Exchange

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State health insurance marketplaces whose establishment was mandated by the Affordable Care Act. Exchanges are to be established by 2014 for individuals and small employer groups (exchanges for small employers are known as SHOP Exchanges). Exchanges are responsible for calculating premiums subsidies, enrollment, quality oversight, certification of qualified health plans that can be sold in the exchange, and other matters. By standardizing health insurance products, enrollment, operations, and oversight, exchanges are also meant to make the process of selecting insurance easier and transparent. An exchange may be run by the state government or the federal government, or a combination of both.

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