By Andrea K. Walker
11:29 AM EDT, May 28, 2013
Thirteen insurers have submitted plans to offer health insurance on the state exchange, or marketplace where individuals can buy insurance under health care reform, that begins open enrollment in October.
The plans must still be certified by the state. Officials with the state Maryland Health Benefit Exchange announced the insurers Monday.
Health reform requires that everyone carry insurance through an employer, a government-sponsored plan such as Medicare or statewide exchanges. Individuals and companies would have to pay a penalty to opt out. The idea is to spread the cost of health care to everyone, while working on ways to deliver it more efficiently.
State officials estimate that one-third of Maryland's 750,000 uninsured residents will gain coverage under reform in its first year. Those living on less than 133 percent of the federally established poverty level -- about $31,000 for a family of four -- also will gain coverage through an expansion of Medicaid.
The 13 companies that have submitted plans in Maryland are:
• Aetna: Aetna Life Insurance Co., Aetna Health Inc.
• BEST Life and Health Insurance Co.
• CareFirst: CareFirst of Maryland Inc., CareFirst BlueChoice Inc., Group Hospitalization and Medical Services Inc.
• Coventry: Coventry Health and Life Insurance, Coventry Healthcare of Delaware Inc.
• Delta: Delta Dental of Pennsylvania, Alpha Dental Programs Inc.
• DentaQuest Mid-Atlantic Inc.
• Dominion Dental Services Inc.
• Evergreen Health Cooperative Inc.
• Guardian Life Insurance Co. of America
• Kaiser Foundation Health Plan of the Mid-Atlantic
• Metropolitan Life Insurance Co.
• United Concordia: United Concordia Dental Plans Inc., United Concordia Life and Health Insurance Co.
• UnitedHealthcare: MAMSI Life and Health Insurance, UnitedHealthcare Insurance Co., Optimum Choice Inc., All Savers Insurance Co., UnitedHealthcare of the Mid-Atlantic Inc.
Health reform requires qualified health plans inside and outside of the insurance marketplaces to cover certain services, known as essential health benefits. In Maryland, the benefits must include services in at least the following areas: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.
Insurance companies must also include enough providers so that services will be readily available to patients. That includes community providers that serve low-income and medically underserved individuals.
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