This is a Private Website that is Licensed and Certified to Assist Consumers with Affordable Care Act (ACA) Compliant Plans in Florida This is NOT the Government Healthcare.gov Website – See Disclaimer at Bottom
2019 Open Enrollment Period for the Health Insurance Marketplace
THE MARKETPLACE IS OPEN FOR 45 DAYS THIS YEAR
November 1st through December 15th
(Apply Before December 15th for a January 1st Effective Date)
Call me at 941-704-8148
Why should you use an independent Florida Health Agent?
What are the REAL reasons to use a Health Agent?
WHO should buy health insurance ON the Marketplace?
In addition, if between 100% and 250% of FPL, you’re also eligible to buy a Cost Sharing Reduction (CSR) plan with reduced deductibles and out of pocket maximums. In order to receive these additional benefits, you must buy a Silver Level plan. More information on these topics is located on the ON Marketplace website page.
WHO should buy a health plan OFF the Marketplace?
So, who wouldn’t want to buy through the Marketplace? Many clients bypass the government website altogether and buy directly from the carrier for one reason or another. Examples of consumers who seek coverage OFF the Marketplace include those with Modified Adjusted Gross Income (MAGI) that is too high (Above 400% FPL) to qualify for any financial assistance through Advanced Premium Tax Credits (APTC). Others find cheaper alternatives compared to what’s being offered by their employer, especially when comparing child only plans and premiums. Other consumer who are snowbirds or have college students away from home, MAY need a plan with a PPO network that covers them in both places. Sometimes, these plans with larger PPO networks are only available OFF the Marketplace.
If any of the above describes you, then you have the option to buy a ACA compliant health insurance plan directly from a carrier (with or without an agent) during the Open Enrollment Period (OEP), or Special Enrollment Period (SEP).
Of course, it’s always best to call an agent to assess your situation and suitability for an OFF Marketplace plan.
Or, visit our “OFF the Marketplace” page.
What and when is the Open Enrollment Period (OEP)?
If you need a January 1st effective date, you need to apply by December 15th.
An Open Enrollment Period (OEP) for ACA Health Plans occurs once a year and will last only 45 days this year. It’s the period of time where consumers are free to purchase or move to a new plan, for any reason, from any approved insurance carrier ON or OFF the Marketplace.
Am I eligible for a Special Enrollment Period (SEP)?
A full QLE list can be found here at healthcare.gov
The Marketplace requires that you now send in proof of your loss of coverage or other proof to support your special enrollment reason.
What health benefits are included in all ACA health plans?
- Guarantee Issue – no medical questions allowed (except tobacco), and you cannot be declined.
- Pre-existing Conditions – are covered with no waiting period, but subject to policy benefits.
- Free Preventative Care – before any deductibles and with a $0 copay. A list can be found here.
- The 10 Essential Health Benefits – are based on federal guidelines, and the state benchmark plan.
- Maximum Out of Pocket Limitations – adjusts higher each year, approximately $7350 per person in 2018.
What is the penalty for not obtaining ACA health insurance?
- 2.5% of your household annual income, OR
- $695 per adult and $347.50 per child under 18
To get a specific penalty amount according to your situation, use this ACA penalty calculator.
Who should consider supplemental plans with an ACA policy?
They are NOT to be used as a substitute for a Major Medical ACA compliant health plan.
You can find a list of supplemental plans and links on the Florida Supplemental Plans page.
Why can't I receive subsidies or Medicaid with my low income in Florida?
BUT, the ACA law also contained verbiage that allows subsidies for those with income between 100% to 400% of FPL, sparing those between 100-138% of FPL, with massive financial assistance to buy private health insurance in Florida through the Health Insurance Marketplace.
Unfortunately, if the combined income for your household size is below 100% of FPL, then you are NOT eligible for financial assistance / subsidies, reduced deductible plans or Medicaid. You are eligible to buy a health plan, but would have to pay the entire premium amount. Not to worry, your income should be low enough to allow you to get an exemption from having to buy coverage or pay any penalties.
Steffen Financial Inc / Owner
Florida Health Agency License #L050583
National Producer Number (NPN) 7939021
20+ Years in the Financial Industry
10+ Years Specializing in Health Insurance
William graduated with a B.S. in Business Administration & Finance from California State University of Northridge (CSUN) in 1992. After working for Invesco Funds Group for 7 years, and Janus Funds for another 5 years; Steffen Financial Inc was launched in 2004. I found my niche with private health insurance and Health Savings Accounts (HSA’s) soon thereafter. When the massive health care reform law (ACA) passed in 2010, I realized my clients were going to need a knowledgeable adviser to navigate the new complicated ACA landscape.
FLHealthAgent.com is an extension of that belief, and communicates exactly what I do for a living. It’s a destination for the increasing trend of Florida consumers seeking valued advice from a Florida Licensed Health Agent. I look forward to working with you.