Frequently Asked Questions
(FAQ)
Q: Can I only be enrolled in health insurance by having a W2 salaried job? A: Nope! In the health insurance industry, there are 2 main markets: Commercial Group vs Individual/Family market. If you are not provided with affordable employer-sponsored health insurance through an employer, you're an Individual/Family market consumer.
Q: What are my options in the Individual/Family Under Age 65 health insurance market? A: In this market, there are 2 main categories: the ACA (healthcare.gov) which is the Health Insurance Marketplace run by the US Government (and by State-Based Exchanges in certain states) vs non-ACA compliant plans AWAY FROM THE MARKETPLACE. The category best suited for you depends on your specific health needs & budget. I direct you towards the category and then suitable carriers & plan options during our 1-1 meetings.
Q: How do I get enrolled in health insurance if its outside of the annual Open Enrollment Period (Nov 1-Jan 15) and I don't have a Qualifying Life Event to give me a Special Enrollment Period? A: If you missed Open Enrollment Period and haven't had a Life Event in the past 60 days or next 60 days, you generally can't enroll in an ACA major medical plan (both on & off-exchange). Your best options are AWAY FROM MARKETPLACE "Limited Benefit Indemnity" or "Short-Term Medical" plans. Can bundle with other supplemental plans to have robust protection.
Q: What if I don't live in MO, IL, MI, or OH and want your health insurance help? A: Not a problem! Through my FMO, The Brokerage Inc, there are plenty of fellow brokers who are licensed in all the US states that I'm not. I can refer you to another broker or have them contact you to advise. If you absolutely need to work with me and nobody else, I can get licensed in your state (determined on a 1-1 basis).
Q: What do I do if I'm worried about the high deductible & Maximum Out-of-Pocket on my major medical health insurance plan? A: Being worried about the sometimes high out-of-pocket exposure on regular health insurance plans like ACA, Medicare Advantage is quite common amongst folks. That where supplemental insurance plans can be very helpful. The most popular types of supplementals: hospital indemnity, cancer/critical illness, accident, disability and life insurance. If the event these plans cover happen to you, it triggers the insurance company to send a cash benefit directly to you tax-free. You may use this money any way you'd like. Most folks first use it to pay for out-of-pocket costs their regular health plan didn't pay for, and then use anything leftover for expenses like rent/mortgage, transportation, groceries etc.
Q: How is ICHRA/CHOICE different from traditional group health plans for employees? A: With traditional group plans, an employer creates a contract with 1 insurance carrier and typically provides only 2-3 major medical health plan options with varying deductibles. With ICHRA, employees have access to all the ACA plan options available in their state which can be up to 105 plans; this provides many options to fit differing health needs & budgets.
Q: Can I provide ICHRA to my employees at any time of the year? Or just during the Fall Open Enrollment Period? A: You can actually create ICHRA for your employees at any time of year! Coverage will start on the 1st of any given month though, and there are no employee waiting periods which is fantastic for brand new employees. There are no minimum employee participation requirements and no minimum employer premium allowance requirements.
Q: My business is in an industry with high turnover. Is ICHRA a better group health solution than traditional for employees who come and go often, giving me less administrative burden? A: Yes, ICHRA is the best known solution for high turnover employers which is unfortunately common in this day and age. Since employees have their coverage on the ACA Individual/Family Off-Exchange market, they continue with their health plan when their employment ends. But when they leave, they must pay 100% of monthly plan premiums themself instead of receiving the employer ICHRA premium allowance which pays a portion.
Q: Who can get enrolled in Medicare? A: Medicare is a federal program designed for Americans age 65+ & those under age 65 who have been receiving Social Security Disability Income for at least 24 months. Those diagnosed with ALS or End-Stage Renal Disease (kidney failure) are also eligible.
Q: Which is best: Traditional Medicare OR a Medicare Advantage plan? A: Neither path is better than the other; it really depends on your specific health situation & budget. The Original Medicare path [Part A & B + Med Supp + Prescription Drug Plan] is generally better for people who are willing to pay several hundreds $ per month premium to have extremely little out-of-pocket costs. Functions better for folks with more health needs and those who travel often. No Prior Authorizations!
Q: Does it cost me money to work with a broker? And are plan premium prices the same when a broker enrolls me? A: It doesn't cost you anything to have a broker like me advise you. We are paid commissions from the insurance carriers when we enroll folks. Plan premiums are the exact same across the board, whether you go through a broker or not. But its advantageous to have a broker there for you throughout the year anytime you have questions/concerns and don't want to deal with your carrier by yourself!