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!

 

Every year the federal government’s Open Enrollment Period (OEP) for health insurance coverage starts November 1 and runs for three months until January 31. It is only during this time that you can get permanent health insurance coverage unless you qualify for a special enrollment period.

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 Consultant 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.

Understanding the Federal Healthcare Exchange Versus a State Marketplace

Under the Affordable Care Act (ACA), each state has the option of forming its own state exchange (otherwise known as a marketplace) to offer health insurance, or they can opt to use the federal exchange.  If your state has established its own state marketplace, you must apply for insurance through your particular state’s marketplace and can obtain the help of an agent such as our Personal Benefits Consultants at HSA for America.

HSA for America is certified to offer plans through most individual state marketplaces and the federal exchange.  We can also write plans “off-marketplace” in most states.

HSA for America’s Annual Comprehensive Policy Review

As a client of HSA for America, you have the opportunity to receive a free Annual Comprehensive Policy Review.  Because new carriers and new health plans are joining the market in 2016all the time, there may be room for you to save even more money, or get better coverage for your money.

During this review, your Personal Benefits Consultant will compare your current plan with the plans available to ensure you remain in the best plan available at the lowest net cost.  Schedule an appointment with a Personal Benefits Consultant by calling HSA for America at 800-913-0172.

Even if you signed up for your current plan on your own or through another agent, you can still choose to use an HSA for America Personal Benefits Consultant when you enroll in a new plan.

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. 

While some plans were scheduled to terminate on December 31, 2014, most carriers are allowing individuals to keep these plans through 2015 or 2016.

If your plan is scheduled to terminate, it's imperative that you contact an HSA for America Personal Benefits Consultant immediately to apply for a new health plan. If you don’t sign up for a new one during OEP, you won’t have health insurance coverage in 2016.

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 Consultant 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 available in 2016 - or you can work with an HSA for America Personal Benefits Consultant to look at other plan options.  Here are your three 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 in 2016.  You should receive notification from your insurance carrier regarding your new 2016 premium. Be aware, however, that there is some risk associated with this option if you receive premium assistance, and here’s why:
    • If you received an advanced premium tax credit for 2015, your tax credit will remain the same for 2016 if you auto-renew.  In general, subsidies are calculated based on the premium for the second least-expensive silver ACA plan. If that premium changes in your area, however, this could affect the amount of subsidy you receive and could increase your monthly health plan premium. Your tax credit will be adjusted during the reconciliation process when you file your taxes for 2015.  (More about that in the next item.)
  • 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 in 2016.  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 healthcare.gov or state marketplace account and “request a redetermination.” Better yet, call your Personal Benefits Consultant and let him or her help you reconcile your subsidy.
    • Because premium tax credits are determined based upon the cost of the second-lowest silver plan, if the cost of this plan changes for 2016, so will your premiums and tax credits for 2016.  If you opt not to request a redetermination, you could be due a refund or you could owe money once your 2016 taxes are reconciled by the IRS, depending on whether your income went up or down. .
  • Sign up for a New Plan.  If you’re considering changing health plans, an HSA for America Personal Benefits Consultant can help you look at all of your plan options, compare rates, and help you submit your application for premium assistance, if you qualify. 

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 Consultants 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.  Remember - All ACA health plans are “guaranteed-issue.”

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 Personal Benefits Consultant 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 Benefits Consultants 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 Personal Benefits Consultant as your certified agent after creating your Covered California account so our Personal Benefits Consultants can help you before, during and after the application process.  Visit our How-to-Authorize page for step-by-step instructions.
  3. If you think you'll be qualifying for a subsidy, get an instant quote on the exchange by clicking the button below and simply apply online.
    ON-EXCHANGE INSTANT QUOTE

  4. You can also bypass the exchange site and sign up quickly and easily directly with the insurance carrier of your choice.  Simply run an off-exchange instant quote by clicking the button below and then apply online.
  5. OFF-EXCHANGE INSTANT QUOTE

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 Personal Benefits Consultant 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 Personal Benefits Consultant 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 Personal Benefits Consultant 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. 

Do I Have to Meet With an HSA for America Personal Benefits Consultant?

You always have the option to schedule a time to speak with one of our Personal Benefits Consultants to sign up for a plan; however, it is very easy to compare plans and sign up on your own.  Once you run your instant quote, you can get quick answers to many of your questions by emailing your Personal Benefits Consultant.  We’ll also be here to help now or at any time in the future, if you ever need anything.

You can bypass the subsidy application process if you know you don’t qualify for premium assistance.  Signing up for an “off-marketplace” plan is easy by following these few easy steps:

  • Run an instant quote.
  • Review your plan options and choose your deductible and coinsurance limits.
  • Click apply and request an application or apply online.

Our application processing team will follow your application through the entire process to avoid any complications and ensure your policy is issued in a timely manner.  You’ll be notified when your policy number is available. 

Why Choose HSA for America?

At HSA for America, we make the entire insurance process easy and hassle-free.  Your Personal Benefits Consultant works with you to help you find a plan and apply, and continues as your Personal Benefits Consultant 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 Personal Benefits Consultant, 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 Consultants by calling 800-913-0172.  You can also learn more about the health care laws and the Affordable Care Act by visiting our health care reform web page.

HSA for America
749 S. Lemay Ave, Suite A3-116
Fort Collins, CO 80524
Contact Us

Click for the BBB Business Review of this Insurance - Accident & Health  in Fort Collins CO

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.