Georgia Health Insurance Exchange Guide

This guide provides an overview of the Georgia health insurance exchange, including the history of the exchange, how the exchange will operate, and exchange information for Georgia residents and small businesses.

Georgia health insurance exchange introduction

As part of the Affordable Care Act (ACA), health insurance coverage for individuals and small businesses became available through new state health insurance exchanges (also called health insurance marketplaces) in 2014.

Most importantly, the key tax credits (e.g., the small business health care tax credits) and tax subsidies (e.g., individual health insurance premium tax subsidies) will only be available for coverage purchased through state health insurance exchanges.

All states had three options for setting up a state health insurance exchange in 2014:

1. Build a state-based exchange
2. Enter into a state-federal partnership exchange
3. Default to a federally-facilitated exchange

Georgia defaulted to a federally-facilitated health insurance exchange in 2014. However, the state created a new state-based exchange, Georgia Access, opening in November 2024.

Georgia health insurance exchange - history

Originally, Georgia Governor Nathan Deal signed an Executive Order in June 2011 to create the Georgia Health Exchange Advisory Committee. The purpose of the committee was to recommend how Georgia should offer a health insurance exchange. The committee released a set of reports recommending a structure for a state-based exchange. However, on November 16, 2012, the Governor's office released an announcement that Georgia would default to the federally-facilitated exchange citing cost and lack of federal guidance.

Now, a decade later, Georgia Access is opening for open enrollment in 2024.

Georgia Access - What is it?

Georgia Access will be operated through a stated-run health insurance exchange. Starting in November 2024, Georgia residents will be able to access information about all the plans available through the exchange. The SHOP exchange will also be available to small businesses with 50 or fewer employees. Coverage from the exchange starts in January 2025.

Georgia health insurance exchange - What plans will be available?

All plans offered through Georgia Access will meet the ACA definition of a qualified health plan (QHP). The plans will be offered by metal level of coverage for essential health benefits (EHB), to allow consumers to compare plans on an "apples to apples" basis.

The four metal levels are:

• Bronze (plan pays 60%)
• Silver (plan pays 70%)
• Gold (plan pays 80%)
• Platinum (plan pays 90%).

Georgia Health Insurance Exchange - Role of Insurance Professionals & Navigators

Georgia Access will follow federal guidelines for insurance professionals selling policies through the exchange and for navigators assisting consumers and small businesses.

Insurance professionals will be able to register with Georgia Access and receive any commissions directly from the carriers (using their Exchange ID number and NPN).

The Georgia navigator program will assist consumers in making choices about their healthcare options and accessing their new healthcare coverage, including access to premium tax credits for some consumers.

This blog post was originally published on May 20, 2013. It was updated on October 17, 2024, to mention Georgia's new state-based exchange, George Access.