What is a state health insurance marketplace?
Health care reform requires each state to have an online exchange or “marketplace” where health insurance can be bought directly from insurance companies by residents of that state. The federal government will run marketplaces in states that choose not to set up their own.
How does the ACA change things for me?
You are required to have a minimum level of health coverage for you and your tax dependents. This is referred to as the “individual mandate” under the Affordable Care Act (ACA). You have the option to buy health insurance from your state’s marketplace. However, although federal tax credits may be available to lower the cost of marketplace coverage, most XPO employees are not eligible for a federal tax credit because they have access to affordable health coverage from XPO. If you are eligible for XPO health coverage, depending on the coverage you choose, XPO health coverage may be more comprehensive and less expensive because XPO pays most of the cost for you.
How does XPO’s health coverage differ from marketplace coverage?
Details on marketplace plans, and the insurance companies that offer them, are available on the marketplace websites. There are two key differences in how you pay for health coverage under the XPO and marketplace plans:
|XPO HEALTH COVERAGE||MARKETPLACE HEALTH COVERAGE|
|Who pays for coverage?||XPO pays most of the cost for you; you pay the rest||You pay 100% of the cost if you have access to an employer plan like XPO’s that is affordable and provides “minimum value” coverage|
|How are premiums paid?||With pre-tax dollars deducted from your pay that lower your taxable income||With post-tax dollars that do not lower your taxable income|
Can I directly compare XPO’s coverage with coverage on the marketplace?
Yes. All health plans are required to provide plan details in a simple, plain-English format called Summaries of Benefits and Coverage that makes it easier to compare coverage from different plans. You will be able to use the information we give you during Open Enrollment each year to compare XPO plan features and rates with plans offered on your state’s marketplace.
Doesn’t the federal government subsidize marketplace insurance?
Yes. The federal government provides a subsidy in the form of a tax credit based on a sliding scale of household income and dependents. However, even if your household income falls within the subsidy range, you and your dependents are not eligible for the federal tax credit if you are eligible for XPO health coverage because XPO offers an “affordable” option, as defined by the ACA, for Employee Only (Individual) coverage.
Does marketplace health insurance cost less than XPO health coverage?
The marketplace includes plans that cover as much as 90% and as little as 60% of eligible expenses. Also, network doctors and hospitals may be different from one plan or region to another. As a result, some marketplace plans may be less expensive than XPO plan options.
However, keep in mind that XPO subsidizes 80%, on average, of the cost of health coverage for eligible employees and their families. Because the XPO Employee Only (Individual) coverage level is affordable under the ACA, you are not eligible for the federal tax credit even if your family income meets the subsidy criteria, and even if the federal subsidy is greater than XPO’s subsidy.
What does the marketplace really mean for me?
Likely, not much. If you are eligible for health coverage under the XPO plan, you can participate in the XPO plan just like any other year. If you decide to enroll in one of the marketplace plans, be aware that you won’t be eligible for a federal subsidy, and unless you have a Qualifying Event, you won’t be able to re-enroll in the XPO plan, if you remain eligible for XPO benefits.
If you are not eligible for health coverage under the XPO plan, you may want to enroll in other health coverage. You can enroll through a family member’s employer plan or through your state’s marketplace. Before you decide, visit the marketplace to determine if you are eligible for a federal tax credit.
Where can I learn more?
Go to www.healthcare.gov. From there, you can explore your state’s marketplace or call 800.318.2596 (TTY: 855.889.4325). If you have further questions, visit or call the XPO Benefit Center.