Starting in 2014, as part of the Affordable Care Act (ACA), health insurance coverage for individuals and small businesses will become available through new state health insurance exchanges. As a recap, all states have three options for setting up a state health insurance exchange for 2014:
Kentucky plans to offer a state-based exchange called Kentucky Health Benefit Exchange. The Exchange will open in October 2013, for coverage starting January 1, 2013.
The Kentucky Health Benefit Exchange will operate as an online marketplace where individual Kentuckians and employees of small businesses can comparison shop for health insurance based on cost, benefits and quality. The Exchange will also allow individuals and businesses to apply for premium subsidies and tax credits, and learn if they are eligible for public coverage under Medicaid or the Kentucky Children's Health Insurance Program (KCHIP). Initially, the small business marketplace (SHOP) will be for employers with 50 or less employees.
Approximately 640,000 Kentuckians are uninsured (approximately 15% of the population).
On July 17, 2012, Governor Steven L. Beshear issued Executive Order 587 establishing the Kentucky Health Benefit Exchange after the Supreme Court ruled to uphold the Affordable Care Act (ACA). The Executive Order establishes the Office of the Kentucky Health Benefit Exchange “within the Cabinet for Health and Family Services.” On December 14, 2012, Kentucky received conditional approval from the U.S. Department of Health and Human Services (HHS) to establish a state-based exchange.
Formal information has not yet been released on the role of agents and brokers with the Exchange. However, it is expected that producers will be allowed to sell policies offered through the Kentucky Health Insurance Exchange, and receive commissions directly from the carrier. It is also expected that producers will need to register, attend training and be certified to sell policies offered on the Exchange.
Under the ACA a Navigator program is required to provide educational materials and assistance to individuals and small businesses accessing the new online health insurance marketplace. Kentucky is currently developing a Navigator program in accordance with federal requirements. According to the Exchange website, Navigators will play a large role with outreach efforts in all 120 counties.