FAQ

I have coverage through my spouse. Do I need to do anything?
What do state exchanges do?
Who is eligible to buy insurance through a state exchange?
Should I look for a plan on the exchange? Would I get better options than my benefits?
If I have family members who are not eligible for Ardent's or another company’s benefits, how do I help them get coverage?
Which states have an exchange and which don’t?
How are state exchanges financed?
What are subsidies for people who can’t afford insurance?
What are the minimum requirements for plans offered through the exchanges?
Are there specific dates when can people buy from exchanges?

I have coverage through my spouse. Do I need to do anything?

You don’t need to take any action if you are happy with your plan.

Back to top

What do state exchanges do?

A state exchange is like an online mall operator, setting up the infrastructure and ensuring good quality merchandise for customers. The law requires exchanges to do specific things on behalf of Americans:

  • Review and certify that the health plans they offer meet minimum standards (also called qualified health plans) and rate each plan based on quality and price.
  • Maintain a website with tools that allow shoppers to compare cost and quality and purchase a plan, plus operate a toll-free hotline for questions.
  • Help plans communicate in a timely way with buyers in plain language on cost sharing, payments, claims policies/procedures, value and participants’ rights.

Back to top

Who is eligible to buy insurance through a state exchange?

The health insurance marketplaces are intended for people who can’t get affordable coverage through their work and for employees of small businesses.

However, anyone can shop in the marketplace. Since you have affordable coverage available through Ardent, you are not eligible for a premium tax subsidy. And we’re fairly confident that you won’t find anything that beats our plan.

Back to top

Should I look for a plan on the exchange? Would I get better options than my benefits?

You have affordable coverage available to you through Ardent. However, you might hear that you can get a better deal elsewhere on the health insurance marketplace. We’ve looked in a general way at what’s available, and we’re pretty confident that you’ll come out ahead financially by sticking with our plans. If you decide to explore the marketplace options, use this form to complete your application.

Back to top

If I have family members who are not eligible for Ardent's or another company’s benefits, how do I help them get coverage?

For those friends and family who need to find health insurance, this overview of the health insurance marketplace can help you get started.

Back to top

Which states have an exchange and which don’t?

States have had three options: set up an exchange, operate the exchange in partnership with the federal government or let the government operate the exchange.

The Obama administration approved 15 states and the District of Columbia to operate exchanges, which offer one-stop shopping for private insurance or Medicaid. By 2019, these exchanges are expected to provide up to 29 million people with affordable care. The approved states are: California, Colorado, Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Vermont and Washington.

The states that have partnered with the government to operate exchanges are: Arkansas, Delaware, Illinois, Iowa, Michigan, New Hampshire and West Virginia.

The remaining states have let the federal government operate an exchange, with no help or funding from the state. They are: Alabama, Alaska, Arizona, Florida, Georgia, Indiana, Kansas, Louisiana, Maine, Mississippi, Missouri, Montana, Nebraska, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin and Wyoming.

Back to top

How are state exchanges financed?

States can charge user fees, taxes or other means to finance the exchange. Each state exchange had to be self-sustaining by 2015. Nearly all states have financed the marketplace with a tax or surcharge on premiums that insurers pass on to policyholders.

Back to top

What are subsidies for people who can’t afford insurance?

Affordable coverage has a very technical definition. Of course, what is affordable to one person may not be affordable to another, depending on income and priorities. People who don’t have access to affordable coverage through their job can apply for coverage through a state exchange to determine whether or not they are eligible for a premium tax credit to help pay the premiums. The credit is basically a cash advance to help cover part of the health insurance premium. The advance may have to be returned if a person becomes ineligible. The exact amount of the credit is determined by the state exchange. If you decide to explore your state’s marketplace options, use this form to complete your application. If you are benefits eligible, you have affordable coverage through Ardent and therefore, you are not eligible for a premium tax credit.

Back to top

What are the minimum requirements for plans offered through the exchanges?

State exchanges are required to certify that each health plan offered through the Health Insurance Marketplace meets qualified health plan standards.

Back to top

Are there specific dates when people can buy from exchanges?

Yes, annual enrollment is typically from October 1 through March 31. People who select a plan by the 15th of the month will be covered starting the following month. However, there are special enrollment periods for people to buy through an exchange—for example, 60 days after the loss of other coverage.

Back to top