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).

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.

Organizations that provide consumer assistance for individuals and small businesses wanting to purchase private insurance through the marketplaces for themselves or, in the case of employers, for their employees. Their primary responsibility is to facilitate enrollment of consumers in health insurance plans offered through the marketplaces. The Affordable Care Act (ACA) requires the use of trained navigators to provide in-person education, and eligibility and enrollment assistance; and permits the use of trained in-person assisters and application counselors. The operator of the marketplace determines the process for establishing and managing the navigator program. Operations will vary depending on the model selected by the jurisdiction. Choices include a federally operated (or federally-facilitated) marketplace, a federal/state partnership or a state operated marketplace.

Programs that make health insurance payments for individuals who are at risk for losing their health, dental and/or vision care coverage and who meet age, income, disability, need or other requirements. Some programs may also provide assistance with deductibles and co-pays.

Programs that provide health insurance for people who do not qualify for Medicaid, do not have access to insurance provided by an employer or cannot afford privately purchased health insurance. Services covered by these programs vary by state but generally include hospitalization, physician services, emergency room visits, family planning, immunizations, laboratory and x-ray services, outpatient surgery, chiropractic care, prescriptions, eye exams, eye glasses and dental care. Other services may include alcohol and drug treatment, mental health services, medical and equipment and supplies and rehabilitative therapy. Eligibility requirements also vary. Included are state and/or local government health insurance programs which may be administered by the state or at the local level, and public/private partnerships between state and/or local government entities and health insurance companies or other private organizations. Health care is generally provided through participating managed care plans in the area.

Individuals who are generally between the ages of 18 and 25 depending on the ages that specific programs use for qualification.

Individuals who do not have adequate coverage to address their medical needs including prescription drugs, doctor visits, medical tests, surgery or other medical procedures or interventions for catastrophic medical conditions.

Individuals and families who have no health care insurance coverage and who may not be receiving adequate medical care as a consequence.