Exchanges are responsible for ensuring that health plans meet minimum criteria. The Exchanges must encourage insurers to compete for business based on the value of the benefits in their health plans, and the Exchange will publicize plan ratings on quality, price and enrollee satisfaction.
Exchanges will also be responsible for determining who is eligible for premium subsidies, certifying exemptions for people from the individual requirement, and sharing information with the IRS. They will also verify whether employees are eligible for premium subsidies through the Exchange because employer-sponsored coverage is not available to them. Further, Exchanges are required to help employers meet their requirements by providing information on their employees' enrollment in health plans through the Exchange.
Exchanges will make it easier to enroll in health plans by offering annual open enrollment periods, and developing a standard form that all people will use to enroll in insurance plans through the Exchange. The ACA also provides grants to consumer assistance programs and requires Exchanges to fund navigators (organizations that can help inform people about their coverage options) and help enroll eligible individuals in the health plan that's right for them.
For more information:
- How will Exchanges coordinate with state Medicaid and CHIP programs?
- How can Exchanges hold health plans more accountable?
- How do Exchanges improve health plan quality and value?