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Insurance FAQs

General

  • A Multi-State Plan option is a high-quality plan offered on the Marketplace, under contract with OPM, the agency that administers health insurance for Federal employees.  OPM negotiates plan benefits, monitors plan performance, and oversees plan compliance with the Affordable Care Act, so you can be assured of consistent, quality coverage.   
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  • The Health Insurance Marketplace is a one-stop shop where you can compare prices on health plans, buy coverage, and obtain Federal subsidies if you qualify for them.  The Marketplace’s open enrollment period begins October 1, 2013, and continues through March 31, 2014.  Multi-State Plan options are offered in 2014, along with other approved plans on the Marketplace.  Individuals and small business owners can enroll directly through a website (HealthCare.gov or CuidadodeSalud.gov), as well as call 1-800-318-2596, a toll-free hotline available 24 hours, 7 days a week.  You can also seek help from Navigators and other neutral assistance personnel who can walk you through the Marketplace application.
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  • The Multi-State Plan (MSP) Program is a program created by the Affordable Care Act and implemented by OPM. OPM evaluates insurance plans submitted by private insurers and certifies plans as Multi-State Plan options for sale in the Health Insurance Marketplace. These plans will eventually be available to consumers in all States and the District of Columbia, after a phase-in period. OPM will monitor the plans’ performance in the market and oversee their compliance with the law, as well as the requirements of the plans’ contracts with OPM. MSP coverage will be available in the Marketplace beginning in January 2014.
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  • No.  Federal employees are eligible for the Federal Employees Health Benefits Program.  Multi-State Plan options are offered through the Marketplace, which can be found through your State or by going to www.HealthCare.gov.  However, both programs are run by the U.S. Office of Personnel Management and subject to the good customer service and oversight OPM provides.
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  • No, MSP options are not generally more expensive than other plans on the Marketplace.  However, the prices for all options on the Marketplace may vary depending on whether they are bronze, silver, or gold level plans.
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  • Insurers selected to offer coverage through the Multi-State Plan Program must be licensed in each State and are subject to all requirements of State law, except those that would prevent the application of provisions of the Affordable Care Act. OPM may set additional requirements for participating insurers in consultation with HHS.
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  • The Affordable Care Act allows for a phased-in approach to MSP coverage; insurers must offer coverage in all fifty States and the District of Columbia by year four of their participation in the program. Click here for a map detailing which states currently offer MSP coverage.
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  • OPM negotiates terms of coverage with each Multi-State Plan issuer, including medical-loss ratio, profit margin, premiums and provider networks. OPM may prohibit issuers from offering MSP options on the Marketplace that fail to meet these terms and conditions. 
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  • The Affordable Care Act requires OPM to contract with insurance companies to offer Multi-State Plan (MSP) options in every State and the District of Columbia.  OPM brings significant experience to this task, having administered the Federal Employees Health Benefits (FEHB) Program for more than 50 years.  The FEHB Program contracts with health insurance companies to offer a wide variety of FEHB coverage options to over 8 million Federal employees, annuitants, and family members across the country.  Consumers that purchase MSP coverage will benefit from OPM’s experience with contract negotiation and oversight of insurers. 
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