Last Step– Having an experienced and knowledgeable agent to assist you in making the right...
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Transcript of Last Step– Having an experienced and knowledgeable agent to assist you in making the right...
Last Step– Having an experienced and knowledgeable agent to assist you in making the right decision
Four key steps to making the right decision
First Step – Knowing all your options
Second Step - Understanding the advantages and disadvantages
Third Step – Choosing the right plan for your needs and budget
ACA Essential Benefits for creditable coverage
• Maternity, pre-existing conditions, mental nervous disorders, annual wellness exam
Who will Obamacare help the most?
•Those who qualify for premium tax subsidies and or have pre-existing conditions
Who will Obamacare help the least?
•Those who do NOT qualify for premium tax subsidies and are in good health.
The majority of consumers have 5 options… Which
option is yours?
5. Employer based coverage
1. No coverage
2. ACA certified Marketplace coverage
3. ACA certified Private
4. ACA non-certified coverage
Disadvantage – Subject to IRS fines for NO coverage (exemptions available)
No Coverage
Advantage – No health insurance premiumsDisadvantage – Responsible for 100% of your medical care
Disadvantage – Limited access to the medical system
Disadvantage – Limited network options
ACA Qualified Market Place Plans
Advantage - Premium and out of pocket tax subsidies available based on house hold AGIAdvantage – Pre-existing medical conditions covered with no waiting periodsDisadvantage – Limited plan options
Disadvantage - Paying the highest premium for health insurance
ACA Qualified Private Plans
Advantage – Pre-existing medical conditions covered with no waiting periods and not subject to IRS fines
Disadvantage – May be subject to IRS fine for not covering Essential Benefits required for ACA plans maternity, pre-existing conditions, mental nervous disorders, annual wellness exam (exemptions available).
ACA Non-Qualified Plans
Advantage – 25% - 50% lower premiums than qualified ACA plans
What happens if I don't pay the fee?The IRS will hold back the amount of the fee from any future tax refunds. There are no liens, levies, or criminal penalties for failing to pay the fee.
https://www.healthcare.gov/fees-exemptions/fee-for-not-being-covered/
How you pay the feeYou’ll pay the fee on the federal income tax return you file for the year you don’t have coverage. Most people will file their 2015 returns in early 2016.Learn more about the individual shared responsibility payment from the Internal Revenue Service.
Employer Based Coverage
Disadvantage – Dependents will not qualify for tax subsidies since group coverage is available
Advantage – Employer pays part or all of the employee’s premium
Disadvantage – Employee pays 100% of dependent coverage
What’s the best premium for your budget?
Teledoc – 24/7 access to licensed physician to receive consultations and prescriptions
It’s your decision…
Optional low cost supplemental coverage (Essential for high deductible medical plans)
What’s the best option for your situation?
What’s the best plan for your needs?
Accident Plan – Eliminate health insurance deductible & out of pocket expenses due to an accident
Critical Illness / life plan - Eliminate health insurance deductible & out of pocket expenses due to heart attack, stroke or cancer