I'm suddenly questioning my understanding of the new ACA Metal Plans. This is my thinking. Could someone please verify whether I am thinking correctly.
1. Any insurance company that wants to can continue offering private insurance plans, subject to the State regulations in which the plan is offered.
2. The plans offered in Point 1 are outside of, and unaffected by, the requirements imposed on the healthcare plans that may be offered through the Healthcare Exchanges.
3. The ACA establishes a requirement for Healthcare Exchanges that will either be run by the individual state, or by the Federal government if the state declines to run the exchange. All states must have a Healthcare Exchange.
4. Any individual insurance carrier may choose whether to offer insurance plans through a given state's Healthcare Exchange.
a. If a carrier does choose to offer a plan through the exchange, it must conform to the requirements published for the Metal Plans: Bronze, Silver, Gold, and Platinum.
b. Any carrier offering insurance plans through the Healthcare Exchanges may still offer other non-exchange plans to the public, subject to state regulations (only?).
5. Specifically - the only required Metal Plans are the ones offered through the Healthcare Exchanges. The plans offered outside of the Healthcare Exchanges are not Metal Plans, and are not subject to the rules imposed on the Metal Plans.
I thought I understood Point 1-5 pretty well. But now I am hearing from some that ALL health insurance plans must be Metal Plans, whether they are part of the Healthcare Exchanges or not. Now I'm wondering whether they are confused, or I am confused.
While the fundamental purpose of the exchanges will be to facilitate the offer and purchase of health insurance, nothing in the law prohibits qualified individuals, qualified employers, and insurance carriers from participating in the health insurance market outside of exchanges
But I can't tell from that language whether plans sold outside of the Exchanges that equal plans sold inside of the Exchanges are to be labled Bronze, Silver, Gold, and Platinum also. I'm thinking that somebody passing by this post will know for certain.
I'm sorry Richard I can't resist.. what are Metal Plans..?
While it would seem this is a loss to carriers because who's going to buy on the private market when they can get cheaper rate in the exchanges?
Quote 4b. Any carrier offering insurance plans through the Healthcare Exchanges may still offer other non-exchange plans to the public, subject to state regulations (only?).No, I don't believe so but I'm not 100% positive, I beleive they agree with the exchanges to operate within a special area of exchanges, however companies such as Aetna, for example, won't lose any market because of their multi=state operations.
4b. Any carrier offering insurance plans through the Healthcare Exchanges may still offer other non-exchange plans to the public, subject to state regulations (only?).
To repeat parts of the quotes in my first post:... nothing in the law prohibits qualified individuals, qualified employers, and insurance carriers from participating in the health insurance market outside of exchanges.An issuer may offer QHPs outside of exchanges as well as inside, but the premiums would have to be the same, even if the QHP is sold through an insurance agent.That seems pretty clear that any carrier can offer plans through the Exchange, and other plans outside the Exchange - as well as offering the same plans for the same price both inside and outside the Exchange. But stay tuned ... perhaps that is an incorrect interpretation. I'm sure we will soon find out.
I thought this was to be affordable....For just myself, a minimum monthly premium of $500 with $5000 deductible & $7500 oop. How is this affordable?