Did you know that you do not have to go to HSA.gov to buy an individual plan if you are not covered under an employer-sponsored group health insurance plan?
Advanced Benefit Solutions Can Help!
Shopping plans, conducting research, and understanding the subtle differences between each plan can be a frustrating, time-consuming experience. When you work with Advanced Benefit Solutions, we are an independent health insurance broker so we do the work for you!
Our team of specialists can shop all available carriers and plans (including ACA plans and beyond) to find you the plan that fits your needs. Even better, we’re available to answer all your questions and even find plans that include your favorite providers.
For employers, it’s important to work with a broker instead of automatically accepting your existing plan’s (likely higher) rate for the next year. If there are changes within your group of employees that shift the overall demographic and needs of your group, your existing plan may no longer be the best fit for your needs.
It all comes down to potential cost savings and personal service. There’s no obligation and we make shopping for insurance easy.
Open Enrollment is Coming
Open Enrollment is the only time of the year during which individuals and families can sign up or switch to a different individual or family health plan. Open enrollment starts on November 1 and runs through January 15 for most states.
The only time you may switch plans outside of open enrollment is if you qualify for a special enrollment period. A special enrollment period is required to purchase coverage outside of the open enrollment window. You are eligible for a special enrollment period if you have experienced a qualifying event.
A qualifying event may be turning 26 while on a family member’s policy, separating or divorcing from your spouse, losing health coverage because of a job loss or change, moving, a change in income or household status (like having a baby.)
There are specific rules for how each of these qualifying events triggers a special enrollment period, so it is best to talk with a professional insurance agent if you are unsure of your eligibility.
Why is there an Open Enrollment Period?
Health insurance is available only during open enrollment to prevent people from only buying health coverage when they’re sick.
If people only got health insurance when they needed care and then dropped coverage, the risk is unbalanced; i.e., there must be healthy people paying premiums while not requiring care to offset the costs of people who are sick receiving care.
How Can I Make Sure My Coverage is in Effect on January 1?
Most states require enrollment to be completed by December 15 in order to have a plan take effect on January 1. Check your specific state for guidelines on open enrollment and plan effective dates.
How To Evaluate Health Insurance Plans
Most Affordable Care Act (ACA) plans offer similar coverage regarding what is covered including emergency care, essential health benefits, hospitalization, mental health, prescription drugs, etc. The ACA requires that health plans cover these things. However, health insurance plans still differ by:
- Plan Design
- Premium Costs
- Copays (for doctor visits, urgent care or emergency room visits, and prescription drugs.)
- Provider Networks
When looking at health insurance options for the next year, first consider what medical needs you anticipate. If you know you are expecting a child or have considerable health care needs, a plan with higher premiums and a lower deductible may be a good choice. If you are anticipating a year without much need for care, a high-deductible health plan may be a more affordable choice.
When researching ACA plans, you will see Bronze, Silver, Gold, and Platinum plans. Bronze and Silver plans have lower premiums and higher deductibles, while Gold and Platinum plans have lower deductibles but higher premiums.
If you want to make sure specific doctors are in network on your plans, check to see what providers are considered in network.
ACA Plan Costs for 2024
Healthcare costs keep rising. Thanks to the family glitch law fix, many individuals may now qualify for a subsidy.
Health insurance rates across the nation increased by 4%.
Group Rate Renewals & Online Enrollment
Like individuals, group rates for employer sponsored plans also have an annual open enrollment. Group plans renew each calendar year. Many employers start receiving their rates for the next year in the 3rd or 4th quarter.
It’s important to compare options early, especially if your rates have increased. There may be an opportunity to make a slight change in the plan or switch carriers to help your plan be as cost-efficient as possible.
Let Advanced Benefit Solutions be your partner for open enrollment this year. Get a quote today.