VIRGINIA GOES SOLO

By Open Enrollment in 2023, Virginia will have its “own” Health Insurance Exchange (marketplace).  Although every state must have an exchange, most (33) run their marketplace on a federally-run I.T. platform. The other 17 states run on independent platforms of their own.  In the fall of 2023, Virginia will become the eighteenth to take advantage of independence and greater flexibility to serve the needs of its population. The first question most Virginians ask themselves is, “How will this affect me?”  The best person to answer is a qualified health insurance adviser experienced in helping clients find the most affordable plan that meets or exceeds their expectations. Most likely, you are among the four-and-a-half million Virginians (53%), members of a group (employers) scheme.  You may not deal directly with the exchange, but your employers do.  They will probably find a more comprehensive range of options, prices, and more providers.  For the year 22/23, Virginia had 12 named insurance providers.  In 23/24, this is expected to go up to become even more competitive. The recently introduced reinsurance program (enabling the state to accept elements of the insurance risks) has reduced the average insurance premium (your monthly payment) by double-digit figures (about 12%).  It will continue through 2024 on the new platform. Excluding military members, about three-and-a-half million Virginian citizens will have direct contact with the new Health Benefit Exchange and access to an improved enrollment system dedicated to the people of Virginia. From the plan year 2024 (O.E. November 1^st– January 15^th), Virginians can search for and compare health insurance plans that are both affordable and appropriate to their needs.  It will cost nothing and save you time to have a health insurance advisor on your side.  You will be confident that you have explored all the options. The Virginia Health Benefit Exchange (a division of the State Corporation Commission) runs the marketplace.  It ensures all the plans on the market meet the Affordable Care Act (ACA.)  For qualified plans, the exchange will offer financial assistance such as premium tax credits and cost-sharing reductions. (scc.virginia.gov/pages/Health-Benefit-Exchange) Virginia has been the leader in letting self-employed individuals be treated as a “group of one,” i.e., to have the advantages usually only available to larger groups and to enroll during the year, not just during open enrollment. ‘Groups’ typically have access to more extensive networks of care providers. According to the latest federal data, there are 356,00 self-employed people in Virginia, many of whom will benefit from lower premium costs (or enhanced coverage) and the new freedom from federal control.  If you are self-employed or thinking about it, consider the coverage and tax benefits to you and your family as a “group of one.” Even if you are included in your employer’s plan, you could be even better off if someone in your family has the right to group coverage or is self-employed. Just under 2 million Virginians are enrolled in Medicare or Medicaid, and nearly 200 thousand are enrolled in both.  It is part of the Benefit Exchange’s mission that they receive the benefits to which they are entitled and access to affordable supplementary plans, e.g., dental. Medicare and Medicaid schemes are designed to help senior and specific disadvantaged groups.  However, they do not cover all the healthcare costs associated with chronic (long-term) illnesses or aging.  Well-chosen supplementary insurance can help to have these expenses.  Your health insurance advisor can help you make your healthcare dollar go further. The next question is -Who pays? The insurance companies pay the federal government an income-related fee (typically.  2.75%) for participating in the federal exchange.  These fees will now come to the Virginia Bureau of Insurance to fund the Virginia Health Benefit Exchange and be reinvested in state health programs. A final question will probably be, “It’s a new system.  Can we trust it?” The answer will be a definite YES!  Virginia follows the examples of Maine, Kentucky, and New Mexico when they transitioned from using the HealthCare.gov enrollment platform to state-run exchanges. The Virginia Bureau of Insurance has commissioned a specially designed system created by Get insured and already used by New Jersey and Pennsylvania. Perhaps you have become accustomed to letting your health insurance plans “roll over” from one year to the next.  Virginia Health Benefit Exchange is changing the landscape of health insurance.  Those changes are your opportunities. The 2023-2024 Open Enrolment is a unique opportunity to review your and your dependents’ healthcare needs with a qualified health insurance specialist and shop confidently in the new market.  The service is free, but the time spent could save you thousands of dollars and just as many regrets.