Group & Individual Health Insurance

The PPACA Act established state marketplaces; California’s marketplace is called Covered California™ and sometimes offers more affordable options with financial support through:

• Federal Tax Credits
• State Tax Credits
• Cost-sharing subsidies
• Medi-Cal assistance

Recent and changes and trends may catch you by suprise.

• In all states coverage was not mandated for 2019, no worry regarding penalties
• In CA coverage will be mandated in 2020 CA, penalties apply
• Temporary policies are not available in CA
• CA legislature has banned coverage alternatives
• Covered Ca is requesting proof of identity requiring an ACA Certified specialist

Today, more than ever, consumers need the help of specialists to help explain and put inplace their options. We can ensure you are well informed, have access to the best healthcare you can afford, and that you don’t end up overpaying and over or under insured. Use your resources wisely… Know what you’re doing … Do the right thing.

In 2020, you will have seven “basic health plan choices”, though the considerations have become even more complex:

1. Individual and Family
2. Small Group
3. Large GrouP
4. Medicare
5. Medi-Cal
6. COBRA

In addition, you will have the choice of “buying on the exchange” or “buying off the exchange.”

Anyone is eligible to buy on the exchange but may find their choice of providers could be diminished and the financial disclosure could be off-putting. But you may have access to “health insurance tax subsidies.” If you meet certain income requirements, and do not have access to affordable health insurance through your employer or another government program, then you are most likely eligible for a subsidy.

Eligibility and the degree of subsidy is based on a standard called the “federal poverty level” (FPL).

Show and Compare health coverage programs at Covered California

You are eligible if:

• your household income is up to 600% FPL.
• your employer does not offer affordable group health insurance.

The discounts will cap the cost of your health insurance at 2% – 9.5% of your household income, if your household income is up to 600% above the federal poverty line (FPL).

If your employer covers your premium, you will not qualify for a subsidy and neither will your family members (so far, this is the interpretation). Generally, it is a good idea to keep the family on the same policy because they share the deductible and out-of-pocket-maximum; but, this may not always be appropriate for every family and strategic number crunching and understanding of nuances will shed enough light so an actionable decision can be made.

You can use the calculator to see what the cost of your insurance will likely be here.

Many businesses may decide to stop insuring dependents, increase employee premium sharing, or drop their employee coverage altogether. A solution for the employer and employees could be setting up a Health Reimbursement Account or HRA. Our associates at Zane Benefits assist by enabling employers to reimburse employees’ for out-of-pocket health expenses and premium expenses, making them 100% tax free.

• Tax Savings: Employer and Employee do not pay taxes on the reimbursements.
• Happier Employees: Employees value health benefits at up to 2Xs taxable compensation.
• Healthier Employees: When employees have health insurance they tend to be healthier.
• Employees can buy plans in or out of the exchange and some will be eligible for subsidies.
• Employers can define their contribution and don’t have to administer a health plan
• Easy and less time to administer.

Employers, business owners, employees, families, and parents:

Know what you’re doing… Do the right thing…. Use your resources wisely.

Get a quote now.

*Every need is unique. These are general estimates and not a final quote.  Please contact Janice at (310) 546-4295 or via email for detailed and accurate information.