This guide provides an overview of the Mississippi Health Insurance Exchange including the history of the exchange, how the exchange will operate, and exchange information for Mississippi residents and small businesses.
Mississippi 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 exchanges.
All states have three options for setting up an exchange for 2014:
- Build a state-based exchange,
- Enter into a state-federal partnership exchange, or
- Default to a federally-facilitated exchange.
Mississippi will default to a federally-facilitated health insurance exchange. The Mississippi Health Insurance Exchange will open for enrollment on October 1, 2013, with coverage starting January 1, 2014.
Mississippi Health Insurance Exchange - History
Originally, Mississippi planned to operate a state-based exchange (www.onemississippi.com). In November 2012, Commissioner of Insurance Mike Chaney issued a declaration letter stating Mississippi’s intent to implement and operate a state-based health insurance exchange, followed by the required blueprint detailing their proposal for a state-based exchange. However, in December 2012 Governor Phil Bryant notified the Department of Health & Human Services (HHS) that he opposed a state-based exchange, and that the Commissioner's office did not have the authority (read release here). The HHS rejected Mississippi's blueprint proposal to run a state-based exchange. Therefore, Mississippi will default to a federally-run exchange.
Mississippi Health Insurance Exchange - What is It?
The Mississippi Health Insurance Exchange will be operated through a federally-run health insurance exchange, also called the Health Insurance Marketplace. Starting in October 2013, Mississippi residents will be able to access information about all the plans available through the Exchange. The SHOP Exchange will also be available to Mississippi small businesses with fewer than 100 employees.
A key part of the Mississippi Health Insurance Exchange is that eligible individuals and families will be able to access individual premium tax subsidies, capping the cost of their premium between 2% to 9.5% of income. Eligibility is based on household size and income (up to 400% FPL). The Exchange will also screen for Medicaid and public assistance programs. These premium tax subsidies will only be available through the Exchange.
According to an estimate by healthcare.gov, approximately 511,760 or 20% of Mississippi's non-elderly residents are uninsured.
Mississippi Health Insurance Exchange - What Plans will be Available?
All plans offered through the Mississippi 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%).
Specific insurance carriers and plan rates will go through a formal review process, and are expected this summer.
Mississippi Health Insurance Exchange - Role of Insurance Professionals & Navigators
The Mississippi 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 Exchange and receive any commissions directly from the carriers (using their Exchange ID number and NPN).
The Mississippi 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 eligible consumers.
Further details on the Mississippi Health Insurance Exchange insurance broker and navigator programs are expected this summer.