Service Tree

The Service Tree lists all services in "branched" groups, starting with the very general and moving to the very specific. Click on the name of any group name to see the sub-groups available within it. Click on a service code to see its details and the providers who offer that service.

Affordable Care Act Qualified Health Plans

Insurance plans that are certified by a marketplace (exchange), provide essential health benefits, follow established limits on cost-sharing (like deductibles, copayments and out-of-pocket maximum amounts), and meet other requirements specified by the Affordable Care Act. A qualified health plan will have a certification by each marketplace in which it is sold.

Health Insurance Marketplaces

Organized marketplaces (also called "exchanges") for the purchase of health insurance that are established by states, the federal government (federally-facilitated marketplaces) or states and the federal government in partnership; and set up as a governmental or quasi-government entity. The marketplaces enable individuals and small employers to compare available private health insurance options on the basis of price, benefits and services, quality and other factors; and are required to provide for the operation of a toll-free call center and an Internet website as consumer assistance tools. They help enhance competition in the health insurance market, provide a range of affordable health insurance choices and give small businesses the same purchasing power as large businesses. They serve as a one-stop shop where individuals can get information about their options; be assessed for premium assistance subsidies (tax credits) which are determined on a sliding scale and cost sharing assistance subsidies; and be assessed for or enrolled in the plan of their choice. The marketplaces are not insurers, so they do not bear risk themselves, but determine the insurance companies that are allowed to participate in them. Health plans provided through the marketplaces are made available to qualified employers and their employees in the small group market through a small business health options program (SHOP).

Private Health Insurance

Organizations including private insurance companies, health plans or individual agents that issues policies or plans that pay the medical expenses of covered individuals. Health insurance policies differ in premium amounts as well as the services they cover, the size of the deductible and/or co-payment, and cost and treatment options. Included are employment-based plans which are offered through an individual's place of employment or that of a relative and direct purchase health plans that are purchased by an individual from a private company.