Since last year, Thanksgiving has a new meaning for people who need health insurance. The time for buying individual and family plans (as opposed to plans through your work) is approaching. If you need to be sure your 2014 insurance is still the best option, or if you are looking for insurance the very first time, the application deadline is very close. Your quickest path to insurance? Call one of our certified brokers to get individualized hands on help at no charge.
DEADLINE: December 15 is the deadline to apply for individual health insurance that begins January 1. Since there are no medical qualifying hoops to jump through any more, you need only apply to get health insurance for yourself and your family. Applications must in no later than Dec. 15 if you want your insurance to begin on January 1.
HOW TO CREATE AN ACCOUNT ON THE COLORADO EXCHANGE: If you want to buy insurance for 2015, it is helpful to have an account on the Connect for Health Colorado (Connect) Marketplace (the state’s health benefit exchange. Click on this link for a guide to doing this: https://www.dropbox.com/s/q3iy9dw8b5df9dl/CreateAccount112814.pdf?dl=0
HOW TO APPLY FOR FINANCIAL ASSISTANCE: Financial assistance with health insurance premiums depends on income level and family size. You may qualify for financial assistance for 2015 if your family income is less than these amounts:
Two People: $62,920
Four People: $95,400
For self-employed people, income is after your business expenses. To create an account on Connect for Health Colorado and see how much assistance you qualify for, click on this link for our easy-to-follow, free guide to doing this: https://www.dropbox.com/s/3bi0fajhm03gnoe/NewCustomerWithFinancial%20Assistance%20app113014.pdf?dl=0
If you want to purchase a plan, but do not qualify or want to apply for financial assistance, use this link for instructions on how to shop for a plan on the Colorado Marketplace: https://www.dropbox.com/s/1t6k83zqlwbheod/NewCustomerNoFA113014.pdf?dl=0
IF YOU HAVE QUESTIONS OR PROBLEMS: If you have technical or computer problems creating an account or completing the financial assistance application, you can call Connect’s Customer Service line at 855-752-6749 for help solving the problem. For questions or issues related to your insurance, rely on your broker.
FINDING THE BEST PLAN: There is no single best health insurance plan. The best plan for each person balances the monthly cost of the insurance, with the health of the person, their preferences for certain doctors, and likely out of pocket costs. My role as a broker is to help compare all available plans to find the one that best meets your needs and requirements. You do not pay anything extra to use a broker.
At Colorado Health Brokers, we all live in Colorado and enjoy helping people find the best possible health insurance plan for their particular situation. I am a broker, also trained and certified to help find financial assistance to help with insurance premiums. There is no charge to you for the help I provide.
On Saturday, September 6, 2013 I spent all day in a training seminar in order to be able to interface successfully with the new Colorado computer software program for the Affordable Care Act. Prior to this I had completed a 10 hour on-line course in preparation for the in-class portion of the training. Our access to the Marketplace, formally known as the Exchange, is scheduled to begin on October 1, 2013. The Marketplace is where individuals, with or without the aid of a broker or guide, can go to find out if they are eligible for federal subsidies for their health insurance premiums, as well as apply for the new ACA qualified plans.
All the on-line courses, as well as the class material was designed for the broker in training to have access to an on-line practice Marketplace in order to fully familiarize ourselves with the program before the kickoff in three weeks. However, the practice programs were not working and are not scheduled to be working before the start of the real thing. I have to give the instructor high marks in attitude and for attempting to familiarize us with how each of the program pages will supposedly work. But, without real practice, we mostly learned the theory of how it is supposed to perform, but no skill in navigating the system.
So, my guess is now I will spend the first week of October stumbling through the Marketplace in an attempt to figure out how it all works.
Do yourself a favor, if you want to work with me to find a new plan under the Affordable Care Act, don’t call me until late October.
On August 27, the Internal Revenue Service (IRS) issued a final rule for the individual mandate provision of the Patient Protection and Affordable Care Act (PPACA).
As a reminder, the individual mandate requires most individuals to have minimum essential coverage in 2014 or pay a penalty. The penalty is called a shared responsibility payment. Some individuals may qualify for an exemption from the mandate so they will not be required to have coverage or pay a penalty. An individual seeking an exemption may do so in advance through an application submitted to the Exchange/Marketplace or after the fact with the IRS through the tax filing process. An applicant can apply for multiple exemptions simultaneously.
The final rule, which is largely consistent with the proposed regulations, confirms the following:
1. What qualifies as minimum essential coverage
2. What wasn’t addressed in regard to minimum essential coverage
3. Who is exempt from paying the penalty
4. How penalties will be determined and paid
1. What Qualifies as Minimum Essential Coverage
An individual is considered to have minimum essential coverage for any month in which he or she is enrolled in one of the following types of coverage for at least one day. Changes from the proposed rule are noted in italics.
• An employer-sponsored group health plan offered in a state, which is defined as the 50 states plus the District of Columbia. This includes plans offered by, or on behalf of, an employer to an employee, e.g. multiemployer plans, single employer collectively bargained plans, plans sponsored by third parties such as professional employer organizations, temporary staffing agency, etc.
• An individual health insurance policy offered in the individual market in a state or through an Exchange/Marketplace in a territory.
• A government plan such as Medicare, Medicaid, Children’s Health Insurance Program (CHIP), TRICARE (a U.S. Department of Defense Military Health System) or veterans coverage
• Insured student health coverage
• Self-insured student health coverage*
• Medicare Advantage plan
• State high risk pool coverage*
• Coverage for non-U.S. citizens provided by another country**
• Refugee medical assistance provided by the Administration for Children and Families
• Coverage for AmeriCorp volunteers**
*Designated as minimum essential coverage for plan/policy years beginning on or before December 31, 2014. For coverage beginning after December 31, 2014, sponsors of high risk pool or self-funded student health coverage may apply to be recognized as providing minimum essential coverage.
**Coverage provided by another country and coverage for AmeriCorps volunteers are no longer automatically deemed minimum essential coverage. However, individuals may apply to have their coverage recognized as minimum essential coverage.
2. What Wasn’t Addressed in Regard to Minimum Essential Coverage
The final rule does not specifically address arrangements in which an employer provides subsidies or funds a pre-tax arrangement (e.g., a stand-alone Health Reimbursement Account) for employees to purchase a plan in the individual market. The final rule also doesn’t address wellness incentives. These issues will be addressed in future guidance.
3. Who is Exempt from Paying the Penalty
The final rule confirmed the broad exemption categories, including a few changes in italics.
• Individuals who cannot afford coverage
• Taxpayers with income below the tax filing threshold. A taxpayer is not required to file a federal income tax return solely to claim the exemption, and may apply for exemption via the Exchange/Marketplace.
• Individuals who qualify for a hardship exemption
• Individuals who have a gap in minimum essential coverage of less than three consecutive months in a calendar year, with the continuous period beginning no earlier than January 1, 2014
• Members of religious groups that object to coverage on religious principles
• Members of health care sharing ministries
• Individuals in prison
• Individuals who are not U.S. citizens and not lawfully present in the United States as defined by Health and Human Services
• U.S. citizens residing in a foreign country who meet certain IRS tests
• Individuals who are not members of a federally recognized Native American tribe, but who are eligible for services from the federal Indian Health Service
4. How Penalties will be Determined and Paid
The first penalties will be due when individuals file their 2014 tax returns in 2015. A penalty is the greater of either a specified dollar amount or percentage of income. The annual penalties for 2014 through 2016 are noted below. Beginning in 2017, penalties will increase based on the cost of living.
• 2014: Greater of $95 per adult and $47.50 per child under age 18, maximum of $285 per family, or 1% of income over the tax-filing threshold
• 2015: Greater of $325 per adult and $162.50 per child under age 18, maximum of $975 per family, or 2% over the tax-filing threshold
• 2016: Greater of $695 per adult and $347.50 per child under age 18, maximum of $2,085 per family, or 2.5% over the tax-filing threshold
If the penalty applies for less than a full calendar year, the penalty will be 1/12 of the annual amount per month without coverage.
Dr. Don SchmidtCanyon Chiropractic Center - Boulder, Colorado
Thank you for saving us money on our health insurance! We really appreciated your willingness to 'hand hold' us through the process. It can be a daunting task to choose from all the available insurance plans out there. You made it almost easy!
Don MartingMartin Auctioneering - Longmont, Colorado
I can't thank you enough for helping me and saving me a significant amount of money. I truly believe that you had my best interest at heart.