frequently asked questions

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No, open enrollment applies only to ACA Public Marketplace (Obamacare) plans and employer-sponsored plans. You can enroll in these plans outside of open enrollment if you experience a qualifying life event, which allows for a Special Enrollment Period (SEP). Unlike employer plans, Marketplace plans can be canceled at any time, giving you flexibility to switch if you find coverage that better suits your needs.  Private health insurance plans, on the other hand, are available for enrollment year-round with no restrictions on when you can sign up or switch. This means you have the freedom to seek a plan that aligns perfectly with your health care requirements without the constraints of seasonal enrollment windows. 

The ACA Public Marketplace, also known as Obamacare, is particularly beneficial for individuals with pre-existing conditions or those seeking maternity coverage. If your income falls below the threshold for government subsidies or premium tax credits, these plans can be quite affordable. However, without these subsidies, the costs can rise significantly. Typically, ACA plans come with higher premiums and deductibles since they are accessible to everyone, regardless of health status. 

Employer-sponsored plans, especially from larger companies, often provide substantial benefits for employees. Employers are generally required to cover at least 50% of the monthly premium for employees, making these plans more cost-effective for individuals. However, a noteworthy downside is that employers are not obligated to contribute toward family coverage, which can lead to significant out-of-pocket costs when adding dependents to the plan. 

Private health insurance plans are medically underwritten, meaning eligibility is based on individual health status. As a result, those who qualify are part of a lower-risk pool, which often leads to lower premiums and better coverage options. This makes private insurance more affordable and can provide superior benefits compared to many ACA plans.

 In summary: 

• ACA Public Marketplace: Good for those with pre-existing conditions; costs may vary widely based on subsidies.
• Employer Coverage: Generally cost-effective for employees, but family coverage may be expensive.
• Private Insurance: Offers lower premiums and better coverage, but requires qualifying based on health.

Yes, there is no contract for any health insurance plan, besides employer coverage. You can cancel at any time for both public Marketplace and Private health insurance plans.

Yes. The Private plans we shop offer nationwide coverage on and off the job through America’s largest PPO network. That means you’re not restricted to your zip code or state the way many government-based plans are. While network access is extensive, coverage is not guaranteed at every provider, so it’s always recommended to check the provider portal before receiving services -especially when traveling or visiting a new facility.  As long as your policy is active and in good standing, you can access care across the U.S. and confirm in-network providers in advance. If you move all we will need to do is update your mailing address, you do not have to find new insurance.

Health insurance prices vary based on several key factors: 

Public Marketplace Plans (ACA/Obamacare): These plans are influenced by your income, age, and zip code. While government subsidies can lower costs for qualifying individuals, those who do not qualify may face higher premiums. 

Private Health Insurance Plans: These plans often involve medical underwriting and are primarily determined by your health status, age, and geographic location. Offering lower premiums and better coverage, but requires qualifying based on health in most cases.

Employer-Sponsored Plans: Costs are typically influenced by the employer's chosen plan options, the size of the company, and group health risk factors. Premiums can also depend on the employee’s age, family size, and sometimes lifestyle factors. 

Health Sharing Plans: These are not insurance but rather a way for members to share healthcare costs. Prices typically depend on the member’s age, health status, and the amount of coverage desired. These plans usually have lower monthly costs but might come with limited coverage and higher out-of-pocket expenses. Health sharing plans are not regulated like traditional health insurance and are exempt from most state and federal insurance laws, meaning there are fewer consumer protections and no guarantee that medical expenses will be shared. Instead of acting as a legally binding contract for payment, these are voluntary, community-based arrangements where members share costs based on a plan's specific guidelines, which often include religious or ethical beliefs and can exclude certain pre-existing conditions or treatments.  

Before enrolling in any health plan, it's crucial to understand the coverage details and how they relate to your specific situation to ensure you make an informed choice. 

As a licensed health and life insurance advisor, we shop a comprehensive range of coverage options, including Dental, Vision, Life, Supplemental, Critical Illness, and Accident Disability insurance. Additionally, we collaborate with trusted licensed referral partners to ensure you receive the best solutions. If there's a product outside our offerings, we'll gladly connect you with an expert who can assist you.