US Federal Exchange

It has been reported that Governor elect Mike Pence is not going to establish an Indianapolis State Based Health Insurance exchange.  If the state does not elect to set up our own exchange then a Federally-Facilitated Exchange will be set up without state partnership.

HHS will establish and operate the Federal Exchange.  Indianapolis will still have options to coordinate with CMCS on decisions and protocols for either eligibility assessment or eligibility determination model with in the federal exchange. HHS intends to work with in collaboration with them, where appropriate, to ensure the best, most effective experience for Hoosier residents.

If Indianapolis does not notify HHS by November 16, 2012, the HHS will operate the federal exchange.

1.  Indianapolis will not be able to administer a reinsurance program.

2.  The Individual and small group markets will be merged into one risk pool.

3.   Indianapolis’s definition of small group employer will be followed.

At this time HHS has released few details on how the federal exchange will operate.  We do not know if the Insurance carriers are going to participate. We also don’t know how the policies will be distributed.

The current administration has made reference to using local agents and brokers to distribute the Federal Exchange.  We should see a online application that not only will allow you to enroll into the exchange but determine if you are eligible for subsidies.