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Currents June 2013: New York Health Benefit Exchange: What Does it Mean for Your Clients? by Angela
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New York Health Benefit Exchange: What Does it Mean for Your Clients?

Angela Pause Smith, Project Coordinator - External Affairs, Outreach & Marketing, New York Health Benefit Exchange

The New York Health Benefit Exchange is where individuals and small businesses will shop for, compare plans and enroll in health insurance coverage. It’s the only place to get federal tax credits that reduce the cost of coverage.

As a social worker, you can help raise awareness about the Exchange by learning what it has to offer and by sharing information with your clients about the ways it can help them obtain health insurance coverage that is right for them.

To shop in the Exchange, consumers must live in New York and must be a U.S. citizen, national or lawfully present non-citizen. Small business owners with 50 or fewer eligible employees can come to the Exchange for a choice of health plans to offer their employees.

Health plans offered through the Exchange will provide a wide range of medical, prescription drug and other health care services. Beginning in 2014, all new small group and individual market plans will be required to cover 10 Essential Health Benefit categories, including mental health and substance use disorder services, and will be required to cover them at parity with medical and surgical benefits. This new requirement will apply to health plans sold both inside and outside of the Exchange.

Experts will be available to guide consumers and small business owners through the enrollment process, help them find the right insurance based on their specific needs and help determine eligibility for tax credits that reduce the cost of coverage. Starting in October, enrollment support will be available online, in person in the community, by phone and by mail.

Open enrollment begins on October 1, 2013 for effective coverage dates beginning January 1, 2014 and ends on March 31, 2014.

More information, including consumer-friendly fact sheets that you can print and share, is available on the Exchange website at  

Sign up for updates on the website or email questions to


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