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Insurance FAQs

General

  • While the multi-state plan provision is intended to create nationwide coverage, the insurers are allowed to phase in the coverage, with coverage in 60% of the states in year one, 70% in year two, 85% in year three, and 100% in year four and each subsequent year.
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  • 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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  • A few MSP options have a nationwide network.  In future years, our goal is to expand reciprocity in plan options across State lines.
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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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  • OPM will negotiate 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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  • 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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