How Does the Marketplace Work?
Frequently asked questions about the marketplace program.
Q: What is the Marketplace?
A: Florida’s Insurance Marketplace is a web-based shopping experience that allows easy access and side-by-side comparison of health care options for individuals, families and businesses.
Q: What products will be offered?
A: Insurers and health maintenance organizations will offer insurance and limited benefit policies while provider organizations may participate with prepaid service contracts offered by health clinics, health providers, pharmacies, service networks, group practices, and professional associations. Other groups may offer health services for a specified amount and type of service or treatment. Payroll services, medical savings accounts and other insurance options that are helpful to employers can also be offered.
Q: Which businesses can participate?
A: Eligible employers include Florida’s small businesses with 50 or fewer employees at the time of enrollment. Other eligible groups designated by the State of Florida include: fiscally constrained counties and school districts; small municipalities; rural hospitals; and the State of Florida.
Q: After a business joins, who in the business is eligible to participate?
A: Employers determine which employees are eligible for benefits and the amount of any employer contribution. State of Florida retirees and employees who are not already eligible to participate in the state group health benefit plan may also shop with us.
Q: How do employees sign up?
A: Enrolled employers will inform employees of the opportunity to shop for coverage and services by providing a web link allowing access to the employer’s customized Marketplace home page. Employees will have up to 60 days to shop and compare their options.
Q: Usually my employer picks my plan, my benefits and the insurance agent for me. How does it work in the Marketplace?
A: Here, the employer may recommend plans but you can shop from the entire range of offerings available in the Marketplace. If you want to seek the advice of an agent, you will have access to licensed insurance agents in your local area who serve the Marketplace. You can pick your own agent and the coverage that suits you and your family.
Q: How do I pay for the coverage and services I choose?
A: Your employer will collect your share of the premium through payroll deduction. Each pay period your employer will forward any employer contribution along with your payroll-deducted amount. Your contribution may also be considered pre-tax, depending on your employer’s benefit plan and the options you pick.
Q: Do I have to leave the Marketplace if I lose my job or change employers?
A: No. Members can continue coverage in the Marketplace. We will arrange a different method of payment for you if payroll deduction is no longer an option.
Q: How is this different from the insurance exchanges I have been hearing about?
A: The differences are significant. In Florida’s Marketplace, participation is voluntary for employers, employees, agents and the health care and insurance community. There are no mandates on individuals; no fines or penalties for employers; and the products and benefits are voluntarily brought to you by the insurance and health care industry. In the Marketplace, you – the employee – choose the level of benefits and services that fit your needs best; no one will tell you what you have to buy.