses that their state’s exchange program requires.