Health Insurance Marketplaces

Organized marketplaces (also called "exchanges") for the purchase of health insurance that are established by states, the federal government (federally-facilitated marketplaces) or states and the federal government in partnership; and set up as a governmental or quasi-government entity. The marketplaces enable individuals and small employers to compare available private health insurance options on the basis of price, benefits and services, quality and other factors; and are required to provide for the operation of a toll-free call center and an Internet website as consumer assistance tools. They help enhance competition in the health insurance market, provide a range of affordable health insurance choices and give small businesses the same purchasing power as large businesses. They serve as a one-stop shop where individuals can get information about their options; be assessed for premium assistance subsidies (tax credits) which are determined on a sliding scale and cost sharing assistance subsidies; and be assessed for or enrolled in the plan of their choice. The marketplaces are not insurers, so they do not bear risk themselves, but determine the insurance companies that are allowed to participate in them. Health plans provided through the marketplaces are made available to qualified employers and their employees in the small group market through a small business health options program (SHOP).