Health Insurance Plan Options
Health Insurance Options for Individuals and Families, w/o Tax Credits
If you can answer “no” to the either of the two below questions, you will not receive tax credits for ACA Marketplace plans and so there is NO reason to buy a health insurance plan through the healthcare.gov Marketplace.
Will the annual income on your 2022 tax return fall under these income thresholds for the number of people in your family?
approximately $86,000 for family of 1
approximately $170,000 for family of 2
approximately $215,000 for family of 3
approximately $260,000 for family of 4
approximately $305,000 for family of 5
approximately $310,000 for family of 6
DURING the time period you need this individual health insurance coverage…
Will you NOT have access to an employer-sponsored health insurance plan through work,?
And…
Will your spouse NOT have access to an employer-sponsored health insurance plan through work?
Why do we say there is NO reason? Because buying a policy through healthcare.gov adds extra, confusing, frustrating layers of silliness to the enrollment process. Plus, you have more options of what might be best! See below for the top 3 options:
The Top 3 Avenues of Buying Your Own Health Insurance If You Do Not Qualify For Tax Credits:
ACA Health Insurance Without a Tax Credit
You can purchase the same health insurance plans that are Affordable Care Act compliant, without a tax credit. We can enroll in the plans directly through the insurance company, not healthcare.gov.
Short-Term Health Insurance For The Entire Year
Short-term health insurance, designed to cover someone for a few months, between job-based coverage, can also cover you the entire year, at a much lower premium cost than ACA health insurance plans.
If You Have a Business, a Group Health Insurance Plan
If you own a business we can also explore group health insurance plans, for as few as 1 (if inc.) employee. Premium costs are similar to individual plans, and you can deduct the premium cost as a business expense.
ACA Health Insurance Without a Tax Credit
Some of the healthcare.gov advertising seems to imply they invented health insurance! But they do not provide health insurance at all, just an extra barrier of enrollment for people that qualify for ACA tax credits. Insurers design, provide and offer service for health insurance plans, and we can work with them directly. It is a much simpler process.
People who choose this avenue of buying their own health insurance do not qualify for the tax credits, and also do not have a business to purchase a group health insurance plan with. They may have considered short-term health insurance, but would rather have the added benefits and protections of ACA compliant plans.
See Plans Now:
If you would like to review the benefit details and costs of ACA health insurance plans click the below button. You can instantly see rates and benefits for N.C. plans.
If you find a plan you know will be best you can even enroll here, with Chip attached as your servicing agent, to help throughout the year.
Or Ask Chip for Help and Recommendations…
Or if you would like more help, and personalized recommendations to your situation, complete the free quote request at the bottom of this page.
Chip will research plans and email you with what he sees as working best.
Short-Term Health Insurance (for the full year)
What is short-term health insurance?
Short-term health insurance plans were originally designed in the 1980’s for someone needing health insurance for 1-6 months (to fill gaps in coverage, such as between job-based health insurance). The plans help people avoid the high cost of COBRA coverage.
When the Affordable Care Act began in earnest in 2014 part of the new laws really held short-term insurance back, in terms of plan length, and also because people who chose short-term health insurance were subject to the tax penalty for not having ACA-compliant health insurance. But those parts of the law have been waived, so you can choose this short-term health insurance coverage free of that tax penalty, and for the full year.
What does the plan design look like?
Short-term health plans are very similar to a high-deductible style plan…a deductible you pay the medical expenses up to, then the insurer pays 100% afterward.
People who are not above average users of health insurance like this option as the premium cost is much less, and the plan offers great coverage when something major or unexpected happens, as many times, depending on the deductible you choose, the out of pocket maximum medical cost you could be liable for is much less than ACA health insurance plans. You cap your out of pocket as low as $2,500.
And even in that deductible period, when you are paying for the medical costs, there are benefits of having the plan! That is because you do not pay the “retail cost” of those visits, hospital stays, surgeries, prescriptions, etc. You pay the discounted cost, the much lower cost the insurer has negotiated with the provider.
How are the provider networks?
There are many insurers offering short-term health insurance, including health insurance companies have built strong nationwide provider networks for their other insurance plans. Amazingly, they utilize those same provider networks for their short-term plans. That means that currently in North Carolina, these provider networks are larger than the networks ACA health insurers offer!
How much of a cost difference is there between short-term and ACA health insurance plans?
It all depends on which plans you are comparing to each other, but short-term health insurance monthly premium costs can be 15-50% lower than plan premium costs for ACA health insurance plans.
Group Health Insurance for Your Business
We work with many small businesses, consultants, “gig economy” workers, self-employed families, etc. Many times their income is over the threshold for tax credits, and so we recommend looking into a group health insurance plan for their business.
Just about any business qualifies.
We can enroll group health insurance plans with as few as 2 employees, no matter how your business is organized, and with as few as 1 full-time employee if your business is incorporated.
The cost is currently less than individual plans.
Insurers see group health insurance plans with 1-50 employees as a much more stable offering than individual plans (which have so much change because of the ACA).
And that means that costs of group plans are currently less than for individual plans, even when you compare plans with the same benefits (most insurers offer the same plan designs in individual and group models).
The premium cost is also a deductible biz expense.
You can deduct the amount the business pays toward health insurance as a business expense, just like with office supplies or lease payments. This helps lower the cost.
And the plan can grow with your business
Maybe your business it just you for now. That is OK, we can choose a group health insurance plan if your business is incorporated.
In the future you may begin to add additional full-time employees as your business grows. You will be able to offer this same health insurance plan to them also, your built in employee benefits plan.
You can enroll in your own health insurance plan throughout the year.
ACA Health Insurance SEP
You can enroll in an ACA health insurance plan throughout the year if you have a Special Enrollment Period.
SEPs include losing job-based health insurance, turning 26 and losing job based coverage, moving to a new county or state, getting married, getting separated or divorced, had a baby, lost Medicaid eligibility, etc.
ACA Health Insurance AEP
If you do not have a Special Enrollment Period (SEP) then to choose an ACA Plan without a tax credit you will need to wait until the Annual Enrollment Period (AEP) to enroll, starting this coming November.
We can set up a short-term health plan to cover you in the interim.
Short-Term Health
You can begin short-term health any day of the year, and coverage can begin as soon as the next day!
That said, we begin most plans at the beginning of a month, to coincide with other coverage ending.
Group Health Insurance
You can start a group health insurance plan at any first of the month, in any of the 12 months in a year.
If you are feeling overwhelmed already, no worries! Chip can help.
The good news is there are a lot of choices, but it can feel overwhelming. See below how Chip can help you through the process, doing most of the work along the way:
You Request a Free Quote
Begin the free process of working with Chip by requesting a quote (see the bottom of this page). Chip will receive your information and research plans suitable to your needs. He’ll then compile all the info into an initial email he will send to you ASAP (including a mix of these plan options).
Recommendations, and Questions Answered
You can review all the information in your own time, then follow up with Chip with your questions. You can have a conversation via email, phone, text, Zoom / Facetime, or an in-person meeting at his office, your home, or at a local coffee shop.
Enrollment in the Marketplace
No matter the plan type chosen; individual, short-term or group health insurance, Chip can enroll you in the plan you choose, then work to follow up with any requested items from the insurance company. He’ll then work to ensure your ID cards and policy arrive.
Free Personalized Quote and Info
Complete the form below and Chip will send you an email with recommended quotes of insurance (including detailed ideas of premium costs and benefits). All in a conversational, “plain speak” explanation of the details Chip is known for (see our reviews on the home page). You can review the information, then follow up with your questions via email, phone call, text, or Zoom / Facetime.
Note: Privacy is something we take seriously, and keeping the information you shared private is of utmost importance to us. We do not share any information with third parties. The minimum of information is shared with an insurance company to put together a detailed free quote and illustration for you.