Businesses hear outline of health care changes

CHAMPAIGN — If you wonder how Illinois' health insurance marketplace is going to work for you, you're not alone.

With less than two months to go before the uninsured and small businesses can begin shopping on the exchange for health coverage Oct. 1, employers are still sorting out how the rules apply to large and small workplaces — and for some, which size category they fit into.

For consumers and businesses, Illinois' health insurance marketplace is a website that will go live when open enrollment begins Oct. 1, Amanda Kozar, regional outreach coordinator for the state's Health Insurance Marketplace, told local business representatives at a Champaign County Chamber of Commerce session Wednesday.

Chamber President and CEO Laura Weis said the local business community is clearly making efforts to keep up with rules that are rapidly changing.

"My perception is that we have a very educated business community on this issue," she said.

But employers are looking for definitive answers, Weis said.

"It's hard to prepare for something when you don't know what the rules are," she added.

Illinois will be seeking to enroll 486,000 people in health insurance for next year, according to information provided by the Chamber.

Through the online marketplace, the uninsured and small businesses will apply for and select commercial health coverage and the low income will apply for coverage through the state's expanded Medicaid program.

Open enrollment will be limited to Oct. 1 of this year through March 31, 2014. Enrollment by Dec. 15 will secure coverage starting Jan. 1, Kozar said.

All marketplace health plans must include 10 essential benefits including:

— Ambulatory patient services.

— Emergency services.

— Hospitalization.

— Maternity and newborn care.

— Mental health and substance-use disorder services, including behavioral health treatment.

— Prescription drugs.

— Rehabilitative and habilitative services and devices.

— Laboratory services.

— Preventive and wellness services and chronic disease management.

— Pediatric services.

Details on Illinois' various marketplace health plans aren't yet available, Kozar said.

Six insurance carriers applied to Illinois to provide 165 qualified health plans, Gov. Pat Quinn's office announced this past May.

The marketplace will be available to small businesses with 50 or fewer employees to shop for more affordable coverage through the Health Insurance Marketplace Small Business Heath Options Program — known as SHOP — and those plans will be available on the SHOP website by premium price and other plan features.

Requirements for large employees, with more than 50 full-time employees (working at least 30 hours a week) to provide affordable coverage have been delayed to 2015.

The best resource to find more information about the Affordable Care Act and marketplace is http://www.healthcare.gov, Kozar said.

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