Q: How will Florida residents access the exchange and what kind of customer support will be offered?
A: Regardless of who runs the exchange, making sure that Floridians have ample guidance in selecting a plan is a key priority. Federal health officials are launching a website with chat capabilities and a 24 hour call center. Individual health companies will also offer their own customer support. Some health plans will have walk-in storefronts and mall kiosks for customers to talk to someone in person.
The new marketplaces are supposed to take the confusion and anxiety out of buying private health insurance for individuals and families who buy their coverage directly. Exchanges are meant to have the feel of an online travel site.
Under the new law, about 8 in 10 customers in the new marketplaces will be eligible for income-based federal aid to help pay their premiums.
Small businesses will have separate access to their own exchanges.
Q: How many plans will residents and small businesses have to choose from?
A: Florida lawmakers still have to decide whether they are going to allow every health care company that wants to offer a plan to be included or whether they will limit the number of plans. Some experts warn that shoppers make poor decisions when they have too many options.
"People make worse choices when they have too many unfettered choices and then it limits competition because people get confused and insurers can exploit that confusion to not compete fairly," said Jonathan Gruber, an economics professor at the Massachusetts Institute of Technology, who worked on Massachusetts' health law.
Q: How will health plans under the exchange differ from current health plans?
A: Plans participating in the marketplaces will have to cover a set of "essential" benefits, including hospitalization, doctor visits, prescriptions, prevention and care for pregnant women and young children. Cost to the consumer will be the main difference among plans, with four levels of coverage: bronze, silver, gold, and platinum. A consumer with a bronze plan will pay lower monthly premiums, but would face higher cost sharing for medical care.
That means some of the plans that Florida small businesses currently offer their employers may have to augment their plans to make sure they are covering those essential benefits. Deductibles, co-pays and premiums may also change.
For example, federal law says plans can't have a maximum deductible of more than $2,000, but experts say a lot of Florida plans have a $2,500 deductible.
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