On or Off Exchange – What’s the Difference?
The names Marketplace and Exchange are interchangeable. They mean the same thing. To keep things simple we use the term Exchange.
- Insurance Companies offer some plans only on the Exchange and some plans only Off the Exchange.
- Usually the plans available On the Exchange are more limited, like HMOs.
- Often the plans available Off the Exchange – Insurance Company Direct have larger Provider Networks, such as POS.
- Some plans will be available both On and Off Exchange, in that case – they will be priced the same. There is no price advantage for the same plan either On or Off Exchange.
The primary reason people with low to moderate incomes enroll through the Exchange is to get the government Subsidy to help pay for their Health Insurance. These subsidies can be substantial.
It seldom makes sense for people that are not eligible for subsidies to enroll through the Exchange. It just adds another layer of compliance requirements by a Federal Agency.
A qualified Health Insurance Agent represents all plans, both On and Off Exchange.
The agent should help the client determine which is best for their situation and be able to enroll either On or Off Exchange.