MARSHFIELD – Security Health Plan of Wisconsin, Inc., has again been recognized as a Qualified Health Plan (QHP) by the Centers for Medicare and Medicaid Services (CMS), able to offer health insurance coverage in 2025 through the Federally-facilitated Exchange (HealthCare.gov), also known as the Health Insurance Marketplace, or just the Marketplace.
“Many people do not realize that the Marketplace makes it easy for individuals and families to enroll in affordable health insurance coverage,” said Security Health Plan Chief Growth Officer Jennifer Shermo. “It’s our priority to ensure our members can choose the insurance coverage that best fits their health care needs and budget.”
In addition, CMS has awarded Security’s Marketplace plans an overall rating of 4 stars for 2025 in its Marketplace Quality Rating System. Each year CMS calculates ratings on a 1-to-5 scale, with 5 the highest, for all eligible QHPs. The ratings measure health plan performance in clinical quality, enrollee experience, plan efficiency, affordability and management.
“While we score consistently well in all indicators, we are most gratified to receive 5 stars for enrollee experience,” said Shermo. “Getting 5 stars means our members rate us highly for customer service and our focus on wellness, care management, and added benefits and services to help them reach and maintain their best possible health.”
Only insurance companies approved as a Qualified Health Plan are eligible to offer coverage through the Marketplace. Purchasing a plan through the Marketplace is the only way individuals can receive a tax credit to help reduce their monthly health insurance premium or cost share reductions to help reduce their deductible and out-of-pocket costs.
Beginning Nov. 1, 2024, people can compare plan options, calculate their tax credit and enroll in a plan at www.securityhealth.org/myplans. The open enrollment period begins Nov. 1 and goes until Jan. 15, 2025. Individuals and families who are re-enrolling for 2025 will not have to make any changes during the open enrollment time period if they don’t want to change plans. Their enrollment and tax credit information will be automatically updated with no break in coverage. However, enrollees are encouraged to update their applications on HealthCare.gov to ensure they’re receiving the maximum amount of extra financial help available to them. For coverage effective Jan. 1, 2025, individuals must enroll by Dec. 15, 2024. Those enrolling between Dec. 16, 2024, and Jan. 15, 2025, will have a Feb. 1, 2025, coverage effective date.
QHPs are plans that have not only been certified by the Health Insurance Marketplace, but also provide coverage for essential health benefits, follow established limits on cost-sharing and meet Affordable Care Act (ACA) requirements. Those ACA requirements include a core set of benefits that provide coverage for preventive services, pre-existing conditions, mental health and substance abuse services, emergency services, prescription drug coverage and hospitalization.
The Health Insurance Marketplace was launched in 2013 as part of the Affordable Care Act. Security Health Plan has qualified as a QHP and earned the certification each year since its inception.