FAQs

A: Open Enrollment usually runs from November to December.

The current open enrollment period for 2020 begins November 1, 2019, and ends December 15, 2019.

If you have qualifying events, you can apply outside of the enrollment period.

A: How to get started:

Step 1:  Check to see if we are in an open enrollment period. If not, check to see if you have a qualifying event (if so, you can get coverage outside of open enrollment). If you do not have a qualifying event, you still have the option to purchase a short term plan.

Step 2:  Determine if you qualify for a credit on the exchange. You will need to know your estimated adjusted gross income for the year. If your income is above the ones listed then you do not qualify for a subsidy. HealthCare.gov provides a chart.

A: Qualifying Life Events:

• Marriage or divorce
• Losing other health coverage (COBRA expiration, losing job-based coverage, aging off your parent's plan.)
• Change in income or household status
• Having a baby, or adopting a child
• Moved to a new coverage area
• Gaining citizenship, or leaving incarceration

A: If you have a qualifying circumstances, you can enroll outside the normal period.

Depending on your circumstances, you may be able to get a plan now that meets the standards of the Affordable Care Act. If you can, then you will not have a penalty. If your circumstances do not allow you to get a plan that meets the standards of the Affordable Care Act, you can still get a plan that is not ACA compliant. This means you will have a penalty, but you can still have coverage. These other plans are short term plans that are not guaranteed issue, and do not cover preexisting conditions or preventative care.

A: Yes, you can.

If you are a small business owner, you can purchase a group plan at any time.  Even if you do not have employees, your state may have plans that allow business owners to purchase a group plan for themselves.

A: The penalty increases each year, and is applied during tax season.

The penalty is calculated one of 2 ways. If you or your dependents don’t have insurance that qualifies as minimum essential coverage you'll pay whichever of these amounts is higher:

2015

2% of your yearly household income. (Only the amount of income above the tax filing threshold, $10,150 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.

$325 per person for the year ($162.50 per child under 18). The maximum penalty per family using this method is $975. The way the penalty is calculated, a single adult with household income below $19,650 would pay the $325 flat rate. A single adult with household income above $19,650 would pay an amount based on the 2% rate.

2016

2.5% of your yearly household income. (Only the amount of income above the tax filing threshold, $10,150 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.

$695 per person for the year ($347.50 per child under 18). The maximum penalty per family using this method is $2085. The way the penalty is calculated, a single adult with household income below $19,650 would pay the $695 flat rate. A single adult with household income above $19,650 would pay an amount based on the 2.5% rate.

2017 and beyond

The fee is adjusted each year for inflation.

See HealthCare.gov and IRS.gov for additional information.

A: If you qualify for a subsidy, you benefit from using the exchange.

Generally speaking (in regard to cost only) you should go inside the exchange if you qualify for a credit or subsidy based on your income.  You can use this calculator to see if you qualify for a credit.  If you do not qualify for said credit or subsidy, there is no special benefit in going through the exchange.

A: You benefit from using a broker.

Some people think that by using a broker they have to pay a fee, or the premium will be higher since they are using the broker's services.   That is not the case with us.  We do not charge a fee for helping you pick a health plan.  The insurance carriers pay us direct.  When you work direct with a carrier, you are working with an employee who represents that one insurance company.   When you work with us, you work with someone who produces for a number of the carriers.  We will recommend what we believe is in your best interest.  We are your advocate.