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Health Insurance Exchange

A health insurance exchange is a market where a individuals select their health insurance coverage. Exchanges can be private, like those used by private companies for their employees, or they can be public, like the ACA’s state-based insurance exchanges that allow individuals to select coverage and receive income-based subsidies if they qualify.

Health Insurance Issuers

Corporations and non-profits that provide health insurance.

Health Insurance Ombudsman

An ombudsman provides a way for health insurance enrollees to dispute, file complaints or ask questions regarding their health coverage.

Health Insurance Portability and Accountability Act of 1966 (HIPAA)

An expansive law relating to employer sponsored health insurance that protects employees who lose a job or change jobs. HIPAA also protects the privacy of medical information.

Health Insurance Premium Subsidies

Tax credits available to families and individuals purchasing health insurance on the exchanges established by the Affordable Care Act if income falls between 100% and 400% of the federal poverty line.

Health Insurance Purchasing Cooperatives (HIPCs)

Groups that organize insurance for specific geographic populations and tailor rates and benefits to the needs of those populations.

Health Maintenance Organization (HMO)

A form of health insurance that requires users to seek care from a specific 'network' of providers, and often requires referrals from a general practitioner before a patient can seek care from specialists.

Health Maintenance Services

Health care services designed to keep individuals in good health rather than treat an active condition. Examples include regular check-ups, immunizations, or dietary consultations.

Health Plan Employer Data and Information Set (HEDIS)

Information provided by the National Committee for Quality Assurance to help insurance companies and employers track health care trends.

Health Reimbursement Account (HRA)

Established benefit plans funded by limitless employer contributions. Current or future health expenses can be paid through this tax-exempt account.

Exchange-eligible Individual

Individuals allowed to purchase coverage through state health care exchanges.