Health insurance exchanges (HIX) also identified as marketplaces that are established by the Affordable Care Act (ACA). It allows individuals to buy and compare coverage offered by competing private health insurance companies. Based on state of residence, consumer uses either their state exchange or federally facilitated exchange. These are online health insurance marketplaces, which are set up by the U.S. Federal Government and certain states.
The marketplace classifies plans into four sections such as bronze, silver, gold, and platinum. Platinum plan cover 90 percent of health expenses in comparison to other plans. However, the costs are commensurate with this coverage level. Health insurance exchanges will offer individual and small businesses with a “one-stop shop” to discover and compare plans based on price and quality.
The plan is selected via online portals where consumers visit virtual ‘shops’ for their health insurances or contact call center to get information regarding coverage option. Those people who qualify for cost-sharing subsidies or premium subsidies may obtain these grants via online portals in several HIX schemes.
Major elements of health insurance exchange (HIX)
It is critical to address all of the cross-functional necessities for enrollment and eligibility, as well as their positive impact on the basic codification of plan benefits, to meet the essential formulas required by the ACA’s product levels.
Health plans will have to either build an aptitude to achieve cost share tracking within their present allegation system or look at supplementary products or extensions to actual systems that are under development to address this matter.
Health plans will also need to consider the assimilation points for the unlike risk programs, both permanent and temporary, that will be managed at both the federal and state levels.
These exchanges are intended to increase competition and ease comparison shopping, avail subsidies to pay for health insurance, and to find health insurance exchange of particular state. Moreover, small businesses may also purchase coverage in the exchange.
All health insurance exchange industry will require interfaces with current systems to ensure seamless transfer of group information, product, and member. However, these next generation health exchanges are early lessons from real-world assessments for health benefits exchange and individual insurance markets. It is the latest trend in an online market place.