Tag Archives: tax credit

Summer Relaxing with a SEP

What’s So Special About Summer?

Didn’t buy health insurance by the deadline? Had some unexpected changes since then and need a plan, fast? A Special Enrollment Period (SEP) might be right for you. We have just what you need this summer to take a little of that heat off.

Dog Days

  1. Ice Cream
  2. Humidity More Ice Cream
  3. Getting a Special Chance to Buy Health Insurance

Every year, as summer turns to fall, and fall to winter, millions of Americans buy health insurance. During that season, the government gives everyone a chance to buy the plan they need, but by early spring, time’s up!

But here’s some good news, everyone knows the world doesn’t stop turning during the summer months. That’s why some special rules help you out when life gets interesting.

Special Enrollment Periods (SEPs) are special chances to buy or make changes to your health insurance plan the rest of the year. Here’s a quick Q&A on how they work.

Interested in signing up or need to learn more? Give us a call at 1-888-382-9771! We’re here to help.

Q:  What’s an SEP?

A: After March 31, only people with a qualifying life event can change their individual or family plan or enroll in a new plan. That’s called having an SEP.

Q: What’s a qualifying life event?

A: Events include:

  • Getting married
  • Having, adopting, or the placement of a child
  • Permanently moving to a new area with different health plan options
  • Losing other health coverage because
    • You lost your job
    • You don’t work enough hours to stay on your employer’s plan
    • Your employer stops paying for your plan or stops paying as much
    • Your plan doesn’t cover the essential health benefits as required by the Affordable Care Act (ACA)
    • A big increase in how much you pay for your plan

Q: Is a change in my income a qualifying life event?

A: For people who already have a qualified health plan, a change in income or household status can be a qualifying life event. Both of these events might change how much government help you can get to pay for your plan.

Don’t forget, you can apply for Medicaid or the Children’s Health Insurance Program (CHIP) any time.

Q: Why don’t I always qualify for an SEP if I lose my coverage?

A: Some events don’t count as a qualifying event:

  • Losing your plan because you didn’t pay your premiums
  • Choosing on your own to quit other health coverage
  • Losing coverage that’s not minimum essential coverage, like a short-term plan or (in some cases) a catastrophic plan

Q: What if I don’t have a qualifying life event?

A: You have to wait until the next Open Enrollment Period (OEP), which will begin during the fall. The government sets the start and end dates of OEP, not Health Alliance.

You can enroll in a Short-Term plan at any time. But remember, they don’t meet the requirements of the ACA for being a qualified health plan, which means you’ll have to pay a tax penalty in 2015.

Q: How long do I have to enroll in a plan after a qualifying event?

A: 60 days.

Q: How do I enroll?

A: You get to choose how you’d like to enroll. Find what works best for you, and if you need help along the way, call us at 1-888-382-9771. Or if you’re in the Champaign area, stop by our office at 206 W. Anthony Drive (near Alexander’s Steakhouse) for help!

Q: When will my coverage start?

A: Your start date depends on your qualifying event.

If you have questions about an SEP or about your situation, give us a call at 1-888-382-9771 or stop by our office—we’re more than happy to help you find the answers.

Save

Affordable Care

Crunching Numbers for You

The Affordable Care Act is here to make health care affordable! Let’s run through some facts about the kinds of help you can get paying for your Health Alliance individual insurance plan, called premium tax credits and cost-sharing subsidies.

What’s a premium tax credit?

A premium is what you pay monthly to have insurance. A premium tax credit lowers your cost to make a plan affordable for you.

What is a cost-sharing subsidy?

A cost-sharing subsidy makes other health insurance costs affordable, like your deductible, coinsurance, and out-of-pocket max.

Who qualifies for help?

There’s a little math involved here. First, you need to know your individual or family income. If your income falls between 100% and 400% of the federal poverty level, you can get help from the government.

You can get government help if you’re…
An individual with a gross income* of $12,000-$46,000 a year
A family of four with a gross income of $24,000-$94,000 a year

*Gross income is everything you make in a year, before any taxes or deductions.

What’s the federal poverty level?

The federal poverty level depends on your family’s size. In 2013, it was $11,490 for a single adult and $23,550 for a family of four. You can make up to 4 times that amount and still get help!

How much help will I get?

Again, there’s a little math involved. A few tools online will do the math for you, or a Health Alliance rep can help find your subsidy amount. Call or stop by our Champaign location at 206 W. Anthony Drive, near Alexander’s Steakhouse—we’ll crunch the numbers for you.

How do I apply this help to my bill?

The only thing you have to do is pick a plan from the Public Marketplace. Any public plan will let you apply for government help. The government deals directly with us after you enroll to apply its help to your bill.

What can I do if I don’t qualify for help, but I still don’t have a lot of money? 

  1. Think about your individual risk. Your individual risk is the plan’s medical deductible added to the out-of-pocket max. This is the most you’ll have to pay (besides the monthly premium,) before a plan will cover 100% of your costs. What are you OK with paying if the worst were to happen?
  2. Pay attention to a plan’s deductible and out-of-pocket max. The higher your deductible and out-of-pocket max, the lower your monthly premium. Keep in mind that if you get sick or hurt, you will have to pay for all your medical costs until you meet your plan’s deductible.
  3. Call or stop by. It’s not a sign of weakness. It’s smart. When you need medical advice, you call the doctor. When you need health insurance insight, you talk to our helpful reps.