Health Insurance

Health insurance helps individuals and families pay for medical care and also provides coverage for unforeseen expenses due to illness or injury. 

The cost (also called a premium) of a health insurance plan and the coverage it provides varies depending on many factors. These factors include your age, where you live, whether it’s an individual or a family plan, your tobacco use, etc. Your premium and coverage are also affected by whether the plan is private, employer-sponsored, public, or government-subsidized. 

Your premium, specifically, will be affected by the following features, which are standard for every health plan:

  • Deductible – the amount you have to pay for a service that is covered by your plan before your health insurance goes into effect
  • Copayment (Copay) – the set amount you pay for a service or prescription drug
  • Coinsurance – the percentage of the cost you have to pay for a service covered by your plan; for example, if your coinsurance is 20%, you pay for 20% of the cost, and your insurance pays for the remaining 80%
  • Out-of-Pocket Limit – the most you will need to pay in a single year for any service that is covered by your plan

The Affordable Care Act

The Affordable Care Act (ACA), sometimes called  Obamacare, went into effect in 2010. Based on its guidelines, no one can be denied health care coverage. Additionally, it provides subsidies for low income individuals and families. You can find out more about the ACA, its benefits, and how it works by visiting

Insurance Complaints

If you have a complaint about your insurance provider or agent, or how a claim is being handled, the Department of Insurance’s Consumer Services Division may be able to help you.

Comparative Analysis Reports

No later than May 15, OCI will conduct an annual data call for mental health and autism to ensure compliance with mental health parity and ASD.