Health insurance marketplaces (exchanges)

Summary of Affordable Care Act (ACA) plan information

The Affordable Care Act (ACA) introduced a new option for small business employers and individuals to access health insurance, health insurance marketplaces, also called Exchanges. These online Marketplaces are established in each state and provide another way to research, compare and enroll in health insurance offered by health insurers.

There are also two types of Marketplaces within each state. One is the Individual Marketplace, where individuals can shop for insurance. And the other is for small business employers, called the SHOP Marketplace, short for Small Business Health Options Program. The SHOP Marketplace provides a place for eligible employers to explore health insurance plans and choose which level of coverage to offer their employees.

The open enrollment period for plans offered through the Individual Marketplaces runs from Nov. 1, 2020 through Dec. 15, 2020. Small business employers can enroll in a SHOP plan throughout the year.

Beginning 2017, states may permit employers in the large group market to participate.

Find health insurance marketplace coverage from UnitedHealthcare

UnitedHealthcare Exchange plans offer a variety of affordable, reliable coverage options. You can find plans available in your area at UnitedHealthcare Exchange plans or you can call 1-800-806-0451 TTY 711.

If you’re looking for ACA plans in New York or Massachusetts, visit or call 1-844-joinUHC to learn about plans available near you.

How ACA health plan levels work

Health plans offered through the Marketplaces are grouped into four "metal" levels: Bronze, Silver, Gold and Platinum. The levels do not mean the quality or how much care the plans provide.

Plan levels differ by how much an employee pays in monthly premiums and by what they pay in out-of-pocket expenses for medical services. For example, bronze plans have lower monthly premiums, but require employees to pay more out-of-pocket when they receive care. And platinum plans may cost more each month, but employees will pay less out-of-pocket when they receive care.

  • Bronze Plan: covers approximately 60% of the actuarial value of the covered benefits
  • Silver Plan: covers approximately 70% of the actuarial value of the covered benefits
  • Gold Plan: covers approximately 80% of the actuarial value of the covered benefits
  • Platinum Plan: covers approximately 90% of the actuarial value of the covered benefits

The Individual Marketplaces are where consumers can find out if they are eligible for federal subsidy assistance. To qualify for subsidies, individuals or families must:

  • Buy insurance through the Individual Marketplace
  • Meet household income requirements
  • Not have affordable health insurance available through an employer
  • Not be eligible for Medicaid or Medicare or enrolled in additional specified government programs

The subsidies can be used to lower the monthly premium costs, and for qualifying individuals, to reduce the out-of-pocket expenses. Subsidies or tax credits are not available to employees who get their health insurance through SHOP or their employer.

Small business tax credit

The small business tax credit is now only available to eligible employers who purchase health insurance through the SHOP Marketplaces, and is now worth up to 50 percent of their premium costs. Employers who qualify must have fewer than 25 full-time employees with average annual wages less than $50,000, and the employer must pay 50 percent of employees' premiums.

For information about your state's Exchange, visit

Model notice available for employers to share with employees on exchanges

On May 8, 2013, the Department of Labor (DOL) issued Technical Release 2013-02 which provides temporary guidance for employers regarding the requirement to notify employees of coverage options available through Exchanges. This Model Notice to Employees of Coverage Options is available for employers to use today if they wish. Employers were to provide the notice to current employees by Oct. 1, 2013, and to all new hires within 14 days of their hire date going forward.

Health insurance marketplaces – broker experience

Affordable Care Act - Broker

Watch this video created to help brokers understand the basics on shopping in the marketplace for individual  plans or for small business plans through the Small Business Health Options Program (SHOP). 

Health insurance marketplaces – employer experience

Affordable Care Act - Employer

Health insurance marketplaces – consumer experience

Affordable Care Act - Consumer