Health Insurance Marketplace 

 

The Health Insurance Marketplace was developed as a result of the Affordable Care Act (ACA), which requires individuals to have health insurance whether through an employer sponsored plan or an individual/family plan available on the Marketplace.  

 

2019 Facts:

  • 2019 Marketplace payers - BCBSTX, Molina, Community Health Choice, and Superior Health Plan (Ambetter)
  • The health law has NOT been repealed.
  • The requirement for most people to have insurance — and most employers to offer it — is also still in effect, but the tax penalty for not enrolling has been repealed effective 1/1/2019.
  • Subsidies for premiums and copays/deductibles for consumers are still in effect for Silver plans.
  • To learn more go to: www.healthcare.gov
  • For income tax filing requirements, visit the IRS website
  • The ACA established that a set of essential health care services must be covered by certain plans, effective in 2014. 
  • Important dealines
 

90 Day Grace Period

  • Under ACA, marketplace regulations give patients with subsidized health insurance coverage three months to pay their premiums and allow health plans to deny or later recoup payments from doctors for services provided to patients who are delinquent. The patients must have paid at least their first month's premium to be eligible for that 90-day grace period. AMA Understanding the ACA Grace Period.


Resources

  • HCMS
    • Health Insurance Marketplace Grid - Provides information regarding each plan offered in the Harris County area including summary of benefits, sample insurance cards, and information regarding the 90 day grace period.