The new health care exchange set up under the federal Affordable Care Act is worth a look for North Dakotans eligible to apply, according to representatives of Blue Cross Blue Shield of North Dakota.

BCBSND, North Dakota's largest health insurer, sponsored a workshop in Minot Wednesday to explain the exchange and the plans that it has available there. Other companies offering plans on the exchange are Sanford and Medica. Sanford has been in North Dakota's insurance market since 2010 and Medica since 2008.

The exchange opened for applications Oct. 1.

Wednesday's workshop was geared toward people curious about individual coverage. People with access to employer-sponsored plansalthough they can drop those plans in favor of the exchange are not eligible for government subsidies through the exchange unless the cost of a single policy at their jobs eats up more than 9.5 percent of their incomes. People eligible for Medicaid or Medicare also would remain on those programs and would not use the exchange.

For many people, though, there's a chance for advance tax credits and government cost sharing to reduce both premiums and medical expenses. It all depends on family size and income, said J.D. Nichol, manager of consumer sales for BCBSND.

Price quotes vary because premiums change with age and factors such as whether someone is a smoker. However, BCBSND presented a scenario for one of its upper level plans in which a couple with four children and an income of $43,900 paid a monthly premium of $119 after the advanced tax credits. The same family would pay $529 with an income of $78,975 or $1,000 with an income of about $126,000 after the advanced tax credit. Without tax credits, the cost would have been $1,028.

Nichol explained that the tax credits are available to people with incomes up to 400 percent of the federal poverty level. For a family of four, that income limit is $94,200.

People get the credits in advance to reduce their monthly premiums. Once they complete their tax forms and their actual adjusted gross incomes are known, they may get additional money or may have to pay back, depending on how their actual incomes compared with their estimates.

Nichol added that people will get at least one opportunity to update their estimated incomes during the year.

The cost-sharing assistance is available to people at 250 percent of federal poverty level, or 300 percent if Native American.

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