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Small Business Employee Benefits and HR Blog

Iowa Health Insurance Exchange Guide

This guide provides an overview of the Iowa Health Insurance Exchange including the history of the Exchange, how the Exchange will operate, and Exchange information for Iowa residents and small businesses.

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. 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. Iowa Health Insurance Exchange

All states have three options for setting up a state Health Insurance Exchange for 2014:

  1. Build a State-Based Exchange

  2. Enter into a State-Federal Partnership Exchange

  3. Default to a Federally-Facilitated Exchange

Iowa is planning to enter a state-federal partnership Exchange, and transition to a state-based Exchange by 2015. 

Iowa Health Insurance Exchange - History

Originally, Iowa formed the Health Benefit Exchange, a collaboration of the Iowa Department of Public Health, the Iowa Insurance Division, the Iowa Department of Human Services, and the Iowa Department of Revenue. The committee was tasked with making recommendations for Iowa's Health Insurance Exchange.

On December 14, 2012, Governor Terry Branstad announced to the federal government that Iowa would pursue a state-federal partnership Exchange. Iowa plans to oversee plan management functions of the Exchange and will continue to perform Medicaid and CHIP eligibility determinations. Iowa plans to work toward a state-based exchange by 2015.

On March 5, 2013, Iowa received conditional approval from the US Department of Health and Human Services to establish a state-federal partnership Exchange. Final approval is contingent upon the Iowa meeting all Exchange activities on time. If Iowa does not meet milestones on time, Iowa will default to a federally-facilitated Exchange.

Click here to read more on Iowa's Health Insurance Exchange Planning.

Iowa Health Insurance Exchange - What is it?

The Iowa Health Insurance Exchange will be an online marketplace where Iowa residents will be able to shop for and compare insurance plans, access any applicable insurance premium tax credits, and be screened for eligibility in public assistance programs such as Medicaid and CHIP. The SHOP Exchange will be available to small businesses in Iowa for businesses with 100 or fewer employees.

According to healthcare.gov, 255,072 or 10% of Iowa’s non-elderly residents are uninsured, of whom 234,100 (92%) may qualify for either tax credits to purchase coverage in the Marketplace or for Medicaid if Iowa participates in the Medicaid expansion (Iowa is still undecided as of May 9, 2013 if they are participating in Medicaid expansion).

Iowa residents and small employers can receive assistance from Navigators, in-person assistors, and insurance agents and brokers. The Iowa Health Insurance Exchange will open October 1, 2013 for enrollment, with coverage starting January 1, 2014.

Click here for more information on the Iowa Health Insurance Exchange.

Iowa Health Insurance Exchange - What Insurance Plans Will be Available?

Under the Affordable Care Act, all insurance plans sold on the Iowa Health Insurance Exchange will be qualified health plans (QHPs) that meet federal requirements and provide essential health benefits (EHB). The Exchange will offer uniform plans categorized in four "metal" levels of value. These metal levels are intended to allow consumers to compare plans with different levels of coverage for EHB. The levels include:

  • Bronze (60% actuarial value)
  • Silver (70% actuarial value)
  • Gold (80% actuarial value)
  • Platinum (90% actuarial value)

At the time of writing specific information on the types of plans, carriers and cost have not been released for Iowa.