People who work for companies with no group health coverage (ie, temporary jobs, companies offering coverage that does not qualify) may be curious about how the new law impacts their situation, we wanted to high light a group we know does very well under the new law. Those who are people who have no access to group insurance through an employer or a spouse’s employer. They often do well under the new law.
If you have:
- No access to group coverage through your employer or a spouse’s employer (access to group insurance very often eliminates you and your family from a subsidy)
- Income between $16,000 to $60,000
The new changes will work in your favor. Here is a real life example:
Mark, 59, works for a company that does not offer group insurance and his wife Deanne, 57, does volunteer work. Neither of them smoke. Mark makes $23,000 a year.
Based on their household size and income the marketplace determined that they are eligible for the following:
· Monthly subsidy of $1,120.86
· Silver Enhance plan (this offers cost sharing reductions to the silver plan). Total plan cost was $1,182.03. With the subsidy the monthly premium they are responsible for is $61.17/month
· Plan Benefits are as follow:
o $500 individual deductible
o $700 out of pocket maximum
o $5 primary copay
o $10 specialist copay
o $15 urgent care copay
o $100 ER copay
o RX copays of $10/$25/$50/$70/25%
As the above shows Mark and Deanne are able to obtain the health coverage they need at a premium they can afford. Some of our clients have premiums as low as $4.60/month. Each person’s situation is different. If you would like to talk with us about your situation, please complete the form to the right. We will contact you and help you determine if the new law helps you.
Here are some common questions we receive from people we help.
Will you charge me to help me enroll? Will I pay more to use you?
No, we are compensated by the carrier you choose. The price is the same if you go through the exchange by yourself or with us. However, we have enrolled hundreds of people so far. We are very experienced with the system and know what works and what causes it to give errors. We learned the hard way so you won’t have to.
Why use you? Why not use a navigator or call the 800 number?
Again, there is no cost to use our services. You get our 16 years of insurance experience at no cost to you. We are contracted with all carriers and certified to write coverage on the Marketplace. We help you understand how the plans work and show you some of the holes in coverages that you need to be aware of. Navigators have no idea what the networks are or where the holes in coverage are because they aren’t licensed with each carrier.
How do you help me?
From the comfort of your own home, we take the time to “hold your hand” through the entire process. We walk you step by step through the system over the phone or online. From subsidy eligibility, plan review, enrollment, and covering what you will need to do after enrollment.
I hope we have shown you the value of working with us as compared to calling the website or working with a Navigator. Why not give us a try to see how we can help you enroll.
Be sure to check the calendar to find a time that’s best for you. Either Kent or Rusty will be happy to help you!