PA STATE-BASED EXCHANGE
We appreciate your interest in Pennsylvania’s transition to a state-based exchange. For this upcoming 2020 open enrollment period, Pennsylvania has officially transitioned to a state-based exchange – federal platform (“SBE-FP”). Pennsylvania will remain a SBE-FP until it makes the full transition to a state-based exchange. This full conversion to a SBE is slated to occur for the beginning of the 2021 open enrollment period. Our intent is to make this transition in a transparent and inclusive manner, with an aim to minimize disruption for valued consumers, the dedicated health insurers serving the individual and small group markets and impacted stakeholders. We will update this page on a rolling basis to communicate progress and milestones regarding the transition. If you have any questions in the meantime, please don’t hesitate to email us at RA-IN-SBEInfo@pa.gov.
*Due to current public health issues, The Pennsylvania Health Insurance Exchange Authority will conduct its April 16, 2020 Board of Directors meeting by telephone only. The public may participate by calling (267) 332-8737, Passcode: 206365317#. For questions, please call 717-787-7000*
*Due to COVID-19, the Pennsylvania Health Insurance Exchange Authority’s (PHIEA) office is closed. To the extent that a complaint or other legal document needs to be served on PHIEA, parties should contact Jonathan D. Koltash, Chief Counsel, at (717) 703-2951 to discuss and otherwise coordinate service.*
None at this time.
August 30, 2019 - Pennsylvania Health Insurance Exchange Board Appointees Announced
On August 29, 2019, Governor Tom Wolf announced all eight of the gubernational and legislative appointees who will be serving on the Board of the Pennsylvania Health Insurance Exchange Authority (PHIEA). These appointees have an array of professional experiences, including working to assist consumers in the enrollment process during open enrollment season, working as an insurer to help drive a more consumer-friendly marketplace, and working to disseminate information and advice on accessing healthcare coverage and services in the Commonwealth. Each of these appointees are leaders in their field and are aligned with PHIEA’s goal of creating more accessible and affordable healthcare for all Pennsylvanians. In addition to these eight appointees, there are three more designated board member positions reserved for the leadership of the three following government agencies: the Pennsylvania Insurance Department, the Department of Health and the Department of Human Services. These Departments’ leaders prioritize the best interest of Pennsylvania consumers and have significant knowledge on healthcare policy initiatives in our Commonwealth. These eleven individuals, eight gubernatorial and legislative appointees and three department leaders, will constitute the makeup of the Exchange Authority’s Board and will be instrumental in moving Pennsylvania in the direction of more affordable and accessible healthcare. For more information on the Governor’s announcement of the Exchange Authority’s Board, click
August 22, 2019 - 2020 Navigator Entity Selected
The Pennsylvania Insurance Department, on behalf of the Pennsylvania Health Insurance Exchange Authority (PHIEA), is pleased to announce the selection of Pennsylvania Association of Community Health Centers (PACHC) as the Navigator entity assisting with the 2020 open enrollment season and health insurance plan year. This entity has been a CMS Navigator grantee for the past six years and is committed to helping individuals across the Commonwealth gain security of coverage. PACHC assists consumers seeking to enroll in Qualified Health Plans (QHPs), Medicaid, the Children’s Health Insurance Program (CHIP) and Medicare through their partnerships with community health centers in all 67 counties in Pennsylvania. They also take special interest in serving individuals and families impacted by substance-use disorders (SUD) and opioid-use disorders (OUD). Their navigators will be trained on how to access SUD/OUD resources across the Commonwealth and PACHC will continue to utilize its long-standing working relationship with state agencies, such as the Department of Drug & Alcohol Programs and Department of Human Services, to educate providers and consumers on various treatments offered and resources available for impacted individuals. As the open enrollment season quickly approaches, please be sure to visit our website: insurance.pa.gov/4healthins, to see a listing of all local health centers with navigator assistance..
August 19, 2019 -
Request for Technology and Call Center Vendor Support Proposals
The Pennsylvania Insurance Department, on behalf of the Pennsylvania Health Insurance Exchange Authority issued a Request For Proposals for technology and call center vendor support, available
The Authority, with the assistance of the PID, issued this RFP to provide those interested in submitting proposals (“Offerors”) sufficient information to enable them to prepare and submit proposals to provide and operate a technology platform and consumer assistance center for the Pennsylvania Health Insurance Exchange. This RFP contains instructions governing the requested proposals, including the requirements for the information and material to be included; a description of the service to be provided; requirements which Offerors must meet to be eligible for consideration; general evaluation criteria; and other requirements specific to this RFP.
July 15, 2019 - Navigator Program for the 2020 Plan Year
The Pennsylvania Insurance Department, on behalf of the Pennsylvania Health Insurance Exchange Authority (Commonwealth), is interested in receiving expressions of interest from firms qualified under state and federal law to be a Navigator for the provision of Navigator program services for the 2020 open enrollment season and health insurance plan year. The purpose of the Commonwealth’s request is to determine what experienced firms are available to assist the Commonwealth in executing its Navigator program within an aggressive timeframe, which contemplates the commencement of Navigator activities in the Commonwealth on September 12, 2019. Additional information can be found
July 2, 2019 - Act 42 passed
Thank you Governor Tom Wolf, Representative Bryan Cutler and Representative Frank Dermody for the leadership that will significantly impact the lives of many Pennsylvanians.