America’s Affordable Care Act allows individuals and families to apply for major medical insurance each year without the need to answer any health questions and includes coverage for pre-existing conditions. The Annual Open Enrollment Period to apply for coverage is November 1^st through December 15^th 2018 and with that in mind, we are happy to provide you with an update on the program and important information related to applying for coverage.

Medical costs can cripple one’s finances and carrying health insurance offers you many benefits including the peace of mind that you and your family are protected in the event of an accident or illness. Peace of mind is priceless. Click here to read more on the benefits of having health insurance.

What you need to know

Open Enrollment is from November 1st to December 15th, 2018. Plans are elected during this time frame with a coverage inception date of January 1st, 2019. You must act by December 15th, 2018 in order to obtain coverage. This is typically for individual policies; group policies may have a different inception date based on renewal.

Here is a great article that offers Open Enrollment tips and some things to consider before choosing a plan that’s right for you.

A great resource guide for up-to-date information is Healthcare.gov. Not only do they publish informative articles about open enrollment, they also offer information regarding wellness. Articles are published frequently that will help keep you up to date with the ever changing healthcare system. Be sure to subscribe to their newsletter to receive information on updates.

Click here for a quick reference guide on terminology often used in insurance quotes and proposals. Getting familiar with these terms will help you to better understand your proposals.

How to Apply

Contact us, your local agent regarding a quote. One of our experienced professionals will be happy to provide you with pricing and the plans available to you.

Our agent will need the following information:

• Name
• Date of Birth
• Smoker/Non-Smoker
• Zip code

Choosing a Plan

There are 4 categories that the plans are placed into: Bronze, Silver, Gold and Platinum

• Each of these compare costs that are shared between you and the provider.
• Each plan will list highlights about what the plan entails.

There are 4 policy types that you should be familiar with:

• Health Management Organization (HMO) – coverage is typically limited and you can only see physicians within your network. These types of policies refer to “preventive care”. Preventive care is referred to wellness checkups, etc. in order to prevent any health issues.
• Preferred Provider Organization (PPO) – this plan type is a network of providers such as hospitals and doctors. Cost will typically be less when you see a doctor within your plan’s network. Referrals are not required when you need to see a specialist.
• Point of Service (POS) – Cost is less if you use providers within your network. POS plans do require a referral from your primary care physician to see anyone out of network. Keep in mind that some plans are open access and do not require a referral from a primary physician.
• Exclusive Provider Organization (EPO) – A plan where coverage is only covered if you go to see a doctor, a specialist or hospitals within the plan’s network (except in the event of an emergency).

We hope that you have found this information helpful when it comes to deciding the right policy for you and your family. As always we are happy to help you choose said policy and thank you for allowing us the opportunity to serve you.

OVERVIEW

On May 21, 2018, the Internal Revenue Service (IRS) issued Revenue Procedure 2018-34 to index the contribution percentages in 2019 for purposes of determining affordability of an employer’s plan under the Affordable Care Act (ACA). For plan years beginning in 2019, employer-sponsored coverage will be considered affordable if the employee’s required contribution for self-only coverage does not exceed:

• 9.86 percent of the employee’s household income for the year, for purposes of both the pay or play rules and premium tax credit eligibility; and
• 8.3 percent of the employee’s household income for the year, for purposes of an individual mandate exemption (adjusted under separate guidance).

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