Hereís a quick rundown
on the most important things to know about the
Health Insurance Marketplace, sometimes known as the
health insurance ďexchange.Ē Follow the links for
more information on each topic.
The new Health
Insurance Marketplace helps uninsured people find
health coverage. When you fill out the
Marketplace application it will tell you if you
No matter where you live, you can use the
In Michigan, the
Marketplace is run by the Federal government.
assists Michigan residents with enrolling in the
Marketplace and in locating in-person assisters who
can guide you through the process.
Most people must have had health coverage in 2014 or
they pay a fee.
you didnít have coverage in 2016, youíll pay the
higher of these two amounts at the filing of
your 2016 federal tax return:
2.5% of your yearly household income.
(Only the amount of income above the tax filing
threshold, about $10,000 for an individual, is
used to calculate the penalty.) The maximum
penalty is the national average premium for a
If you donít have coverage in 2016,
youíll pay the higher of these two amounts:
2% of your yearly household income.
Using the percentage method, only the part of
your household income thatís above the yearly
tax filing threshold ($10,150 for individuals,
$20,300 for couples filing jointly in 2014, the
most recent year available) is counted.
The maximum penalty is the national average
premium for a bronze plan.
$695 per adult for the year ($347.50 per child
The maximum penalty per family using this method
Youíre considered covered if you have
CHIP (i.e., MI Child), any
job-based plan, any
plan you bought yourself,
TRICARE, VA health coverage, or some other kinds
of health coverage.
If youíre eligible for job-based insurance, you can
consider switching to a Marketplace plan.
But you wonít qualify for lower costs based on your
income unless the job-based insurance is
unaffordable or doesnít meet minimum requirements.
You also may lose any contribution your employer
makes to your premiums.
If you have Medicare, youíre considered covered and
donít have to make any changes. You canít
use the Marketplace to buy a supplemental or dental
Marketplace open enrollment ends February 15, 2015.
Questions? Call 24 hours a day, 7 days a week:
1-800-318-2596 (TTY: 1-855-889-4325) or call the
tri-county health department and talk to a certified
Branch County: 517-279-9561, ext. 0104# or
Hillsdale County: 517-437-7395, ext. 0104#
St. Joseph County: 269-273-2161, ext. 0104#
How to Apply for Marketplace Coverage?
apply for health coverage in the Marketplace 4 ways:
with a paper application, online, by phone, or in
person with an assister.
status updates about HealthCare.gov site
performance and the actions weíre taking to improve
Apply with a paper application
fill out a paper application and mail it in. Youíll
find out whether youíre eligible for lower costs on
private insurance, Medicaid, or the Childrenís
Health Insurance Program (CHIP).
you get your eligibility notice, you can either go
online to compare, choose, and enroll in a plan or
contact our call center. A customer service
representative will help you.
or someone on your application is eligible for
Medicaid or CHIP, a representative will contact you
a paper application, download the
application form and
Apply online in 4 steps:
you apply online, youíll follow a 4-step process:
Set up an account. Start by going to the
Marketplace page. First you'll provide some
basic information. Then choose a user name,
password, and security questions for added
Fill out the online application. You'll
provide information about you and your family,
like income, household members, current health
coverage information, and more. This will help
the Marketplace find options that meet your
needs. Important: If your household files
more than one tax return, call the Marketplace
Call Center at 1-800-318-2596 (TTY:
1-855-889-4325) before you start an application.
This is a very important step. Please donít skip
it. Representatives can provide directions to
make sure your application is processed
Before you begin, it may help to have this
(if youíre an eligible immigrant who wants
forms, or other information about your
numbers for any current health coverage
about any health coverage from a job thatís
available to you or your family
Compare your options. You'll be able to see
all the options you qualify for, including
private insurance plans and free and low-cost
Medicaid and the
Childrenís Health Insurance Program (CHIP)
(i.e., MI Child). The Marketplace will tell you
if you qualify for
lower costs on your monthly premiums and
out-of-pocket costs on private insurance.
Youíll see details on costs and benefits to help
choose a plan thatís right for you.
After you choose a plan, you can enroll online
and decide how you pay your premiums to your
insurance company. You must pay your premium by
the date the insurer provides before your
coverage can begin. Payments must be received by
December 15, 2016 to assure that you are covered
for 2017. If you or a member of your family
qualifies for Medicaid or CHIP, a representative
will contact you to enroll.
what you can do to get ready to enroll. If you
run a small business, hereís what you can do to
get ready to offer coverage for your employees in
the SHOP Marketplace.
have any questions, thereís plenty of
live and online help along the way.
Apply by phone or with an in-person assister
apply by phone, call 1-800-318-2596, 24 hours a
day, 7 days a week (TTY: 1-855-889-4325). A
customer service representative will work with
you to complete the application and enrollment
can also apply with the help of an assister who
can sit with you and help you fill out a paper
or online application. The Branch-Hillsdale-St.
Joseph Community Health Agency offers trained
and certified navigators and application
counselors in each of its three county offices.
We are currently taking appointments. Call and
ask to talk to a Navigator to schedule an
517-279-9561, ext. 0104# and 0337#
County: 517-437-7395, ext. 0104# and 0337#
County: 269-273-2961, ext. 0104# and 0337#
Find in-person help
states, there are people trained and certified to
help you understand your health coverage options and
enroll in a Marketplace plan. Theyíre known by
different names, depending on who provides the
service and where theyíre located. All can provide
the help you need with your application and choices.
LocalHelp.HealthCare.gov to find help in your
area. You can search by city and state or zip code
to see a list of local organizations with contact
information, office hours, and types of help
offered, such as non-English language support,
Medicaid or MI Child enrollment, and Small Business
Health Options Program (SHOP).
Types of In-Person Assisters?
Certified application counselors, navigators,
in-person assistance counselors, and other
assisters: These are professional individuals or
organizations that are trained to help consumers
looking for health coverage options through the
Marketplace, including help with completing this
application. Services are free to consumers. You can
ask to see certification showing theyíre authorized
to perform this work. They can help you complete
this section. The ID number is the navigatorís
identification number. This is a unique alphanumeric
ID (13 letters and numbers) given to each navigator.
Agents and brokers: Agents and brokers can help
you apply for help paying for coverage and enroll in
a Qualified Health Plan (QHP) through the
Marketplace. They can make specific recommendations
about which plan you should enroll in. Theyíre also
licensed and regulated by states and typically get
payments or commissions from health insurance
companies when they enroll consumers. They can help
you complete this section.
both ID numbers for agents and brokers:
User ID: A unique ID that the agent or broker
creates when registering with the Marketplace.
National Producer Number (NPN): A unique number
(up to 10 digits) thatís assigned to each licensed
agent or broker. An NPN can be easily located by
going to the National Insurance Producer Registryís
website at www.nipr.com.
Permission for information submitted: By
submitting this application, you represent that you
have permission from all of the people whose
information is on the application to both submit
their information to the Marketplace, and receive
any communications about their eligibility and
Privacy Act Statement (effective 09/01/2013)
authorized to collect the information on this form
and any supporting documentation, including social
security numbers, under the Patient Protection and
Affordable Care Act (Public Law No. 111-148), as
amended by the Health Care and Education
Reconciliation Act of 2010 (Public Law No. 111-152),
and the Social Security Act.
the information provided about you and the other
individuals listed on this form to determine
eligibility for: (1) enrollment in a qualified
health plan through the Federal Health Insurance
Marketplace, (2) insurance affordability programs
(such as Medicaid, CHIP, advanced payment of the
premium tax credits, and cost sharing reductions),
and (3) certifications of exemption from the
individual responsibility requirement. As part of
that process, we will verify the information
provided on the form, communicate with you or your
authorized representative, and eventually provide
the information to the health plan you select so
that they can enroll any eligible individuals in a
qualified health plan or insurance affordability
program. We will also use the information provided
as part of the ongoing operation of the Marketplace,
including activities such as verifying continued
eligibility for all programs, processing appeals,
reporting on and managing the insurance
affordability programs for eligible individuals,
performing oversight and quality control activities,
combating fraud, and responding to any concerns
about the security or confidentiality of the
providing the requested information (including
social security numbers) is voluntary, failing to
provide it may delay or prevent your ability to
obtain health coverage through the Marketplace,
advanced payment of the premium tax credits, cost
sharing reductions, or an exemption from the shared
responsibility payment. If you donít have an
exemption from the shared responsibility payment and
you donít maintain qualifying health coverage for
three months or longer during the year, you may be
subject to a penalty. If you donít provide correct
information on this form or knowingly and willfully
provide false or fraudulent information, you may be
subject to a penalty and other law enforcement
order to verify and process applications, determine
eligibility, and operate the Marketplace, we will
need to share selected information that we receive
outside of CMS, including to:
Other federal agencies, (such as the Internal
Revenue Service, Social Security Administration
and Department of Homeland Security), State
agencies (such as Medicaid or CHIP) or local
government agencies. We may use the information
you provide in computer matching programs with
any of these groups to make eligibility
determinations, to verify continued eligibility
for enrollment in a qualified health plan or
Federal benefit programs, or to process appeals
of eligibility determinations;
Other verification sources including consumer
Employers identified on applications for
Applicants/enrollees, and authorized
representatives of applicants/enrollees;
Agents, Brokers, and issuers of Qualified Health
Plans, as applicable, who are certified by CMS
who assist applicants/enrollees;
contractors engaged to perform a function for
the Marketplace; and
Anyone else as required by law or allowed under
the Privacy Act System of Records Notice
associated with this collection (CMS Health
Insurance Exchanges System (HIX), CMS System No.
09-70-0560, as amended, 78 Federal Register,
8538, March 6, 2013, and 78 Federal Register,
32256, May 29, 2013).
statement provides the notice required by the
Privacy Act of 1974 (5 U.S.C. ß 552a(e)(4)). You can
learn more about how we handle your information at
Before you apply, preview plans and estimated
you fill out a Marketplace application, you can do 2
things to learn your options:
using both the Kaiser calculator and the plans and
prices tool together, you'll be able to see the
plans and full prices available to you, and find out
whether you'll qualify for lower costs.
income is too high to qualify for lower costs, there
4 ways you can buy a health plan.
business coverage: If you own a small business and
want to apply for SHOP coverage for your employees,
youíll follow a different process.
Begin that process now. Select your state from
the drop down menu. Then click the green button to
take the next step.
Still Need More Information?
more information, contact your local county health
department office or visit