Affordable Care Act

FAQs, Part I

^3957EAB73AB5DD5D7176CF849E79CFEE91E1E0C2B9026C039B^pimgpsh_fullsize_distrAs our clients grow into educated insurance consumers, we often get a lot of questions along the way. Here we’ve compiled a list of the questions we’re most frequently asked, so you can understand some of the complexities in shopping for insurance. Make sure to check our blog weekly for the latest videos and answers to your insurance questions. Click the question below to view the full post and video.

Q1: Are there fees for working with a Crosspointe Agent?
A1: No! There are no fees for working with an agent at Crosspointe! Whether you shop online by yourself or talk to one of our expert insurance advisors, your plan premium will be the same. Another benefit of working with one of our advisors is that you’re working with an educator, not a sales person. You’re getting an expert, focused on finding the right health plan that covers you and your family or your business based on your needs. We want to help you find the plan you need, and the best part is: It’s always FREE.

Q2: How does ACA impact Small businesses?
A2: In 2015, businesses with 50 or more employees will be required to offer health insurance, but those with less than 50 employees hold no similar obligations. Many small businesses find that health insurance is their largest expenditure (second to payroll). By offering employees a group insurance plan, they may be preventing them from taking advantage of premium tax credits. These tax credits are only offered to those who do not receive benefits from their jobs or are 400% below the poverty line. Because employees may be subject to these benefits, employees could receive Federal tax credits to help pay for their insurance premiums; employers could save money themselves by not offering group insurance.

Q3: Why do I need a health insurance broker?
A3: The Internet puts a lot of information at your fingertips, including everything you ever wanted to know about health insurance. While it’s nice to have this information available, finding the right health insurance plan is important and there are a lot legislative complexities to navigate. It can be very difficult for consumers to sort out their best option on their own. The new healthcare laws impact how tax credits work and without the help of an agent, it can be hard to figure out how to use them to your advantage. Crosspointe makes the process of finding the right insurance plan simple, guiding you through your entire enrollment process. Purchasing a plan with the aid of an advisor has NO ADDITIONAL COST, so there’s no reason not to consult an expert.

Q4: How are premiums calculated?
A4: In the past, it was necessary to answer questions about everything from family history, lifestyle, employment history—everything but the kitchen sink! With the new laws and the Affordable Care Act, premiums are calculated based on: Age, where you live, whether you use tobacco or not, and household income. If your household income is at or below four times the federal poverty level, the cost of your plan will be reduced to make it more affordable. You also won’t have to worry about seeing your rates increase or being denied coverage based on a pre-existing health condition. You cannot be turned down or charged more; only the above four factors apply.

Q5: How do I know if I qualify for tax credits?
A5: Tax credits are based on household size and income, and will come in the form of an immediate reduction on the cost of the insurance plan that you choose, allowing those eligible the freedom to choose the plan that makes the most sense for their lifestyle. If you are a small business owner, self-employed or don’t have coverage through your job, you may be eligible for a tax credit.

Q6: I don’t want to use Obamacare (Patient Protection and Affordable Health Care Law). What are my options with insurance?
A6: The Affordable Care Act is a collection of rules and regulations related to how health insurance operates in America. The ACA is not an insurance program. In the law, there are two main components that are meant to help make health insurance more affordable for the general population. The first ensures that you or a loved one cannot be denied or charged more for coverage due to a pre-existing health condition. The second element allows for tax credits for reducing health care cost depending on access to health insurance coverage, your income, and employment.

Check out our blog for more videos and more answers, coming soon!

What are my insurance options without the Affordable Care Act?

Q6: I don’t want to use the Affordable Care Act. What are my insurance options?

A: “I don’t want anything to do with Obamacare.” “I don’t want to sign up for health insurance through the government!” We hear these concerns and understand, but the law is not a health plan, or coverage, ACA contains the rules that govern health insurance in America. The new laws focus on two key elements:

  1. If you have a pre-existing health condition, you will not be denied or charged more for coverage.
  2. Depending on household income and access to coverage through your employer you may have access to a credit that will reduce your healthcare costs.

We are not here to debate the merits of the ACA, but rather, we want to find the ways it can best work for you. Don’t wait or get penalized for not having health insurance in 2015. Give us a call at 888.788.1565 today or submit a request for a quote online to discuss the options available currently and what you can do to cover yourself, your family or business.

 

 

 

All about the premiums.

^C352FB1508D39544E0FD010C25C3E4ECA344BCF96A986AC632^pimgpsh_fullsize_distrIn the past, getting health insurance meant being put through the ringer. You would have to answer an endless stream of questions about your health. Depending on your answers, you could be denied insurance or subject to higher premiums. With the changes introduced in the Affordable Care Act, myriads of health questions and pre-existing conditions are no longer a threat to those seeking health coverage. Your coverage is based solely on the four items listed below.

Individual health insurance eligibility is based on:

  • Where you live
  • Income
  • Age
  • Whether or not you use tobacco products

After considering those four criteria, that’s it. Coverage is guaranteed. You cannot be declined or charged more based on a health condition like in the past, and determining the monthly cost of your insurance plan depends on your needs.

The most important thing to note from the above criteria is that your premium will be partially based on your household income. Those who meet certain criteria may not be aware of ways to save money on their health insurance. Individuals at or below 400% the federal poverty level or who do not have access to a group health insurance plan through an employer are eligible for a Premium Tax Credit. With this tax credit you will receive money to help you pay the premiums for your health insurance. In many cases, these federal tax credits are enough to cover the entire cost of some plans and significantly reduce others.

Do you know if you’re eligible for a federal tax credit? Do you have questions about how your premiums are being calculated? Crosspointe Insurance Advisors will work with you to determine which insurance program fits your needs, while guaranteeing the best price possible. Give us a call today or request for a quote to find the tax credits you are eligible for, and the policy that fits your lifestyle and budget.

So, do I really need health coverage?

In the past buying your own health insurance was difficult. Those looking to get covered would have to answer questions about their age, height, weight, mediations, health history and then at the end of a long underwriting process, premiums would be increased based on these factors or, in some cases, people would be denied coverage all together.

Millions of Americans continue to go without health insurance, hoping they won’t get sick or have an accident. Sure, if you do have a medical emergency, you can go to the emergency room without health insurance and you will be treated. However, you will be expected to cover the entire cost of your treatment yourself.

As you may know, the Affordable Care Act (ACA) has a law in place (often referred to as the Individual Mandate) that now makes enrollment into a “qualified health plan” a requirement.

If you didn’t have coverage in 2014, you’ll have to pay one of these two penalties when you file your 2014 federal tax return:

  • 1% of your yearly household income.
  • $95 per adult and $47.50 per child (under 18).The maximum penalty per family using this method is $285.

Despite the debate, the Affordable Care Act can make getting health insurance easier and more affordable for many Americans. There are two man reasons.

  1. Coverage Is Guaranteed!

Along with the requirement for everyone to enroll in health coverage, the Affordable Care Act also changes the way individuals and families qualify for health insurance. Starting in January of 2014, individual and family health plans were guaranteed issue without underwriting. That’s right! Insurance companies can’t base your premium costs on your health history. The only factors they can use are: age, tobacco use and factors for the area in which you live.

  1. Premium Tax Credits

If you’re an individual or family without access to employer sponsored health insurance, there’s a new tax credit available to that can reduce your monthly premium AND potential reduce your deductibles and copayments on your qualified health plan. To be eligible for the premium tax credit, you’ll need to meet these 5 requirements.

  • Your household income is 100 to 400 percent above the Federal Poverty Level (chart below).Most people in this range will be eligible, but not everyone. We can help you determine eligibility, just request a free quote!
  • Your employer doesn’t offer health insurance that pays for at least 60% of your benefits and costs you less than 9.5% of your income.
  • You are not able to use other government health programs, such as Medicaid or Medicare.
  • You file a joint return if you’re married.
  • Another person does not claim you as a dependent.

 Household Size

 100%

 133%

 150%

200%

250%

 300%

400%

 1

$11,670

$15,521

$17,505

$23,340

$29,175

$35,010

$46,680

 2

15,730

 20,921

23,595

  31,460

39,325

47,190

62,920

 3

19,790

 26,321

29,685

  39,580

49,475

59,370

79,160

 4

23,850

 31,721

35,775

  47,700

59,625

71,550

95,400

 5

27,910

 37,120

41,865

  55,820

69,775

83,730

111,640

 6

31,970

 42,520

47,955

  63,940

79,925

95,910

127,880

 7

36,030

 47,920

54,045

  72,060

90,075

108,090

144,120

 8

40,090

 53,320

60,135

  80,180

100,225

120,270

160,360

Chart c/o http://familiesusa.org/product/federal-poverty-guidelines. Source: Calculations by Families USA based on data from the U.S. Department of Health and Human Services.
*If you find your income outside of the above chart there are many options for health coverage but you just won’t qualify for the premium tax credits. The guarantee issue laws still apply and you will have access to purchase plans on or off the marketplace in your state.

Now that you know a little more about ACA and some ways it can help your family, knowing when and how to enroll can be tricky. Most people will enroll in a new 2015 health plan during the Open Enrollment Period starting November 15th, 2014 and ending February 15th, 2015. If you miss the enrollment period, you may not be eligible to enroll again for a while.

You can apply for coverage outside of open enrollment periods due to: getting married, having a baby, a loss of coverage, moving from one state to another, adoption, divorce, a significant change in income and a few other reasons. All of these situations are called Qualifying Life Events. Typically–you only have 60 days to make a change or enroll in a plan due to a Qualifying Life Event.
Have you decided to get covered but aren’t sure how to find a plan? That is where Crosspointe Insurance Advisors can help. Our advisors are here to work with and for you to determine the insurance program that best fits your needs. The consultation and great advice come at no cost to you. Give us a call today at 888.788.1565 or request a quote online and we’ll find the best plan for you!

 

Affordable Care Act and Small Businesses

Q2: How does the Patient Care and Affordable Care Act (ACA) impact small businesses?

A: In 2015, businesses with 50 or more employees will be required to offer health insurance, but less than 50 holds no similar obligations. Many small businesses (less than 50 employees) find that health insurance is their largest expenditure second to payroll. By offering their employees a group insurance plan, they may be preventing them from taking advantage of premium tax credits, only offered to those who do not receive health benefits with their job and meet certain guidelines on household income. Both employers and employees may benefit from individual insurance plans.

For more information about the Affordable Care Act and your small business, contact Crosspointe Insurance Advisors.

Why do I need an Insurance Broker?

Shopping for health insurance can be frustrating.  If you’re like most people, reading the fine print is not your idea of fun.  However, when it comes to finding a health insurance plan you shouldn’t pass over those important details.  Working with an agent from Crosspointe will make the process easy.  We understand that every situation is different and there’s not one plan that will work for everyone.

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If you work with an agent from Crosspointe, they will…

1. Find out if you’re subsidy eligible: The Affordable Care Act changed everything about insurance. Yes, coverage is guaranteed and the insurance companies won’t ask about your pre-existing conditions BUT arguably the most important and most impactful part of the new law is the federal subsidies made available to individuals and families within 400% of the Federal Poverty Level.

For example, a family of four in Indiana with a household income of $50,000 could qualify for more than $514 a month in subsidies to reduce the cost of their health plan. This same family could enroll in a Bronze plan for $96 per month or a Silver plan for $247 per month.

By not understanding how these subsidies work, many Americans missed out on subsidies to help reduce their health insurance costs in 2014. Our agents are licensed by each state and certified to help you navigate the new laws. Contact us to find out if you’re subsidy eligible.

2. Help you compare plans and enroll in coverage: Not sure if you should you enroll in a health maintenance organization (HMO) or preferred provider organization (PPO)?  Maybe you’re not even sure what those terms mean.  That’s OK!  It’s our job to ask you questions and help you enroll in the right plan.  Need to know if your doctors and prescriptions are covered. We’ll do that, too.  As an independent broker we work with all the top carriers in each state to determine which plans work best for your lifestyle.

3. Make sure you understand your coverage: Do you know what you’re going to pay for your medication? When you visit a specialist? What the most you could pay out-of-pocket for a major medical condition is?  When you’re finished speaking with one of our experts, you’ll be able to answer each one of these questions with confidence. At Crosspointe, we want each of our clients to be educated consumers about insurance.

I’m sure by now you’re wondering what working with Crosspointe Insurance will cost you. Crosspointe Insurance Advisors work at the low rate of $0 an hour. Yes, you read that right—$0.

Whether you buy a plan on your own or allow us to facilitate the process, you’ll pay the same premium cost for your health plan. All our fees are included in that premium by the carrier to help them manage your health plan throughout the year, so you owe us $0 for our consultation.

The 2015 Enrollment Period is fast approaching and finding the right health insurance is tough. Crosspointe Insurance Advisors will work with you to determine which program fits your needs, while keeping it affordable for you. Give us a call at 888.788.1565 today or submit a request for a quote online.  Don’t wait for the deadline to act!

Are you concerned about how the new laws impact your business?  Read our recent post on how the Affordable Care Act impacts Group Health Plans.

 

Q: So What’s the Truth, Can I Keep My Current Health Coverage or Not?

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Q: So what’s the truth, can I keep my current health coverage or not?

A: Well, there’s a very technical term we use in the insurance industry as a response to this question … “kinda sorta.”  All kidding aside, there has been a lot of mention in the media over the past week about people receiving letters from their insurance carrier notifying them their coverage is ending.

In some cases you can take this at face value.  There are carriers who have decided not to offer plans that comply with the new Affordable Care Act guidelines.  In this case, you will be forced to make a change in your coverage and timing is everything.  If you determine you are not subsidy eligible (you can read more about that here), it is important to change to a new plan before January 1st, 2014.  If you are going to be eligible for a federal tax credit subsidy, you’ll likely wait to start your coverage until January 1st to capture the additional savings.

The carriers that are not offering ACA compliant plans in 2014 are in the minority.  In most cases, you will have the option to elect an early renewal for your current plan which will extend the ability to keep your current coverage in place through the end of 2014. For individuals and families who are not subsidy eligible due to income or access to coverage through their employer, this will likely be the preferred option.  This is because new ACA compliant plans will be significantly more expensive than current costs. Unfortunately, we can only delay the inevitable rather than avoid it entirely. Everyone will be forced to change to an ACA compliant health plan in 2015, but we are optimistic there will be some legislative fixes to provide relief by then.

Decisions like these are complicated and the stakes are VERY high to make the right call.  We specialize in helping you put the right strategy in place and keeping the process simple.  Don’t fight through the headaches of Healthcare.gov and the state marketplaces, we can do it for you quickly and easily … and we don’t cost you a dime.

Health Insurance – What to do now?

As we’re sure you’re aware, the Federal Marketplace Website has been having significant issues not allowing people to view quotes and enroll in coverage as advertised.  Hopefully, it will be fixed in the next month, but there’s plenty of work to do now.

At a very basic level, the law can be boiled down to two main changes:  

  • Your eligibility for coverage and rate you pay will no longer be determined based on your health.  All plans will be “community rated” and priced according to the following three factors: Age, Area of Residence, and Tobacco Use
  • If your 2014 household income is below 400% of the Federal Poverty Level and you do not have health coverage available through your employer, you will likely be eligible for a federal tax credit subsidy to offset some or all of the cost for your plan. The following graph illustrates where the household incomes fall based on household size (up the left) and percentage of the federal poverty level (across the top).

Chart

If you are subsidy eligible, we can help you enroll in a plan that takes full advantage of the federal subsidies available to you once the marketplaces are operational.  If you decide on a plan and are able to start and application on your own, you’ll find my broker information below.  It doesn’t cost you anything to add an agent to your policy, but will be very valuable in helping you navigate questions, coverage issues, etc.

If you determine from above that you and your family are NOT subsidy eligible, YOU SHOULD NOT use the marketplace website.  There are likely better options available for you outside of this marketplace.  Many major insurance carriers have opted not to participate in the marketplace and you will not see those options available if you search there exclusively.

You have until December 15th, 2013 to make the right decision.  If you don’t have the right information you could end up paying thousands more for your coverage.  That’s where we come along side and advise you on the best strategy for your situation … and our compensation comes directly from the carrier at no cost to you.

If you decide to start a new application on healthcare.gov or kyenroll.ky.gov (in Kentucky) without me, please add my information on the page that asks, “Tell us if you’re getting help from one of these people.”  Select “Agent or Broker” and fill in all four of the applicable following fields:

  • First Name: Joshua
  • Last Name: Mushlock
  • FFM User ID: jmushlock
  • NPN Number: 8181538

 

Actively working for you,

Josh Mushlock

Co-Founder, Crosspointe Insurance Advisors

 

 

Crosspointe & Obamacare: What You Need to Know

What does Crosspointe Insurance Advisors have to do with the “Affordable Care Act,” also known as “Obamacare?”

First off, we are not Obamacare. In fact, other than being fully certified through the state and federal health insurance marketplaces, we aren’t affiliated with Obamacare in any way. Our guiding mission has been to help people find, understand, and enroll in health insurance coverage for the past six years.

Unlike other insurance agencies, our company started with a passion and primary focus to help individuals and families navigate the difficult challenges of shopping for health insurance. We are proud to have helped thousands of people to date choose and enroll in a health plan that makes sense for them.

Our job is not to offer a political commentary on Obamacare. Truth be told, like any reasonable person who looks at the new law, we believe there are clear advantages and disadvantages as it stands.

Most people would agree it’s a good thing to see those who were previously denied coverage based on their health history gain access to the coverage they need. However, we’re left scratching our head at the fact gross premiums have dramatically increased in the face of a law named, the “Affordable Care Act.” We also have deep questions about the economics and sustainability of the subsidies that are designed to make coverage affordable for household incomes falling below 400% of the federal poverty level.

While we continue to be a voice to our lawmakers advocating for necessary changes, we maintain our primary role is to help people navigate current realities. If you work for a large employer (50+ employees), you can expect to see very little change in your coverage and cost. However, if you fall in one of the following three categories, a short conversation with one of our advisors could make a dramatic impact:

1. Individuals and families who purchase their own health insurance coverage and expect their 2014 household income to fall below 400% of the federal poverty level.*
2. Individuals and families who purchase their own health insurance coverage and expect their 2014 household income to exceed 400% of the federal poverty level.*
3. Business owners and employees of companies with less than 50 employees.

The strategies for each group above differ greatly, but it is urgent to deploy the right game plan for each situation now, as the clock is ticking. Our experienced advisors are equipped and available to make the entire process smooth and simple. You can view real-time quotes and find more information at www.crosspointeinsurance.com or by calling us at (888) 788-1565.

Josh Mushlock
Co-Founder, Crosspointe Insurance Advisors

*Federal Poverty Level Chart
Federal Poverty Level Chart

According to the Kaiser Family Foundation:
“About half (48%) of people now buying their own insurance would be eligible for a tax credit that would offset their premium. Among those who will be eligible for tax credits, the average subsidy would be $5,548 per family”