Marketplace Health Insurance Enrollment Rules

There is still some confusion about the new Health Insurance Marketplace enrollment period times. You can enroll this first year only in the new Affordable Healthcare Marketplace from October 1 to March 31, 2014. If you want to start on January 1, 2014, the first day the new insurance programs will start, you need to be enrolled by December 15th. This enrollment period is only if you buy on the Marketplace and receive tax subsidies/tax credits. Continue reading “Marketplace Health Insurance Enrollment Rules”

What is the Cost of Obamacare in Raleigh, NC?

What are the costs of health care plans offered under the Affordable Healthcare Marketplace for individuals or families who are currently uninsured or not covered by a job-based health plan.
What you’ll pay for a Marketplace plan depends on five things:
1. The level of coverage you choose
2. Whether you qualify for a subsidy
3. Where you live in North Carolina
4. Your age
5. Whether you smoke
More than 70% of people applying for coverage are entitled to some form of tax credit or subsidy. The lower your income, the larger the subsidy you will get.
When choosing a plan, it is important to not just look at premium price. Other factors like deductibles, out of pocket maximums, doctor networks and generally how frequently you use your insurance or things you need to consider.
An experienced Certified Marketplace Health Insurance agent like me is free to use. We get you the exact same rates as if you enroll on your own but we know the ins and outs of the all the Marketplace plans so we insure you get the right plan for you needs. We are also here for help down the road should you have any problems.
We can get you immediate quotes today,even with the government marketplace not working. We’re here to help.
Sherie Samstag Bryan
(919) 977-1272

Which New Metal Tier Is Right For You?

Excerpted from U.S. News & World Report:

Consumers turning to the new marketplaces created by the Affordable Care Act will find health insurance plans organized by “metal” tiers — bronze, silver, gold and platinum — as well as a catastrophic tier — that signal a new era of comparison shopping. Up to now, every company had a unique plan design and it was very confusing to try to comparison shop. Now that should be simplified.

“The metal tiers provide consumers with a standard measurement so they can easily compare and understand which plans will offer more comprehensive coverage and cover a greater portion of their health care costs,” says Lydia Mitts, a health policy analyst at Families USA. Continue reading “Which New Metal Tier Is Right For You?”

How the Tax Subsidies Work

With the Affordable Care Act, how much of the premium is offset by tax subsidy? How do taxpayers know?

Starting in 2014, close to half of Americans buying health care on the exchanges will be eligible for tax credits to help offset the cost. The Kaiser Family Foundation estimates the average subsidy will come to roughly $5,500 or about two-thirds the cost of the premium.

Your personal subsidy will depend on your family’s income and the cost of insurance available to you on the exchange, What makes this so hard to quantify is due in large part to the varying cost of health insurance in each state.

The subsidy will equal the difference between the premium for the second-lowest-priced silver plan (also known as the benchmark plan) and a specified percentage of income. In 2014 the percentage will range from 2% for those with incomes below 133% of the federal poverty level and goes up to 9.5% for individuals and households with incomes up to 400% of the poverty level (which is about $24,000 to $94,000 a year for a family of four in 2014).

You check out this subsidy calculator at to help figure out your individual credit. For example, a non-smoking, single 25-year-old earning $28,000 a year would, according to the calculator, receive a tax credit of up to $835 or 27.5% of the overall premium.

For more individualized help, please contact us.


Who Qualifies for a Tax Credit/Subsidy?

Health insurance subsidies are provided only in the new Marketplace. They are actually instant tax credits and they provide a major benefit to millions of Americans. They will help make health insurance affordable for individuals and their families.

The Affordable Health Insurance Marketplace subsidies are calculated according to income and family size. If your income is between 100% to 400% FPL (Federal Poverty Level), you will be eligible for tax credit subsidies. The subsidy scale is a progressive schedule, so that the higher the financial need for affordability tax credits, the higher the subsidy. The subsidy is also known as the “premium tax credit”. It will offset the price of health insurance for those who qualify as of 2014. The income ranges for 100% to 400% FPL in 2013 are as follows (we expect a slight increase in 2014):

Individual with annual income of $11,490 (100%FPL) to $45,960 (400%FPL)
Family of 2 with annual income of $15,510 (100%FPL) to $62,040 (400%FPL)
Family of 3 with annual income of $19,530 (100%FPL) to $78,120 (400%FPL)
Family of 4 with annual income of $23,550 (100%FPL) to $94,200 (400%FPL)

Continue reading “Who Qualifies for a Tax Credit/Subsidy?”

The Marketplace Basics in NC

The NC Health Care exchange will open on October 1, 2013. This is part of the Affordable Health Care Act or Obamacare as it is also known. For individuals who do not currently have health insurance/ health plans this may make it affordable for you to finally buy health insurance.

Some big changes in the new policy. Preexisting conditions will no longer exempt you or cause huge premium increases. This is called premium equity. Insurers can’t charge huge increases to people with pre-existing conditions. This change affects 20 million children under the age of 19 also! The law also limits insurers’ ability to impose age-related premium increases or gender increases for private coverage. Continue reading “The Marketplace Basics in NC”