• ACA (Under 65)

Health Insurance Explained

This five-minute cartoon video that explains health insurance using fun, easy-to-understand scenarios. It's a light-hearted treatment of a difficult topic, breaking down important insurance concepts, such as premiums, deductibles and provider networks. The video explains how individuals pay for coverage and obtain medical care and prescription drugs when enrolled in various types of health insurance, including HMOs and PPOs.

Explaining the ACA

Our goal is to help Arizonans achieve better health through the kind of care they demand and deserve. We dedicate ourselves to best serve our clients through always focusing on each and every customer's needs.

Most people who qualify for Extra Help will pay:Two options for those seeking Small Group, Individual, and family healthcare insurance will be:

  • Off the exchange (do not qualify for tax credit assistance nor any Cost Share Reductions(CSR) )...or joining outside of annual open enrollment period.
  • On the exchange (qualify for assistance -300% below to poverty income). Must be enrolled during the open enrollment or with an SEP opportunity.

Standard Benefits Packages

Each metal level there can be several plans available, which will vary according to the deductibles, co-insurance andcopays offered. Some plans offer lower monthly premiums that may charge more out-of-pocket fees for care, while others have higher premium plans that cover more costs when you need care; other plans will fall in between.

In addition to the metal level plans, issuers can offer catastrophic plans (less than 60%; below bronze). Eligibility for catastrophic plans is limited to:

  • Individuals under age 30
  • Individuals who otherwise do not have an affordable coverage option, or who may qualify for a hardship exemption to the minimum essential coverage requirement If an individual qualifies for enrollment in a catastrophic plan, the catastrophic plan counts as minimum essential coverage.

There is no set AV for catastrophic plans. Instead, enrollees in catastrophic plans have a higher deductible limit than enrollees in Bronze, Silver, Gold, or Platinum plans.

Income sources to include to determine on or off exchange

  • Wages
  • Salaries
  • Tips
  • Net income from any self-employment or business (generally the amount of money taken in from a business minus business expenses)
  • Unemployment compensation
  • Social Security payments, including disability payments - but not Supplemental Security Income (SSI)
  • Alimony

Other items to include when estimating your client’s 2015 income are: retirement income, investment income, pension income, rental income, and other taxable income such as prizes, awards, and gambling winnings.

Don’t include the following kinds of income:

  • Child Support
  • Gifts
  • Supplemental Security Income (SSI)
  • Veterans’ disability payments
  • Workers’ compensation
  • Proceeds from loans (like student loans, home equity loans, or bank loans)

Wonder if you qualify for a Special Enrollment Period?

Here are a few questions to consider. Remember, you will need to apply to officially determine eligibility.

Did you or anyone in your household in the past 60 days OR do you expect anyone in your household to lose of coverage in the next 60 days?

Did any of the following apply to you or anyone in your household in the past 60 days?

Changes in household size:

  • Got married
  • Had a baby
  • Adopted child or had a child placed with you for foster care
  • Got divorced or legally separated and lost health insurance
  • Aging off parents plan (turning 26)
  • Cobra running out
  • Loss of employment for any reason whether voluntary or involuntary
  • Death

Changes in residence or income:

  • Moved to a new residence
  • Had a change in income

Changes in status:

  • Gained citizenship or lawful presence in the U.S.
  • Released from incarceration (jail or prison)
  • Going on or coming off ACCHESS
  • Are you a member of a tribe, or an Alaska Native corporation shareholder?

Take full advantage in determining the proper medal of your plan, deductibles and MOOP, Dr's, tax credits or CSR, SEP eligibility, Network of plan, company for your ideal insurance needs, and much more with the Marsh Assurance Group. Never ever any cost nor obligation for our assistance and invaluable education.

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