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Frequently Asked Questions

 

How will the Health Benefits Exchange help Rhode Islanders?

The Exchange will be a tool for Rhode Islanders, small businesses and their employees to easily compare health insurance options, learn if they qualify for discounts, and eventually sign up for other programs.

Most people will connect with the Exchange through a website, but they'll also be able to get help on the phone, in the community, and at government offices.

Over time, the Exchange will play an important role in helping all Rhode Islanders stay healthy by making it easier to get quality health care at a reasonable, predictable price.

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What can Rhode Islanders look forward to when the Exchange opens?

  • Great Customer Service: Confused about your health insurance options? Want someone to walk you through the process? We'll have people available on the phone, in person, and online, ready to help.
  • Easy to Use: The Exchange will make buying health insurance as easy as shopping online or buying from a catalog.
  • Affordability: The Exchange will offer discounts to Rhode Islanders that can't afford health insurance. Over time, it will also play a crucial role in improving the cost and quality of health care in this state.

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Who can use the Exchange?

Everyone can. Even if you have insurance, you can use the Exchange as a tool for learning about benefits and evaluating whether your health insurance is affordable.

Rhode Islanders who may buy insurance on the Exchange include:

  • Rhode Islanders who don't have health insurance from an employer
  • Employees that can't get affordable health insurance through their jobs
  • Small businesses

In the future, the Rhode Island Exchange might open up to bigger businesses and more people.

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How will the Exchange help small businesses?

Any small business owner knows that buying employee health insurance is confusing and expensive. You have little to no bargaining power over the cost of health insurance. Changes in the health and age of your employees can dramatically affect the price of coverage and it's difficult to find a plan that meets everyone's needs.

Rhode Island's Exchange is here to help. When small businesses purchase plans on the Exchange, their employees will be able to pick the health plan that works best for them.

Some business with less than 25 full time workers already qualify for tax credits if they offer affordable health insurance for their employees. The tax credits are worth up to 35% of the cost of premiums and rise to 50% in 2014.

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What if I get my health insurance at work and want to keep my current plan?

If you get insurance through your job, nothing will change. But, just as before the law was passed, your employer can always offer different health insurance options. If those options become unaffordable, you can check out the Exchange for a better deal.

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How does the Exchange make health insurance more affordable?

The Exchange helps Rhode Islanders afford health insurance in short term and long term ways. Let's start with the short term:

  • tax credits for private health insurance: Some Rhode Islanders will be eligible for "sliding scale" tax credits for private health insurance. These discounts come in the form of tax credits and they're designed to make health insurance more affordable.
  • Expanding RIte Care – Rhode Island's Public Health Insurance Program: Pending approval in 2014, some low income residents without children will qualify for Rhode Island's high quality health insurance program for children and families. RIte Care will offer free and low cost insurance to Rhode Islanders depending on their income.

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What kind of tax credits can Rhode Islanders expect?

Rhode Island will use income and family size to determine who qualifies for these health insurance "discounts". Prices for health insurance will vary by person's age and the type of plan they want to buy, but here's a good example of what Rhode Islanders can expect.

Let's use the example of a 45 year old who is married with two kids and wants a plan that pays for 70% of her medical services.

Here's an estimate of how the tax credits might lower the monthly cost of insurance for that family of four depending on their income:

Table 1. Federal Health Insurance tax credits for a Family of Four by Income

Annual Income
Monthly cost of insurance WITHOUT subsidy
Monthly cost of insurance AFTER subsidy
Total monthly savings/subsidy
$35,137
$1,187
$117
$1,070
$46,850
$1,187
$246
$941
$70,275
$1,187
$556
$631
$93,700
$1,187
$742
$445

Note: this example does not include the value of additional cost-sharing tax credits which the Affordable Care Act also provides.
Kaiser Family Foundation Subsidy calculator accessed at: http://healthreform.kff.org/SubsidyCalculator

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How will the Exchange reduce health care costs in the long run?

The Exchange's goal is to both offer tax credits and help slow down the rising cost of health insurance. How will that work? The Exchange will become a key tool for putting pressure on the health care system to make wiser and less expensive decisions. This is part of a larger collaboration that makes sure people are getting the right care in the right place at the right time.

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How will Rhode Island pay for the Exchange?

Federal funds are supporting the planning, establishment and initial operations of the Exchange through the end of 2014 (one year after the Exchange opens). After that, the Exchange must find a way to raise its own money for staff, supplies, and rent. Exchange board and staff is now weighing different options to ensure its success well into the future. tax credits for health insurance will continue to come from federal funds.

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