Your HSA for America Guide to Affordable Care Act Open Enrollment

HSA for America provides you with all of the necessary resources to guide you through the process of signing up for a health plan. Our goal is to ensure your experience is easy and hassle-free!

NOTE: We are currently outside of open enrollment. To sign up now, you need to qualify for a special enrollment period, or sign up for a short-term plan to cover you until the next open enrollment. There are also healthshare plans which are available all year round.

Health Insurance or Healthshare

Healthshare programs are not health insurance, but in many ways they serve the same purpose. They are groups of like-minded people who have banded together to share medical expenses. 

Healthshare programs are not required to cover the same benefits that ACA plans do. Most also have limitations on how and when they will pay expenses related to pre-existing conditions. So they are not for everyone.

The cost is generally less than half the full price of health insurance, so they are particularly appealing to those who do not qualify for subsidies to pay for their health insurance.

For more information go to our Healthshare page.

If you don’t want any gaps in coverage, and don’t qualify for a special enrollment period, check out short term insurance. It covers you in case of a substantial medical event, such as an accident or hospitalization, but it won’t pay for doctor’s visits and routine wellness. It’s definitely a wise choice if you have absolutely no coverage right now, and need some protection until OEP. Your Personal Benefits Manager(PBM)can help you with the entire process and answer any questions that you might have.

Read the information that follows to get an understanding of what OEP is all about, and what steps you need to take to make sure you utilize that time to secure the best health insurance solution possible.

What If You Have a “Grandfathered” or “Grandmothered” Health Plan

Choosing HSA for America enables you to stay up-to-date on decisions that may affect your grandfathered and grandmothered health plans.  Grandfathered health plans are plans that were purchased on or before March 23, 2010 when the Affordable Care Act was signed into law.  Grandmothered plans are non-ACA plans that were in force on October 1, 2013, and were granted extensions to renew for a specific period of time. 

If your plan is scheduled to terminate, it's imperative that you contact an HSA for America PBM immediately to apply for a new health plan.

If you’re happy with your grandmothered or grandfathered health plan and the insurance company notifies you that it is not terminating the plan, you don’t have to do anything.  But there are several factors you’ll want to consider when deciding whether to keep your plan or switch to a new ACA health plan:

  • Do you qualify for premium assistance for an ACA health plan to reduce your monthly premium?
  • Does your plan have policy restrictions that an ACA plan doesn’t have?
  • Does your current plan cover preventive care - ACA plans do!
  • ACA plans are guaranteed-issue, meaning you can’t be denied coverage due to a pre-existing illness.
  • Have your premiums gone up? Let’s take a look at your options.

Your Personal Benefits Manager can do a policy review to see if you would be best served by keeping your current plan or switching to a new health plan.  Simply schedule a phone appointment to get started. 

What if I Already have an ACA Plan?

If you already have an ACA approved plan, you have the option to keep your current plan - if it’s still being offered - or you can work with an HSA for America PBM to look at other plan options. Here are your four options:

  • Do Nothing and Let Your Current Policy Auto-Renew.  If you’re happy with your current plan, you can keep it and allow it to auto-renew - assuming it’s still offered. You should receive notification from your insurance carrier regarding your new premium. If there is a change in your tax credit, it will be adjusted during the reconciliation process when you file your taxes.
  • Keep Your Current Plan and Request a Redetermination of Your Subsidy.  Again, if you’re happy with your current plan, you have the option to keep your plan - if it’s still offered. But to ensure you receive the proper premium subsidy from the start rather than waiting for your taxes to be reconciled by the IRS, log on to your or state marketplace account and “request a redetermination.” Better yet, call your PBM and let him or her help you reconcile your subsidy.
  • Sign up for a New Plan. If you’re considering changing health plans, an HSA for America PBM can help you look at all of your plan options, compare rates, and help you submit your application for premium assistance, if you qualify.
  • Switch to a healthshare program. These non-insurance programs are a way to share the risk of unexpected medical expenses with a group of like-minded people. The monthly membership cost is typically half that of health insurance. More information is on the Healthshare page.

I’m New to HSA for America - Can You Help Me?

Absolutely - whether you already have an ACA plan or you’re looking for the first time, our Personal Benefits Managers can help you find the plan that’s right for you and help you apply for premium assistance if you qualify for it.  No matter where you sign up for a health plan, your plan premium already includes the cost of an agent - so there’s never any cost to you for our services.

You also have the option to sign up on your own and have us listed as your agent of record.  This allows an HSA for America PBM to assist you with any health plan issues or questions you might have in the future.  Here’s what you have to look forward to:

  1. If you live in Colorado, you can apply for a health plan on your own through the Connect for Health Colorado Marketplace, but you must list us as your agent of record so our Personal Bebefits Managers can help you with any health plan or claims' issues in the future.  Visit our How-to-Apply web page for step-by-step instructions. 
  2. If you live in California, you can apply for a health plan on your own through the Covered California Marketplace.  However, you need to authorize your assigned HSA for America PBM as your certified agent after creating your Covered California account so we can help you before, during, and after the application process.  Visit our How-to-Authorize page for step-by-step instructions.

Our HSA for America processing team will follow your application from start to finish to ensure your policy is issued quickly, and you’ll still have lifetime access to an HSA for America PBM if you ever need anything.  You’ll be notified with your health plan ID number once your policy has been issued. 

You can choose to schedule an appointment with an HSA for America PBM at any time. Do remember however, that period just before and during the OEP is our busiest time of year, so you should get a phone appointment scheduled right away before we are completely booked.  Your PBM will work with you and:

  1. Review all of the plans available in your area and help you find the best plan available at the lowest net cost..
  2. Give you the opportunity to review plan copays, coinsurance, out-of-pocket costs and deductibles (aggregate versus embedded).
  3. Help you submit your health plan application.
  4. Help you submit your application for premium assistance, if you qualify.
  5. Keep you up to date on the progress of your application and ensure your plan is issued in a timely manner.
  6. Contact you with your policy number once your policy has been issued.
  7. Will be available any time you need assistance with premium payment issues or claims’ issues.
  8. Offer an Annual Comprehensive Policy Review to ensure you remain in the best plan and value year after year. 

Why Choose HSA for America?

At HSA for America, we make the entire insurance process easy and hassle-free.  Your PBM works with you to help you find a plan and apply, and continues as your PBM even after your policy is issued.  Every year we’ll complete our Annual Comprehensive Policy Review, so you can feel confident knowing you will remain in the best valued health plan year after year.

You will always have direct access to your PBM, who is always available to assist you with any issues you might have including claims or premiums issues.  Our goal is to help you keep more of your money in your pocket - where it belongs!

As changes happen, we’ll keep you up to date on anything that could affect your costs.  We also regularly share tips and advice that will continue to save you money on your health insurance and medical expenses throughout the year.

Schedule a time to meet with one of our experienced HSA for America Personal Benefits Managers by calling 800-913-0172.

HSA for America
749 S. Lemay Ave, Suite A3-116
Fort Collins, CO 80524
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Disclaimer: All information on this website is relayed to the best of the Company's ability, but does not guarantee accuracy. Information may be out of date. The content provided on this site is intended for informational purposes only and does not guarantee price or coverage. This site is not intended as, and does not constitute, accounting, legal, tax, and/or other professional advice. Determination of actual price is subject to Carriers.