45 years of insurance expertise and
We can help you with Individual & Group Health insurance including the new Health Exchange for both Individual and Shop (small business) coverage.
"Open enrollment for Health insurance effective January 1st, 2017 is available November 1, 2016 - January 31, 2017. So unless you qualifying for a Special Enrollment Period (see below) you can't get health until that time."
The 4 metal plans
Plans in the Health Insurance marketplace consist of 4 "metal” categories ( Catastrophic plans are also available to some people ). Metal plans are based on you and your plan split health care costs.
- Bronze 60% average plan pays
- Silver 70% average plan pays
- Gold 80% average plan pays
- Platinum 90% average plan pays
Qualifying events for a Special Enrollment Period
There are 9 triggers that would permit you to obtain health coverage outside the annual open enrollment period. Contact our office for further detail on each.
- Involuntary loss of other coverage Cancelling the plan or failing to pay the premiums does not count as involuntary loss.
- Individual plan renewing outside of the regular open enrollment. allows a special open enrollment for people whose health plan is renewing – but not terminating – outside of regular open enrollment.
- Becoming a dependent or gaining a dependent as a result or birth, adoption, or placement in foster care.
- Marriage If you get married, you have a 60 day open enrollment window that begins on your wedding day.
- Divorce If you lose your existing health insurance due to a divorce and other (court ordered children coverage, etc.).
- Becoming a United States Citizen this qualifying event only applies within the exchanges.
- A permanent move to an area where different qualified health plans (QHPs) are available. A permanent move to a new state will always trigger a special open enrollment period, because each state has its own health plans. Even a move within your state may apply.
- An error or problem with enrollment (or non-enrollment) that was the fault of the exchange, HHS, or an enrollment assister
- Employer-sponsored coverage reducing benefits such that it no longer provides minimum value, or becomes unaffordable - employee pays more than 9.66 percent of income for just the employee’s portion of the coverage in 2016