News Alerts

What do HIX and Health Insurance Marketplace Have In Common?

They are two different names for Health Insurance Exchanges. HIX is an acronym for Health Insurance Exchange. The term Health Insurance Marketplace was adopted by the federal government to avoid the notion that individuals exchanged one plan for another. HIX was created to limit the necessity of spelling out “health insurance exchange” repeatedly and is expected to become the most common verbiage by which to reference the exchanges. Several states who expect to offer exchanges to their residents have developed websites with creative names for their state’s plan: Avenue H (Utah) and Silver State Health Insurance Exchanges (Nevada) to name two.

Several states (20 at last count) have received conditional approval for their exchanges based on a blueprint submitted to Health and Human Services (HHS) and their readiness for an October 1, 2013 opening, coinciding with the benefits open enrollment season. The administration of these exchanges vary from a state only exchange to a partnership exchange with HHS assuming some management activities. HHS will assist those states who have received conditional approval with the development necessary to meet the October 1 deadline. Any additional approval is dependent upon meeting HHS requirements for the success of an exchange.

Little information has been made available to individuals so that they can understand what health insurance will be offered. ACA requires that exchanges offer 4 levels of insurance: bronze, silver, gold and platinum. Within these tiers of coverage there can be as many as 10 factors that will differentiate them, and undoubtedly affect the premiums. Other ACA mandates, such as the elimination of lifetime and annual limits, must also be a component of the exchanges’ alternatives.

Where are the other 30 states in the HIX race? The dates for blueprint submissions have been extended, however, many states have openly declined to participate in health insurance exchanges. One state submitted a blueprint that was rejected because the state agency that regulates insurance is separate from state governor who is Republican . Given the work that needs to be done by the individual state, the federal government in partnership with states, and federal plans alone, it’s hard to imagine all this work could be done by the open enrollment deadline. All of this work is critical to meet the individual mandate so that those that are uninsured have a place to purchase health insurance.

For additional information, contact EAB HealthWorks.