illinois guide to health insurance

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Illinois health insurance exchange

Three insurers join Illinois exchange; online SHOP launches soon

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More than 685,000 Illinois residents enrolled in private insurance or Medicaid since October 2013, and the state’s uninsured rate in Illinois dropped more than 3 points according to a Gallup survey.

The drop in the uninsured rate is definitely good news. However, about 12 percent of state’s population remains uninsured, and officials know they need to make an even bigger effort to reach them than last year. The state plans an extensive outreach campaign to reach those who didn’t sign up for coverage in 2014.

Officials recently awarded nearly $26 million to 37 organizations, with plans to target last year’s hard-to-reach groups: Latinos, African Americans, and millennials.

Another key message of this year’s outreach campaign targets those who enrolled last year. Officials are encouraging everyone who is covered now to take a look at their options for 2015. Given that subsidy levels, personal circumstances, and health plans offerings can all change, a new plan may be a better fit going into 2015.

A recap of 2014 enrollment

About 217,500 Illinois residents enrolled in qualified health plans (QHPs) during 2014 open enrollment and 468,000 have signed up for Medicaid as of Sept. 30. Get Covered Illinois announced that the state exceeded the initial enrollment target set by the federal government by 52 percent.

Of those Illinois residents who selected a QHP, 77 percent qualified for financial assistance, compared to 85 percent nationally. A report released in June by the U.S. Department of Health and Human Services showed the average monthly premium, after tax credits, for Illinois consumers was $105. Twenty-five percent of enrollees pay $50 or less per month after subsidies.

Twenty-nine percent of Illinois residents selected a bronze plan (20 percent nationally), 56 percent selected a silver plan (65 percent nationally), 15 percent selected a gold plan (9 percent nationally), 1 percent selected a platinum plan (5 percent nationally) and 0 percent selected a catastrophic plan (2 percent nationally). Thirty-one percent of Illinois enrollees were between the ages of 18 and 34.

Slim chance for state-run exchange

Illinois runs its marketplace, Get Covered Illinois, as a partnership with the federal government. State residents use the federal marketplace,, to enroll.

The Quinn administration favors transitioning to a state-run exchange, and there is a possibility the state legislature will take up the issue before the end of 2014. However, even advocates of a state-run exchange are guarded about the likelihood of passing the legislation.

2015 participating insurers

More health plans will be competing for business on the Illinois exchange for the 2015 plan year. In mid-June, the Illinois Department of Insurance announced that ten insurers submitted applications to sell 504 health plans: 306 policies for individuals and 198 for small groups. For the 2014 plan year, six insurers offered 165 policies in Illinois: 120 individual plans and 45 for small groups.

Three new companies are planning to participate in the Illinois marketplace for 2015: Assurant Health, United Healthcare, and IlliniCare Health. IlliniCare Health is a partnership of Centene and several Chicago hospitals. Centene is a large player in the managed Medicaid market, and it entered the individual insurance through the ACA marketplaces in several states in 2014.

Small business exchange

Illinois is one of five states where small businesses (those with between 2 and 50 employees) will get early access to the federal Small Business Health Options Program (SHOP) online portal. Small employers in Illinois as well as Delaware, Ohio, Missouri and New Jersey will get access in late October, while other states that use will get access starting Nov. 15.

Currently, small businesses can sign up for a SHOP plan by working with a broker or by submitting a paper application. The online enrollment function that is going in the fall of 2014 had been delayed so technical staff could work on fixing the marketplace used by individuals.

Illinois is delaying the launch of “employee choice” on the small business, or SHOP, exchange. The option allows employees of small businesses that use the SHOP to select from a range of plans rather than being limited to a single plan selected by their employer. The federal government let states that use the federal marketplace choose if they want to implement employee choice for 2015. Illinois is one of 18 states that is delaying implementation of employee choice.

2015 rate outlook

2015 premiums for Illinois have not yet been released. According to tracking by PricewaterhouseCooper as of Sept. 25, premiums are increasing six percent on average across the nation.

History of the Illinois exchange

Gov. Pat Quinn’s administration announced in July 2012 that the Illinois marketplace would operate as a state-federal partnership. Quinn had hoped to leverage the partnership model as an interim step toward a state-run marketplace for the 2015 coverage year. However, a state exchange bill passed in the Senate in 2013 didn’t get a vote in the House. Advocates for a state-run exchange now fear it may be 2018 or later before the state takes over sole control of the exchange.

Illinois health insurance exchange resources

Get Covered Illinois

Health Care Reform in Illinois

State Exchange Profile: Illinois
The Henry J. Kaiser Family Foundation overview of Illinois’ progress toward creating a state health insurance exchange.

Health Care Assistance
Office of the Attorney General
1-877-305-5145 (toll-free nationwide) TTY: (312) 964-3013
Serves residents enrolled in private health insurance

Office Consumer Health Insurance and the Ombudsman for the Uninsured 
Illinois Department of Insurance
(877) 527-9431 (toll-free nationwide)
Serves residents who are uninsured as well as residents who have health insurance problems or questions.