Five Functions the exchanges offer:
- Consumer assistance – Staff will manage the exchange website and call centers. “Navigators” will help consumers use the exchanges. These are not licensed agents or brokers.
- Plan management – Consumers will be able to choose QFP’s sold on exchanges and see important date for QHP.
- Eligibility – Applicant information is collected and verified to determine eligibility for enrollment, tax credits or subsidies.
- Enrollment – Staff (not licensed agents or brokers) will help consumers enroll and send information to health plans as well as transmit information related to premium tax credits and cost-sharing reductions as required by HHS. (Health and Human Services)
Financial Management – Exchanges will perform several financial functions including handling user fees, risk adjustment, reinsurance and risk corridor programs (this program runs from 2014 – 2016 and give HHS governance over refunds and charges for QHP’s that go over or under projected costs).
