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Category: Individual Health Insurance

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March 31st Marks the Last Day to Purchase Health Insurance for 2014

The last day for individuals and families to purchase health insurance for the 2014 year is coming up. The deadline for purchasing any plan off of the open market is March 31, 2014.

What Happens on March 31, 2014?

Health insurance policies are only available for purchase during a period known as open enrollment. Open enrollment is when insurance companies are required to accept applicants for one of their health insurance policies.

Insurance companies that are offering health insurance coverage to individuals and families have scheduled open enrollment to end on March 31, 2014. If health insurance has not been purchased by that date, the individual and/or their family will have to wait for the 2015 open enrollment period – which is scheduled for some time in November 2014.

What Will Happen if Health Insurance is Not Purchased by March 31, 2014?

 Individuals and/or families who have not signed up for health insurance coverage and who have not filed and/or qualified for an exemption, face a possible penalty. The penalty is assessed as part of the Affordable Care Act.

The fine that will be assessed is as follows:

  • 1% of household income – with a maximum of what the average bronze plan premium would have been
  • $95 per person/$47.50 per child under 18 – each family will have a maximum of $285

The penalty will be assessed at whichever is higher.

For more information on health insurance coverage and upcoming deadlines for the Affordable Care Act, contact Bernardini & Donovan Insurance, located in Redlands, California, today.

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How to get health insurance outside of open enrollment periods

Putting aside all the seemingly continuing problems with the new health insurance Marketplace websites, people are now wondering if they can still get health coverage beyond the government open enrollment periods. It is possible if you have a "qualifying event" that create special enrollment conditions.

Qualifying Life Events

The following events are "triggers" that may make you eligible to purchase health insurance even after enrollment periods end. According to HealthCare.gov, these events generate a "special enrollment period."

  • You get married.
  • You have a new birth or adopt a child.
  • You move to a new state offering different health insurance options than those you had previously.
  • You lose former health coverage, other than your voluntary cancellation or for non-payment of premiums.
  • You’re already enrolled, but your income changes or other life events affect your eligibility for tax credits or government assistance to pay premiums.

Special Enrollment Periods

When you have one of these events, you can enroll in a health plan for up to 60 days following the qualifying event. In 2014, open enrollment ends on March 31. After that date, you’ll need to have one of these events to enroll without penalty.

For more information, contact Bernardini & Donovan Insurance, your California individual and group health insurance experts. Their professionals will answer your questions and you’ll get the advice you need to proceed.

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Employer sponsored coverage, and Covered California premium subsidy, consumers be ware!

It has been brought to our attention through various sources that consumers are being misinformed and misled when it comes to qualifying for premium assistance through Covered California. We want to address this issue, as it has the potential for severe consequences.

Employees who are offered coverage through their employer cannot receive subsidy if their employer offers “affordable” coverage. How is “affordable” coverage defined under the Affordable Care Act? To determine if the coverage is “affordable” or not, we look at the employee ONLY monthly rate for health insurance coverage. The cost to add dependents, spouse, children, etc. DOES NOT play a role in this calculation. If the employee only pays less than 9.5% of the gross household income for health insurance, the coverage is deemed “affordable”.

A simple calculation would look like this. Let’s say the gross HOUSEHOLD income is $50,000. 9.5% of the gross family income would be $4750.  So, the EMPLOYEE ONLY would have to pay less than $396 per month ($4750 divided by 12 months equals $396 per month) for the coverage to be “affordable”. It is quite easy for an employer to provide “affordable” coverage. If the EMPLOYEE ONLY pays less than 9.5% of the gross household income on a monthly basis, ALL family members are disqualified from receiving subsidy through Covered California.

However, the children, based on the gross HOUSEHOLD income, may still qualify for Medicaid. Bottom line, if your employer offers you coverage, you need to check and see if it is affordable before looking to Covered California for subsidy. It is quite likely you will NOT be eligible for it.

Call us with questions at 909-792-5100.

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Individual and Family Health Insurance: The Value of Using an Agent

With 2014 just around the corner, and everyone being required to have health insurance or pay a fine, many individuals all over the country are trying to figure out the best plan for them and/or their family. Unfortunately, it’s no easy task with so many different insurance companies and health insurance plans out there. Because of this, many are turning to a professional agent for help.

Why would someone need the help of an agent? An agent can be very helpful when trying to find the best health insurance plan, especially when you’ve never shopped for insurance before or are not very familiar with insurance terms. The value of an agent is truly indescribable.

You see, when you purchase individual health insurance from your place of employment, there is an individual on-site that can answer any questions you have. A professional agent can do the same when you are purchasing on your own. An agent can help you fill out the initial application for health coverage and can even assist in filing of claims in the future. Should you be turned down for insurance from one company, an agent can assist you in the next steps – something you may otherwise not have known.

If you need assistance in choosing family or individual health insurance, contact Bernardini & Donovan Insurance Services to speak to a certified Covered California agent that can help ensure you choose the right plan for yourself and/or your entire family based on plan details, cost and your personal situation.

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Purchasing Insurance Through Individual Insurance Storefronts

Insurance storefronts are similar to most other retail businesses only the companies sell insurance instead of an actual product. Individuals meet with licensed insurance agents who can assess their situation and determine the type of policy and coverage that would be most beneficial for their circumstances.

A reputable agent can tell you what policies you qualify for and what you need to do to get signed up for coverage. They will explain all fees, deductibles and expenses associated with your policy. In some cases, a storefront agency also works through exchanges. The agent can help you get signed up for the insurance plan you are eligible for and make sure you have all of the coverage for your particular needs.

Bernardini & Donovan Insurance Services is a full service insurance agency located in Redlands, CA. Its staff of reputable agents can answer all of your questions concerning health insurance and what each plan covers. Insurance policies cover a wide range of treatment plans and procedures. By going through certified agents, like those at Bernardini & Donovan Insurance, they are available to help you get the coverage you need at an affordable price.

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Benefits of Working with an Independent Insurance Agency

There are many challenges to purchasing the right health insurance coverage. The more you know about how the industry works, the more capable you’ll be in making smart decisions concerning your health care needs.

When purchasing health insurance, you have a choice of working with either an independent agency or a captive agency. An independent agency will offer you policy options from a variety of different insurers, giving you greater choices for evaluation. A captive agency works with only one insurance carrier. This limits the number and variety of health plans from which you can choose.

Working with an independent agent offers you greater flexibility in the company you choose. In the event you are dissatisfied with a certain insurer, your agent can suggest alternative companies within their jurisdiction, enabling you to retain his services to acquire the better coverage you seek. Working with a variety of top insurance carriers provides independent agents with greater knowledge and experience in their field. It also enables them to establish a more extensive network of insurance contacts to expand their services to you.

Bernardini & Donovan Insurance Services, Inc. is an independent insurance agency.  For more advice on choosing California health care coverage, contact Bernardini & Donovan Insurance Services, their agents are ready to help you find the right plan for your health insurance needs.

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If I Buy My Own Insurance, Do I Need to Work with an Exchange?

As the Affordable Care Act takes effect, more people will be looking into purchasing their policies from an exchange. This does not, however, limit your choices. You are free to buy your own individual health insurance on the private market if you so choose.

Getting coverage on the private market has its advantages and disadvantages. If you already have coverage, you can simply extend your grandfathered policy to meet the new health insurance requirements. Grandfathered policies may not offer all the benefits of newer Obamacare plans, but premium costs are lower and they do meet many people’s current health care needs.  Not all insurance companies have maintained grandfathered plans, so you may be forced to purchase Obamacare plans if you wish to remain insured.

You can also buy a policy off the exchange if you’re getting health coverage for the first time. You will need to research plans and prices to ensure you get suitable coverage at an affordable price. One disadvantage of buying a policy on the private market is that you cannot qualify for government subsidies. If your income makes you eligible for these benefits, an exchange-based policy can help you save on health care costs.

If you have questions about the exchange, the certified agents at Bernardini & Donovan Insurance Services are here to help guide you through the exchange to make sure you get the coverage you need.

 

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Buying Insurance Through a Broker or Agent

With 2014 almost upon us, more people will be searching for health insurance coverage. You can purchase coverage through an insurance agent or broker or the state exchanges. The following explores some of the differences in purchasing coverage through these two mediums.

Buying your coverage through an exchange gives you access to federal subsidies if your income falls beneath 400% of the official poverty line. However, if you don’t qualify for these subsidies, it may be more convenient for you to purchase your coverage directly from an agent or broker.

Many insurers are offering coverage comparable to Obamacare standards to include mental health and maternity benefits at competitive costs. In addition, individuals who already have insurance coverage can continue with their grandfathered policies and avoid the extra expense of an Obamacare policy.

Using an exchange, you can easily compare insurance features and prices online. However, the enrollment process is more time consuming and complex, due to the amount of paperwork required. In contrast, buying a policy from an agent or broker is quick and easy, with no government intervention.

By carefully studying your options, you can choose the medium best suited to you for your health insurance coverage. For more insight into health plans, coverage and prices in Redlands, California, contact Bernardini & Donovan Insurance Services.

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Purchasing Coverage: What Are Your Options Outside the Exchange?

The Affordable Care Act mandates that all Americans must obtain some type of health insurance before January 1st, 2014. For those who do not wish to use a Health Marketplace or Exchange option, policies can still be purchased from private insurance brokers and agents as long as the policies meet the guidelines put in place by Obamacare.

The Affordable Care Act stipulates that all policies sold by agencies outside the exchange must meet or exceed the requirements of exchange policies at an affordable cost to the consumer. It also requires insurance companies to offer policies that fall within two higher level categories such as “gold and silver” or “elite and premier”. These types of policies may be more affordable in the long run for individuals who rarely seek medical attention.

Individuals who want to explore their health care options outside of the state exchange, can call Bernardini & Donovan Insurance Services. A licensed insurance agent will address your concerns and answer any questions you may have about the Affordable Care Act and private insurance.

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Individual Health Insurance: How will Covered California make it easier for me to compare different health plans?

Covered California is a health insurance marketplace, which will make it easier individuals to compare an array of qualified health plans from private insurance companies. The marketplace will allow you to shop for individual health insurance through Covered California exchanges online, over the phone or in person to select the perfect insurance option for your budget and health needs.

How will Covered California allow me to compare individual health insurance plans?

There will be four levels of coverage offered:

  • Bronze
  • Silver
  • Gold
  • Platinum

With the increase in ranking, the medical expenses covered in each category go up, with platinum being the highest ranked, making it compare plans in the same category or across categories.

For expenses happening at the time of receiving health care services – doctor visits or emergency room trips, for example, the health plans covering more medical expenses tend to have lower costs when receiving care but a higher monthly payment.

You can choose to pay a lower monthly cost and pay more when you need medical care, or a higher monthly cost so that when medical care is needed, you pay less. You are able to choose the level of coverage that best suits your personal budget and needs.

Finding the perfect individual health care insurance plan can be confusing. For more information about how individual insurance through Covered California can benefit you and your family, contact the Redlands insurance experts at Bernardini & Donovan Insurance Services.

let Bernardini & Donovan find the right plan for you

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