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Marketplace (ACA)

 

Marketplace (ACA)

  • The marketplace, also known as ACA or U65 (Under 65), may seem shrouded in mystery with its various names.
  • Simply put, the Marketplace is shorthand for the “Health Insurance Marketplace ®,” a service for shopping and enrolling in medical insurance.
  • It was created by the Affordable Care Act in 2010.
Marketplace (ACA)

Marketplace explained

Get ready because here's the big reveal we've all been waiting for!

  • In simple terms, the Marketplace is like an online store or catalog for health insurance, set up and funded by the U.S. government. It's where all U.S. citizens can go to see and compare their insurance options. The Marketplace shows plans for regular-income folks and also shows offered discounted plans from carriers for lower-income individuals who qualify for a tax credit. 
  • Some insurance carriers choose to participate in the Marketplace, while others do not. If a carrier does not participate, it simply means that they have chosen not to have their policies displayed on the Marketplace website. In such cases, you may need to explore their policy options through alternative means, such as contacting the carrier directly.
  • The Marketplace empowers you to view policies from different carriers and compare them side by side based on your information. Essentially, it's a health insurance quote webpage funded by the government. Tax dollars are well spent here because it fosters transparency, allowing for easy comparison of insurance carriers and policies. Plus, you can receive instant quotes—a valuable resource for citizens navigating the complexities of insurance.

Demystifying the Affordable Care Act, the Marketplace, and Premium Tax Credits

Let's untangle a common misconception: the relationship between the Affordable Care Act (ACA), the Health Insurance Marketplace, and premium tax credits.

  • The ACA, also known as Obamacare, is a landmark healthcare reform law passed in 2010. Among its provisions is the creation of the Health Insurance Marketplace, an online platform where individuals and families can shop for and enroll in health insurance plans that comply with ACA standards.
  • Now, here's where it gets interesting: while the Marketplace is the place to go for exploring insurance options, it's not the one doling out premium tax credits. That job falls to the IRS. Premium tax credits are financial assistance provided by the IRS to help eligible individuals and families afford health insurance premiums.
  • So, how does the Marketplace fit into all of this? It's like the middleman, showing you whether you're eligible for premium tax credits based on your income and household size. Think of it as your guide, pointing you in the right direction.
  • But here's the kicker: even if you don't qualify for any tax credits from the IRS, the Marketplace still shows you policies from carriers. These are not special or specific to only the Marketplace but rather represent a range of options available in the insurance market.

 

Marketplace (ACA)
Marketplace (ACA)

So, what is the Marketplace?

The Marketplace is the only government-owned insurance market search engine, akin to Google or Bing, legally permitted to collect your personal tax information. This data is used to determine your eligibility for a premium tax credit from the IRS. While private insurance websites exist, only the Marketplace has the authority to provide an official IRS determination regarding tax credit eligibility.

Carriers have the discretion to decide whether they want to participate in the Marketplace and accept the government's terms for offering discounted policies to qualified individuals. Regardless of whether you qualify for a premium tax credit or not, the Marketplace is an insurance search engine and will still show you policy options from carriers participating in the Marketplace. This ensures that individuals have access to a range of insurance options, regardless of their eligibility for subsidies.

A few Marketplace participants 

Several carriers have chosen to participate in the Marketplace and accept the government's terms for providing discounted policies to qualified individuals. Here are a few examples:

  • United Healthcare

  • Aetna

  • Humana

  • Cigna

  • BlueCross BlueShield

  • Ambetter

Ready to sign up? 

Filling out an application is easy!

You will need the following information in order to fill out an application.

  • Information about your household size. Figure out who in your household will apply together before you start your application.
  • Home and/or mailing addresses for everyone applying for coverage.
  • Information about everyone in your household, like Social Security Numbers and birth dates.
  • Information about the professional helping you apply, if you’re getting help completing your application. This could be an agent, broker, or assistant.
  •  Information on how you plan to file your 2024 taxes.
  • Employer and income information for every member of your household (like from pay stubs or W-2s).
  • Your best estimate of what your household income will be in 2024.
  • Policy numbers for any current health plans covering members of your household.
  • Information about any job-based plan you or someone in your household is eligible for. You can use the Employer Coverage Tool to help collect this information. (You’ll want to fill out this worksheet even for coverage you’re eligible for but don’t enroll in.)
  • Notices from your current plan that include your plan ID, if you have or had 2023 Marketplace coverage.
  • Document information for legal immigrants and naturalized citizens.

 

Self-enroll: 

Simply click the link below to self-quote and self-enroll into an ACA marketplace plan via the Healthsherpa marketplace enrollment tool. 

 

Health & Life (1)

Alternatively 

If you would like to insure full accuracy and a worry free enrollment, please fill out the contact form below and a licensed broker will reach out to you as soon as possible. 

Helpful links:

The official website of the U.S. governments Healthcare.gov 

The official website of the U.S. governments IRS

You can use both sites to find information on your 1095-A form. 

What is a 1095-A form?

The Health Insurance Marketplace issues the 1095-A form on behalf of the IRS. The Marketplace provides this form to individuals enrolled in a qualified health insurance plan through the Marketplace. It contains information about the coverage you had during the previous tax year, including details such as the months you were covered, the premiums paid, and any premium tax credits received. You'll use the information on this form to complete your tax return and reconcile any advance premium tax credits you received with the actual amount you were eligible for based on your income.

 
 

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