What is the difference between a Public exchange and a Private exchange?

The Affordable Care Act provides public exchanges (or marketplaces).  You as a consumer have the option to shop for your health insurance through either type of exchange and there are pros and cons associated with both.  The REALTORS® Insurance Marketplace (RIM) offers both exchanges (public and private).

Below is a snapshot of the differences between the Public and Private:

Marketplace Differences

Public

Private

Who sponsors it? Government entity – either a state or the federal government.  Depending on where you live; each state has decided to build its own exchange or default to the Federal.  Insurance agents can offer and enroll consumers into the public exchange. Private company such as the NAR Members health insurance exchange.
What does it offer? Primarily health, dental, and/or vision insurance through multiple carriers which have been approved by the government. Health, dental, vision, plus an array of other insurance products ranging from supplemental to life to critical illness to more – through multiple carriers
Who uses it? Primarily individuals buying insurance and small businesses with up to 100 employees Primarily individuals, self-employed people, employees, and retirees of sponsoring organizations.
Who pays? Consumer, small employer, or both (federal subsidies are available to individuals with household incomes up to 400% of federal poverty level). Consumers (both employed and self-employed individuals) and employers
Is coverage Guaranteed Acceptance? Yes, all plans on the public and private exchanges are guaranteed acceptance (meaning you cannot be turned down based on medical history). Yes, all plans on the public and private exchanges are guaranteed acceptance (meaning you cannot be turned down based on medical history).
 “What types of plans are offered?”  All plans must include minimum essential health benefits.  Plans are from various insurance companies and will offer five levels; Catastrophic (Only available to individuals under the age of 30), Bronze, Silver, Gold, and Platinum. All plans must include minimum essential health benefits.  Plans will vary based on plan design, geographical location, and insurance company.  You will find different insurance companies and offerings on private exchanges.  Many insurance companies have opted out of public exchanges.
Will all insurance companies from my state be represented on each exchange?  I guess the point we are trying to make here is that it is beneficial to explore both public and private exchanges.  No. Some insurance companies have decided to be on the public exchange, others on the private exchange, and still others on both. It is beneficial to explore both public and private exchanges.

No. Some insurance companies have decided to be on the public exchange, others on the private exchange, and still others on both. It is beneficial to explore both public and private exchanges.

In general, private exchanges will offer more selection and options (more plan designs), which means lower costs.  However, you cannot get a subsidy on a private exchange – only on a public exchange.

To see what your state is doing regarding public marketplace (exchange) you should register for a quote on the www.RealtorsInsuranceMarketplace.com website.  We encourage you to contact a licensed SASid representative at 877-267-3752 who will help you decide which exchange (public or private) and/or health plan best suits your needs.

How does REALTORS® Health Insurance Marketplace work?

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REALTORS® Insurance Marketplace makes health insurance easy to understand and convenient to buy. The Marketplace is a comparative shopping site that provides NAR members with a roster of health, dental, vision, and supplemental insurance plans and products, including a private Major Medical health insurance exchange, just for NAR members.

The private Members Health Insurance Exchange is an easy-to-use mini-site within this website. Here, members can easily obtain quotes and purchase insurance directly online or over the phone with assistance from a licensed benefits specialist.

Here’s how it works:

  • Insert your geographic and demographic information into the Marketplace quoting engine.
  • Based on the information you’ve provided, you will be shown the options available to you on both NAR’s private exchange for members, and either the federal government exchange or your state-based exchange. You can quote, shop, and enroll directly online.
  • If you would like assistance you can call a licensed benefit specialist at 877-267-3752. They are available to you both during the enrollment process and afterwards as well, if you need help later on. Personal consultations are always complimentary.