What is the Guided Coverage Marketplace?

Guided Coverage Marketplace is an online benefits platform built specifically for individuals seeking to purchase health insurance. The award-winning and simple-to-use platform is an interactive decision-support tool that analyzes and recommends a personalized benefits solution based on an individual’s health care preferences, financial position, and risk tolerance.

Guided Coverage Marketplace is not affiliated with any specific carrier. You will have the ability to compare the recommended insurance options from national and regional health insurance companies as well as plans offered on the Public Exchange.

What is a Health Insurance Marketplace/Exchange?

A Health Insurance Marketplace (also known as an Exchange) is a way for individuals to shop for health insurance on their own. National and regional insurance carriers make their plans available to the public through the Marketplace.

How do I know which plan to choose?

The decision making tools ask questions about your health care needs, financial position, and risk tolerance. There are informational links throughout the enrollment process to explain your options. You can also create comparisons of the plan options that most interest you to help you select the plan that best meets your insurance needs.

When you’ve decided on the plan you want, just click the “Add to Cart” button. From the shopping cart, click the “Checkout” button and then “Apply” and continue to submit your application.

When can I enroll through the Guided Coverage Marketplace?

You can enroll in health insurance during Open Enrollment which begins on November 1, 2015 and ends on January 31, 2016. Coverage will be effective in 2016.

Are there any exceptions to when I could enroll outside of the Open Enrollment period?

Yes. You may be able to enroll outside of this time period if you have a Qualifying Event, which is a change in life status during the year. Examples are: losing coverage through an employer, marriage, divorce, birth, or adoption, or a change in number of dependents, or moving to a different state or out of your health plan’s coverage area.

If you have a Qualifying Event, you have 60 days from that event to enroll in new coverage. To avoid a gap in coverage, you should apply for coverage up to 45 days before your current insurance terminates. You can also enroll up to 60 days after your plan expires, during a “Special Enrollment Period.”

After the 60-day Special Enrollment Period, you may only enroll during the Open Enrollment period in November of 2015 for coverage that is effective in 2016. Unless you have a "Qualifying Event," you cannot enroll in a new health plan except during an Open Enrollment period.

To find out more about this, visit the Marketplace Resource Center.

When should I apply?

If you have a Qualifying Event, you can apply for coverage up to 45 days before your existing plan terminates. If you would like to avoid a gap in coverage, you should apply before your plan expires. It can take ten days or more to receive notification of approval from the insurance company.

What is a subsidy?

A subsidy is a credit from the government that can be applied to your monthly health insurance premium. Individuals under age 65 who are not eligible for coverage through their employer, Medicaid, or Medicare, can apply for a tax credit subsidy that is only available through the public exchange.

How will I know when my application has been accepted and I have insurance?

Once the carrier has received the premium, you will receive a welcome letter, ID card and plan details via mail or e-mail letting you know that the application has been accepted and your covered is in effect. Your coverage will be effective on the "Start Date" or "Effective Date" shown on your acceptance letter.

What are acceptable ways to pay my premium?

Payment terms can vary from state to state, and by carrier. Most insurers are required to accept money orders, personal checks, automatic bank transfers, and pre-paid debit cards. Many insurance companies do not accept credit or debit cards unless required by the state.

What happens if I forget to pay my premium?

It’s important that you pay your premium every month. However, if you happen to miss the due date, you have a grace period during which you can pay the premium and your insurance will still be in force. The grace period varies by carrier.

If you are receiving a premium tax credit and miss a payment, the insurance company must provide a 90-day grace period during which time past due premiums can be paid. After the 90-day grace period, your coverage may be terminated. Note: the grace period only applies if you have already paid at least one month’s premium.

I don’t go to the doctor very often. Am I required to have health care coverage?

Yes. Everyone is required to have health insurance, either through an employer, a government program like Medicare or Medicaid, or by purchasing coverage on your own. If you do not have health insurance coverage, you may have to pay a tax penalty.