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Hard to believe that we are on the fourth year for Obamacare in North Carolina.  Time sure does fly.

If you have been putting off enrolling in Obamacare or need to change your coverage this needs to be completed during November 1 2016 – January 31 2017.  The chart below shows when a new plan will go into effect based on the date the application is submitted:

To qualify for subsidies through the health insurance marketplace for Obamacare coverage in 2017 you must meet the following requirements:

1. Cannot have access to employer coverage.  If coverage is offered through your employer or your spouses employer you are most likely not eligible for subsidies through the marketplace.
2. Must have Modified Annual Gross Income (MAGI) between 100 – 400% Federal Poverty Level.  See this page for the chart to see if you fall in the income range

Over the first 3 years of Obamacare in North Carolina we have assisted over a thousand individual obtain coverage properly and effieciently.  Here is how we can help you:

1. Explain the subsidy process and help ensure you get the maximum subsidy amount based on your information.
2. Help you retain your subsidy throughout the year by making sure that proper documentation is submitted when required.
3. We are licensed insurance professionals that are contracted with the carrier (s) that participate in the marketplace.  This allows us to explain to you the benefits of the policy and why one may be better than the other.  You don’t get this doing it yourself or calling healthcare.gov.
4. Help you enroll in the plan that YOU choose making sure that you understand and receive maximum benefits offered.
5. We do all this remotely so you never have to leave your home nor doyou don’t have to get dressed up to meet someone.  Everything is handled over the internet and phone!  Very simple and convenient process.
6. Absolutely NO COST to you.  We are compensated by the insurance companies and by using us the plans DO NOT cost any more.

So if you are reading this and YOU ARE NEW TO THE MARKETPLACE we would like to help you.  Simply fill out the form to the right or click the button below.  Either Rustty Williams or Kent Kingsley will contact you to review your situtation.  The whole process should take less than 30 minutes and often times less. 

Have you learned you have a tax penalty for not having health insurance in 2014?  If so, there could be a new Special Enrollment Period (SEP) for you.  This enrollment allows those who did not have health insurance coverage during 2014 or had coverage that did not meet minimum essential coverage as defined by the law to enroll in coverage after the Open Enrollment Period (Feb 15th) ended.

You now have the opportunity to enroll in coverage during this one time SEP.  It starts March 15th and ends April 30th.  In order to qualify you must meet the following:

• Are not currently enrolled in health coverage through the Marketplace for 2015
• Attest that you paid the fee for not having health coverage in 2014
• Attest that you first learned of this penalty after Open Enrollment ended (Feb 15th)

You must be able to answer yes to all of the above questions.

How does this affect you? 

You could now be eligible to purchase coverage through the Marketplace during this SEP (March 15th thru April 30th).  You may qualify for a subsidy based on your household income and family size.  This does not exclude you from the 2015 penalty, but it does allow you to reduce it since you will have coverage for part of 2015.

Who does this not help?

If you had coverage for 2014, but did not renew the policy, this SEP does not apply to you.  If you did not update your coverage during Open Enrollment, you cannot make changes during this SEP.  This one time SEP is only available to those who can answer yes to the 3 bullet points listed above.

What should you do now?

If you qualify, you may be seeking help to determine what options might be best for you.  We have helped 1000+ North Carolinians find coverage that fits their budget and needs.  In order for us to help you, simply complete the form on the right side of our website (ObamacareForNC.com).  Under “Life Change,” select “I have the Tax Penalty.”  Once you have completed this form, we will reach out to help you move forward.  We can handle the entire process over the phone and via computer.  We work hard to make this process simple and painless for you.  Act now, this one time SEP will be over before you know it.

With tax season upon us we wanted to put out some information that may assist you with your 2014 federal income tax return if you received subsidies with your NC Obamacare.

Just as a reminder as to how the subsidies work…the IRS will compare the income from your 2014 tax return to the income you estimated on your health insurance application.  If the income on the application is lower than the amount you estimated you may be eligible for additional premium tax credit.  It works the other way too…if your income is higher on the tax return than what you put on the application then you may owe additional premium tax.  In other words they will “reconcile” the subsidy on your taxes, meaning “if you received too much subsidy, you have to pay some of it back.  If you did not get all the subsidy you were supposed to, you would get it back in your tax return as additional tax credit.”

You will be receiving a Form 1095A from the Health Insurance Marketplace in early February.  This form will show that you had coverage for the year (thus avoiding the tax penalty) and will also detail the gross monthly premium (column A) as well as the subsidy amount (column C) that you received.  This information will now be required when you complete your 1040 tax return.  When you receive the 1095A in the mail make sure that you keep this with your tax information so that you will have this when you prepare your 2014 tax return.

We have also put up a page on this site with some important links  to help you with the process.  You can find this page HERE.

If you or anyone you know still needs assistance with their 2015 NC Obamacare coverage please complete the form on the right of this page and we can assist you!

The Patient Protection and Affordable Care Act (PPACA), aka Obamacare, is a very confusing and overwhelming law that has many people up in arms.  While many hate it, some love it, and some are indifferent the fact of the matte is as of today it is here and will be in full swing starting January 1, 2014.

As professional health insurance agents we aren’t here to defend the law.  Rusty and Kent’s role is to make sure our clients understand the implications and the benefits that this will impose on them.  In doing some research we came across this video produced by the Kaiser Foundation that we thought really did a good job of explaining the gist of what is coming

Take a few minutes and watch this video as it should clarify a lot of your questions.  Enrollment will begin in 53 days and will be a VERY hectic time period so if you would like to be on our list to follow up with to go over your options please make sure to fill out the appointment form on our home page.  Enjoy.

One of the confusing factors with Obamacare starting in 2014 is how do you buy coverage on the NC health care exchange?  The main determining factors are whether or not you have health insurance options from an employer (either through you or a spouse) and what is the modified adjusted gross income (MAGI) for the household.

Here is a flow chart that tries to simplify this mess a little bit (click on picture to make bigger so you can see it):

To determine if your MAGI qualifies you for a government subsidy click here.  Once this is determined then you will know whether or not you qualify for the premium reduction.  All this will be a pretty seamless process behind the scenes since you will not see the subsidy; it will just be subtracted from your monthly premiums.  These reductions for many will be substantial allowing for affordable coverage.

If you have employer coverage available chances are you would not qualify to buy coverage inside the exchange for anyone in the family.  Why is this?  Well by law your employer has to pay at least 50% of the employee’s premium.  With the employer covering such a high percentage this will make most employee’s coverage be lower than the 9.5% used to determine affordability by CMS.  We think this is a flawed measure by not counting in what it costs for the family to be on the plan….but it is what it is at the time.

Click here to learn more about your NC health care exchange options.

As we get closer to the start date for enrollment with Obamacare (October 1st), many people are starting to learn the ins and outs of how this will affect them.  Estimates are that 2/3 of North Carolinians will qualify for some form of subsidy under the new law.

How do I know if I qualify for a subsidy?

The subsidy calculation will be based on your household Modified Adjusted Gross Income (MAGI) which can be found on line 37 on your 1040 tax form.  This is NOT your total income of your household.  This number reflects certain deductions based on your tax return.  Obamacare uses the Federal Poverty Limit to determine who qualifies for a subsidy.  You can see if you may qualify by visiting our Obamacare Subsidy page.  If you have access to affordable coverage through work, you may not qualify for a subsidy.

How is the subsidy applied?

If you qualify for a subsidy, the health insurance company you enroll with will notify the government that you have enrolled and qualify for a subsidy.  You will pay your portion of the premium (total premium minus subsidy) to the insurance company and in turn the insurance company will receive the balance from the government.

What happens if my income changes?

For those whose income fluctuates yearly, a “claw back” could impact them.  If your income changes (either increases or decreases), thus causing a change of your subsidy eligibility; the government could claw back the subsidy when you file your taxes.  This process is called “reconciling.”  If you no longer qualify for a subsidy one year but received it, the government will add what you should not have received to your income tax bill.  On the other hand, if you did not receive the full subsidy you qualified for; that amount you did not receive would be added to your tax return.  In the event that your income does change (increases or decreases) you will have the opportunity to go into the system to adjust the subsidy during the year to ensure that you aren’t over or under receiving your allotment.

Click here to learn more about the subsidy and if you qualify.