An update on important deadlines—and how members are using the health care online marketplace. ON NOV. 1, 2013, THE STATE BAR OF TEXAS LAUNCHED THE TEXAS BAR PRIVATE INSURANCE EXCHANGE, a multi-carrier private exchange designed exclusively for its members and their staff and dependents. For some time, the State Bar of Texas Insurance/Member Benefits Subcommittee had explored implementing a private exchange to provide bar members with assistance in making health insurance choices. After carefully evaluating and comparing an array of private exchange models developed by thirdparty administrators and health insurance carriers offered by other state bars across the country, the subcommittee selected Member Benefits Inc. to administer the Texas Bar Private Insurance Exchange. The Florida-based company has a history of more than 30 years of running successful association programs, including work for the Florida Bar and the State Bar of Georgia. Member Benefits Inc. developed the Texas Bar Private Insurance Exchange to serve as an online marketplace where members can compare plans from multiple competing providers. The new private exchange offers plans from carriers that are not available through the federal public exchange, which features four basic plans (bronze, silver, gold, and platinum) that are qualified by the guidelines set forth in the Affordable Care Act. The Texas Bar Private Insurance Exchange works to help members compare and customize the coverage that is best for them and offers both individuals and employer groups a wide range of health insurance options, including access to and choices from: • The public exchange • The private exchange • Non-qualified health plans (plans that do not meet the ACA requirement of providing minimum essential coverage) The Texas Bar Private Insurance Exchange is divided into two extranet portal components—one for individuals and small employers with fewer than five employees and another for employers with five or more employees. Features include multiple insurance provider options; voluntary products such as dental, vision, disability, and term life; and additional customization options like cafeteria plans and defined contributions. “The third party administrator that we picked has great technology,” said Tim Kelly, chairman of the State Bar of Texas Insurance/Member Benefits Subcommittee. “You can go enroll yourself, pick the options that you want, and it will tell you what your total is, and off you go.” HOW THE TEXAS BAR PRIVATE INSURANCE EXCHANGE WORKS WITH THE PUBLIC EXCHANGE The State Bar of Texas recognizes that not all bar members will need to or want to pursue coverage through the private exchange. With the federal public exchange website, healthcare.gov, now up, the licensed benefits counselors at the Texas Bar Private Insurance Exchange are assisting bar members, spouses, and employees of members who may qualify for a government subsidized plan through the federal exchange, or marketplace. A simple calculator used during the private exchange registration process helps members determine if they qualify for subsidized coverage. If they do, counselors are available to assist with the government application and in selecting coverage through the federal marketplace. This free and optional service allows members to receive advice when making insurance decisions. HOW THE TEXAS BAR PRIVATE INSURANCE EXCHANGE WORKS FOR INDIVIDUALS Those seeking alternatives to the public exchange might consider choosing the private exchange. Since the Texas Bar Private Insurance Exchange’s fall 2013 launch, more than 4,000 bar members have created accounts using the online individual portal. There, they are able to view plans from a variety of qualified health insurance providers, compare benefits and costs, and make purchasing decisions based on their specific health needs and budgets. With assistance from benefits counselors, members evaluate how to best move forward with health insurance decisions. New carriers and products are continually being added to the list of member options as more information becomes available. Aetna, Blue Cross Blue Shield of Texas, Cigna, and Humana currently all offer plans, and new options from Scott & White and United are expected to be available this month. Additionally, the number of non-qualified options increases in January, providing members with even more options. Certain non-qualified plans, which don’t meet all the requirements the law provides, might be a preferred option for some State Bar members. An example would be a plan that is designed to cover catastrophic expenses. Because non-qualified plans don’t meet the requirements of the ACA, consumers who choose this option must pay a tax. However, the combined cost of the tax and lower premium may be lower than the premium for a qualified plan. “Not all health care providers are going to even offer their products through the public exchange,” said Kelly. “With the State Bar Private Insurance Exchange, we get more health care choices in terms of providers.” Currently, health insurance companies are accepting enrollments through the private exchange for a sixmonth period, ending March 31, 2014, for coverage effective dates starting in 2014. A special enrollment period may be opened thereafter to those with qualifying circumstances. Some important private exchange deadlines to consider during open enrollment: HOW THE TEXAS BAR PRIVATE INSURANCE EXCHANGE WORKS FOR EMPLOYER GROUPS The State Bar Private Insurance Exchange allows the option for employers to offer alternative health insurance choices to their employees. Just as all employees are unique, so are their benefit needs. The private exchange gives employers with five or more enrolled employees a way to address the different requirements of each employee, while also managing the company’s bottom line. Member Benefits Inc. states that this results in cost control and predictability for the employer—and greater involvement and choice for the employee. Employers that set up a private exchange account can define a contribution strategy and allow employees to log in and shop for their own benefits. Once employers set guidelines, employees may receive enrollment assistance from benefits counselors and will also have the opportunity, if qualified, to access subsidized coverage through the federal public exchange, healthcare.gov. Interested employers can now access: • A cost and benefit analysis comparing private exchange health plans to their existing group health plan, if applicable; • A live demonstration of the private exchange employer portal; and • A proposal including all costs and benefits included with the private exchange. For more information about the Texas Bar Private Insurance Exchange, call (800) 282-8626 or go to texasbar.memberbenefits.com. To get updates on specific plan information and enrollment periods, connect with the State Bar of Texas on Twitter (@statebaroftexas) and Facebook.
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