Affordable Care Act (ACA) Insurance Marketplace FAQs

1. What is the Notice of New Health Insurance Marketplace Coverage Options document and why did I receive it in my email?

This federally required document is sent to employees annually. It introduces the Health Insurance Marketplace and provides information to help you compare plans in the Marketplace. Review the Health Insurance Marketplace Notice.

2. What is the effective date for Oklahoma's Health Insurance Marketplace?

Coverage begins January 1. The enrollment period is planned for October through December. NOTE: OU's employee insurance coverage also begins January 1, with a shorter enrollment period of Nov. 3-21, 2014.

3. Does OU's health insurance plan meet the federal standard of "minimum essential coverage?"

Yes, OU's plans provide the type of coverage an individual needs to meet the individual responsibility requirement under the Affordable Care Act.

4. How do OU's plans compare to plans available in the Marketplace?

To help you compare options, plans in the Marketplace are categorized as Platinum, Gold, Silver, and Bronze based on how much the plan would pay of your out-of-pocket health care costs. If you get sick, Platinum plans would pay, on average, 90% of your out-of-pocket health care costs. Gold plans pay 80%, Silver plans pay 70%, and Bronze plans pay 60%.

5. What are my options?

Your options depend on what kind of employee you are.

  • Full-time employees (.76 -1.0 Full-Time Equivalent) and graduate assistants (.5 Full-Time Equivalent or greater) can purchase a plan from the Marketplace, but they are not eligible to receive federal tax credit subsidies or discounted premiums. See #6-11 for details.
  • Part-time employees (.75 Full-Time Equivalent or less), graduate assistants (less than .5 Full-Time Equivalent) and student employees can purchase a plan from the Marketplace, and might qualify for federal tax credit subsidies or discounted premiums based on their family size and family income. See #6-11 for details.

6. Does OU provide "affordable health insurance" as defined by the Affordable Care Act?

Yes, affordability as defined by the Act means that the employee pays less than 9.5% of their income towards the cost of their own employee only coverage. Under that standard, all full-time OU employees and half-time graduate assistants have affordable coverage.

7. My family coverage costs me more than 9.5% of my income. Is my coverage still affordable?

Yes, affordability as defined by the Affordable Care Act is based only on the employee-only coverage category.

8. Does OU's plan meet the "minimum value standard?"

Yes, a health plan meets this standard if it's designed to pay at least 60% of the total cost of medical services for a standard population.

9. How do I qualify for a subsidy from the Marketplace?

Based on family size and income. Visit for more information. However, since all full-time OU employees and half-time graduate assistants have affordable coverage that meets the minimum value standard as defined under the law (see #4 & 6), no full-time OU employees or half-time graduate assistants will be eligible for a subsidy, even if they would otherwise qualify under the income requirements.

10. Can I go the Marketplace to purchase insurance?

Employees could choose to waive OU coverage and purchase from the Marketplace. However, all full-time OU employees have affordable coverage as defined under the Affordable Care Act; therefore, no full-time OU employees would be eligible for a subsidy.

11. I work half-time and my coverage is not affordable. Can I go to the exchange and qualify for a subsidy?

Yes, you can, and depending on your total family income and family size, you may qualify for a subsidy.

12. How can I compare OU coverage with Marketplace plans?

There are several things to consider when comparing plans.

  1. It's important to compare similar plans- a gold plan vs. a gold plan, for example.
  2. Be mindful that the OU rates and the Marketplace rates for dependent categories are not directly comparable. The Marketplace uses different categories of coverage for dependents than OU does.
  3. OU premiums are deducted from an employee's paycheck before taxes are calculated and therefore essentially cost less than an equal rate on the exchange.
  4. It's important to carefully compare networks of doctors and hospitals. A Marketplace plan with comparable benefits may have a very different network from OU's plans.

13. I am planning to retire from OU soon. How will the Marketplace affect my retiree medical insurance?

No changes are planned for OU retiree medical insurance at this time. However, the proposed federal rate structure in the Marketplace makes rates for 55-65 year olds lower than OU 's current rates. Consequently, retirees may find it advantageous to enroll their spouse in a Marketplace plan. The impact of the Affordable Care Act on retiree medical insurance will continue to be examined over coming years.

14. Where can I get more information?

Find information about the Health Insurance Marketplace at Plan descriptions and rates are available in the Marketplace. Generalized comparisons between OU plans and Marketplace plans are not available because options in the Marketplace are based on the unique characteristics of each individual seeking coverage. Individuals can review their personal Marketplace options by visiting