What is the Pearl Health Care Exchange?
The Pearl Health Care Exchange is a private exchange marketplace where members and employers can shop for affordable insurance for themselves and their families.
Who can enroll in the Pearl Health Care Exchange?
All ACS Members and their families are eligible during the annual Open Enrollment Period from November 1 through December 15. To enroll outside of the Open Enrollment Period, you must experience one of the following life-changing events:
- Graduating from college and losing your student health plan
- Moving to a new home – you may be able to sign up for a new health plan if different plans are available in the area you move to
- Getting married
- Having a baby or adopting a child
- Turning 26 years old – you have 60 days from the day your coverage under your parent’s plan ends to find a new plan
What is the difference between a public and a private exchange?
A public exchange is set up through the federal or state government, or a combination of both. Health insurance companies or brokerage firms set up private exchanges. You may not feel completely equipped to take on the responsibility of choosing your own health insurance on a public exchange. A variety of options is wonderful, but can sometimes become overwhelming when tasked with making an informed decision in a complex marketplace. The Pearl Health Care Exchange offers support that extends beyond the online portal. Licensed advisors will work with you and make plan recommendations based on your specific needs.
I have insurance through my employer. Can I still get coverage from the exchange?
Yes. During the open enrollment period, you are free to compare plans and pricing available on public or private exchanges with the coverage available through your employer.
What is a subsidy, and do I qualify?
The Affordable Care Act created government subsidies to help lower and middle-income families pay for health insurance. These subsidies help pay for monthly health insurance premiums, as well as health insurance costs, such as co-insurance, copays, and deductibles. Eligibility for a health insurance subsidy is based on comparing your income to the federal poverty level. The federal poverty level changes every year, and is based on your income and your family size. You can estimate your tax subsidy and apply your savings directly to the plans offered on the exchange.
Will I be turned down for a pre-existing health condition?
Most plans offered after January 1, 2016 cannot refuse to cover you or charge you a higher premium based on a pre-existing health condition. This remains true through the public as well as the private health care exchanges.
What if I have additional questions?
We have benefits counselors available to answer your questions for you.
Is the private exchange available in all states?
No, not at this time. Due to complexities and differences in health insurance providers and the public exchange rules in each state, the health insurance products offered through the Pearl Health Care Exchange are not available in all states. State availability for the Short Term Health Plan is listed above. Residents in the following states are eligible for the Major Medical Exchange: AR, CA, CO, FL, GA, HI, IL, IN, IA, KS, KY, LA, MD, MI, MS, MO, MT, NE, NV, NH, NJ, NM, ND, OH, OK, OR, SD, TX, UT, VA, WI, WY.