For persons buying health insurance individually (rather than through a job), the deadline to apply for coverage for 2014 was March 31. Under the new rules, you are not eligible to obtain coverage for 2014, unless something changes that qualifies for a special enrollment period. As a result, one of the following may apply to you:
YOU QUALIFIED FOR A LIFE-CHANGE EVENT
People who undergo some change in their lives or situations, may be granted a special enrollment period. Here are examples of life change events:
- You got married or were legally united through a civil union or domestic partnership
- Your family grew through birth or adoption
- Your legal residence changed
- You were incorrectly or inappropriately enrolled in a health plan for some reason that is not due to an error or omission on your part/li>
- Your income changed enough to impact your eligibility or amount of financial assistance
- Your household size has gotten smaller
- One of your dependents is no longer eligible for coverage under your health insurance plan because he/she is turning or has turned 26
YOU EXPERIENCED A LIFE CHANGE EVENT QUALIFYING YOU FOR A SPECIAL ENROLLMENT PERIOD
You may be eligible for a special enrollment period to get 2014 coverage if any of these apply to you:
- You lost a plan that provided minimum essential coverage (MEC), including a loss of Medicaid coverage due to an increase in your income.
- You lose employer-sponsored coverage or it becomes unaffordable as defined by the law.
- You turn 27 and are no longer eligible to be on your parents’ insurance plan
- You gain Citizenship or Immigration status
- You move to Colorado, or out of your plan’s service area
- Your family situation changes (marriage, divorce, birth or adoption, death)
- You have a gain or loss of eligibility for the tax credit or cost sharing reduction
YOU MISSED THE DEADLINE TO GET INSURANCE, BUT DON’T QUALIFY FOR A SPECIAL ENROLLMENT PERIOD
If you do not qualify for a special enrollment period, there are some things you can do to lessen your risks:
- Accident Insurance to cover out of pocket medical costs arising from some accidental injury
- Critical Illness insurance to provide cash for expenses if you are diagnosed with a critical illness
- Disability Insurance to provide cash in case you cannot work.
- Dental or Vision insurance
- Fixed Benefit plans that provide a flat amount for various types of medical services.
Colorado Health Brokers can help you navigate any of these situations. Please email or call if you would like to see whether you can benefit from any of these options, or have any questions about health and related insurance.
A major change brought by the Affordable Care Act (ACA) is to create an open enrollment period for people to purchase insurance (previously, individual insurance could be sold year-round). Whether you currently have insurance or not, the Open enrollment period allows you to review your current coverage in order to determine if you want to make a change. For first-time buyers of insurance, this gives you the opportunity to search both and off the health benefit exchanges operated by some states and the Federal government.
Colorado Health Brokers will search for plans both on the Connect for Health Colorado health benefit exchange (sometimes called “marketplace plans”) and directly with the insurance companies (sometimes called “off marketplace plans”). We will explain your options, pros and cons, and work with you to make the best possible choice for your health insurance coverage.
Short-term disability insurance provides monthly payments to help cover expenses if you are so disabled as to not be able to work at your profession. The monthly benefit amounts vary and are usually tagged to your current income. Benefits usually begin about a month after the disability is determined and continue for up to 12 months. This benefit can help you to cover living expenses and other costs during this difficult time. This insurance is available to individuals or as a group benefit offered by employees.
A death or critical illness in the family can sap savings and make day-to-day life more difficult and expensive. There are a couple of ways to lessen these risks:
TERM LIFE INSURANCE
Provides payment of a fixed amount upon the death of the insured person. Some policies also pay a partial benefit upon diagnosis of a critical illness. Amount of the policy premium is based on the dollar amount of the benefit, length of the term, and the person’s age and health. For example a 10-year term life policy for $250,000 would pay that amount if the insured person dies during the 10-year period. After ten years, you must either renew or find a new term policy
Example: Dean and his wife Julie have just had a baby. They have a mortgage and do well on their two incomes. If Dean were to die, Julie would have trouble making mortgage payments and caring for their child. Dean purchases a $500,000 life insurance policy for a 15-year term. This will pay Julie and the baby $500,000 for their use as needed.
CRITICAL ILLNESS INSURANCE
Pays a fixed amount of money upon diagnosis of any of the listed critical illnesses. This money can be spent for any kind of expense—not just medical expenses. Policies are for specified dollar amounts.
Example: Ann runs a small business that employs two other people. The business is new and struggling to become profitable. If anything happened to Ann, the business would suffer greatly. Ann purchased a critical illness policy in the amount of $150,000. If diagnosed with one of the critical illnesses, the plan would pay her $150,000 to support herself and the business.
Under the Affordable Care Act (ACA), employers who have 50 or more employees are required to offer health insurance to their employees. Smaller employers (under XXX employees) are not required to provide health insurance. However, if a small employer wishes to undertake group health insurance coverage, there are many plans and insurance companies available to serve these needs.
Covers medical costs incurred as a result of a covered accident, which are not covered by your health insurance. In case of a serious accident, this kind of plan would compensate you for amounts you pay against the deductible amount, copays and the like up to the dollar limit of the plan you purchase.
Example: Bill’s insurance plan has a $5,000 deductible and a $6,350 Out Of Pocket Maximum. Bill is involved in a covered accident resulting in a $50,000 doctor/hospital bill. His health insurance will require him to pay everything up to $5,000 out of pocket and then some percentage of subsequent claims until the $6,350 Out Of Pocket Maximum is reached. The insurance company will then pay the remaining $43,650 costs. If Bill has a $10,000 accident policy, the plan will reimburse him for his $6,350 out of pocket expense.
Standard medical insurance typically does not cover medical services outside the US. If you are taking a vacation or periodically travel outside the US for work or play, travel insurance may be for you. Plans can be obtained for as few as 5 days or as much as a year or more. Executive plans cover all travel for a year. Premiums are reasonable and there are many options to choose from. Let a professional benefits advisor with CHB help you identify the best options for your situation and needs.