Private Health Insurance Exchange Alternative to HealthCare.gov
In 36 states there is a private-health-insurance-exchange alternative to the www.healthcare.gov website for comparing health insurance plans and purchasing
marketplace health insurance. In addition to fulfilling the Affordable-Care-Act individual mandate to purchase
health insurance that meets the qualifications for basic essential coverage by January 1, 2014 or risk a tax
penalty, this alternative health insurance marketplace also enables insurance purchasers to obtain their
Affordable-Care-Act subsidies, also known as premium tax credits at the time insurance is purchased, just as would
be the case if the transaction were conducted through the www.healthcare.gov website.
This health insurance exchange alternative is the spin-off of a written agreement between the
federal government and eHealthInsurance, the country's first and largest private health insurance exchange, on July
31, 2013. The agreement authorizes eHealthInsurance to assist the government in enrolling subsidy-eligible
individuals in qualifying health insurance plans offered by well-established major insurance companies with good
A.M. Best ratings.
Because the agreement gives eHealthInsurance access to the federal electronic data hub,
eHealthInsurance is essentially a private health insurance exchange with federal-insurance-exchange authority.
Visitors to the website can determine whether or not they qualify for Affordable-Care-Act subsidies also known as
premium tax credits via using a health insurance subsidy calculator available on the site, prior to comparing
health insurance plans. If insurance purchasers do qualify for health insurance subsidies the credits will be
automatically applied to their monthly premiums at the time the insurance is purchased, in much the same manner as
would be the case if the purchase had been made through the www.healthcare.gov website.
Having begun operations in 1997, eHealthInsurance has developed a state-of-the-art user-friendly
online platform which makes shopping for health insurance easy, efficient and trouble-free. In comparing insurance
plans, up to four different plans can be compared side-by-side, matching plans based not only on monthly premiums,
but a number of other variables including deductibles, coinsurance, annual out-of-pocket maximums, primary doctor
and specialist office visit costs, type of insurance plan (HMO versus PPO), plan metal type (bronze, silver, gold
or platinum), lifetime maximum, out-of-network coverage, out of country coverage, health savings account
eligibility, preventive health coverage, prescription drug coverage, emergency and urgent care coverage, and
coverage for substance abuse, mental health, hospice, major dental, vision, maternal and pediatric services.
Additionally, the platform calculates the costs for treatment of hypothetical minor, mid-sized and major event
scenarios with and without insurance, and then shows the cost savings with insurance for each plan in the
Before comparing health insurance plans various plans can be reviewed individually or selected for
comparison after sorting based on names of insurance companies, type of insurance plan, monthly premium,
deductibles, coinsurance, plan metal type, and additional coverage provisions.
Since the agreement between the federal government and eHealthInsurance applies only to states
whose Affordable-Care-Act exchanges are being operated solely or jointly by the federal government and does not
apply to states in which the exchanges are being state operated, the eHealthInsurance exchange is not available in
16 states and the District of Columbia as of November 20, 2013. Those states are California, Colorado, Connecticut,
Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Rhode Island,
Vermont, and Washington. As of November 20, 2013 there are no agreements between private health insurance exchanges
and state operated exchanges, but agreements could be forthcoming in the future.
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