• Skip to primary navigation
  • Skip to main content
  • 1-800-960-1371
  • Agent Login
  • Quoting Tools
    • Life
    • Senior
  • Free Marketing Guide
  • Blog

AgentLink

With AgentLink, you have easy access to the carriers you want and the tools and resources you need to offer the best to your clients.

  • Products
        • Life
          • Info
          • Products
          • AML Training
          • Quoting Tool
        • Senior
          • Info
          • Products
          • Certifications
          • Compliance
          • Quoting Tool
        • Group Benefits
          • Info
          • Products
          • Our Process
          • Quote Request Form
        • Individual Benefits
          • Info
          • Products
          • Our Process
          • Enrollment Tool
        • See our Concierge Services
  • Tools
  • Resources
    • Marketing Guide
    • Carrier Links
    • Group Compliance Resources
    • Sales Webinars
    • Training Webinars
    • Marketing Webinars
    • Errors & Omission Program
  • About
  • Contact Us
  •  1-800-960-1371
  • Life Quoting Tool
  • Senior Quoting Tool
  • Marketing Guide
  • Blog
Previous
Next
Recommendation #2 During Open Enrollment: ACA-Compliant Individual Health Insurance Plans

Recommendation #2 During Open Enrollment: ACA-Compliant Individual Health Insurance Plans

We know that the future of the healthcare industry is uncertain. That’s why we have created four recommendations for the coming open enrollment period (OEP). Last week, we discussed our first recommendation, group health insurance plans (link when that one is published). This week, we examine Affordable Care Act (ACA)-Compliant insurance plans for individuals.

Individual health plans are for people who don’t get insurance coverage through their employer and are not eligible for Medicare or Medicaid. Unfortunately, there are fewer individual health insurance options for agents to offer their clients during the 2018 OEP. Carriers are pulling out of counties across the nation because of the uncertainty of the future of the ACA and the industry as a whole. With limited options and massive rate increases, clients and agents alike are concerned about the long-term stability of the individual market.

Pro’s and Con’s for ACA-Compliant Individual Health Plans

For health plans to be compliant, they must be qualified. The Health Insurance Market qualifies plans and these plans provide essential health benefits, follow established limits on deductibles, co-payments, and out-of-pocket maximum amounts while also meeting other requirements under the ACA. All qualified plans must meet the ACA requirement for having minimum essential health coverage.

Although the marketplace is experiencing instability, there are advantages for ACA-Compliant plans. As of 2014, all plans became guaranteed issue, which means that medical history will no longer keep someone from obtaining coverage. Other advantages of ACA-Compliant plans are that they cover all required benefits like maternity leave, mental health care services, and more.

Con’s of ACA-Compliant individual plans include higher premiums and co-payments, limited networks like Health Maintenance Organizations (HMO’s), and dealing with the individual insurance marketplace. For those with many medical expenses throughout the year, the silver lining of higher out-of-pocket costs is that all plans are subject to out-of-pocket maximums. The maximum for individuals in 2017 is $7,150. If a consumer reaches this amount, their health insurance carrier will begin to pay 100% of medical expenses.

Additionally, there are pro’s and con’s regarding HMO health insurance plans. These plans are the most popular plans to purchase as they offer a wide variety of care from the doctors and healthcare providers within the network. However, they can seem limiting since they usually require a primary care physician to coordinate care and refer patients to specialists.

Help Your Clients Pick The Right Plan

The OEP for 2018 coverage is a short 45 days beginning November 1st and ending on December 15th. You can get ahead of the game by dedicating more time to knowing everything you can regarding the options available in your market. By doing so, you will help your clients pick the right plan for their needs and will be able to spend more time enrolling. You should know the following policies regarding the plans available in your area:

  • Deductible amounts
  • Coinsurance agreements
  • Pharmacy benefits
  • Available subsidies
  • Possible penalties

If you missed our recent blog on 6 ways you can prepare for a smooth OEP, catch up here. The goal is to sign up as many clients with the right plan for them during OEP. You can do so by knowing the in’s and out’s of the available plans and following the information on the blog linked above to have a successful enrollment.

If you are an individual seeking medical coverage, find out if you qualify for a subsidy, which is based on your income. If you do qualify, you must purchase insurance through the exchange as that is the only way subsidies are available. If you’re an insurance agent, take the next step in preparing for open enrollment by calling Myra Gifford at (800) 960-1371 ext. 1213 for more information on ACA-Compliant individual health plans.

Filed Under: Open Enrollment

Previous Post: « Recommendation #1 During Open Enrollment: Group Health Insurance Plans
Next Post: Recommendation #3 During Open Enrollment: Faith Based Health Care Sharing Programs »

You might also enjoy...

healthsherpaHeathSherpa Improves How You Market & Enroll ACA Clients

At AgentLink, we’re proud to partner with HealthSherpa, an innovative healthcare technology and the country’s largest ACA agent enrollment platform. As a faster and easier alternative to Healthcare.gov, you’ll have the leading technology you need to maximize your Marketplace experience. HealthSherpa is also the #1 Marketplace […]

Read More
life insurance for seniorsWhat kind of Life Insurance Products are a good fit for Seniors?

At its core, life insurance is a contract between a policy holder and a life insurance company where the insured agrees to pay for a policy on a regular basis and the insurer in turn agrees to pay a sum of money to beneficiaries upon death […]

Read More

Don’t forget to browse the free tools and resources we offer our agents and prospects, including our popular online quoting tools

Download the Digital Marketing Guide

Go to Resources

Get Contracted Now

Contract with us, to get appointed with your desired carriers

Please enter your email address below  to stay up-to-date with changes in the industry.

  • This field is for validation purposes and should be left unchanged.

Copyright © 2023 · Showcase Pro on Genesis Framework · WordPress · Log in

  • About
  • Contact
  • Careers
  • Life
  • Senior
  • Group Benefits
  • Concierge Services

Agent Login

Resources

Tools

Free Marketing Guide

1-800-960-1371

AgentLink Kentucky Office
2001 Lake Point Way, PO Box 23570
Louisville, KY 40223
Toll Free: 800.960.1371
Direct: 502.245.1371
Fax: 502.245.0978

AgentLink Indiana Office
3077 East 98th Street, Suite 135
Indianapolis, IN 46280
Toll Free: 866.462.9067
Direct: 317.569.8490
Fax: 317.569.8705

Copyright © 2021 AgentLink. All Rights Reserved.
Website Design and Digital Marketing by The Marketing Squad

  • Senior Products
  • Quoting Tool
  • Get Contracted
  • Brittney: 502-245-1371
  • Life Products
  • Quoting Tool
  • Get Contracted
  • Scott: (502) 245-1371
We use cookies to make our website a better place. Cookies help to provide a more personalized experience for you and web analytics for us. To learn more, and to see a full list of cookies we use, check out our Privacy Policy.
Cookie SettingsAccept
Manage consent

Privacy Overview

This website uses cookies to improve your experience while you navigate through the website. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may affect your browsing experience.
Necessary
Always Enabled
Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.
Non-necessary
Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. It is mandatory to procure user consent prior to running these cookies on your website.
SAVE & ACCEPT
  • Products
    ▼
    • Life
      ▼
      • Info
      • Products
      • AML Training
      • Quoting Tool
    • Senior
      ▼
      • Info
      • Products
      • Certifications
      • Compliance
      • Quoting Tool
    • Group Benefits
      ▼
      • Info
      • Products
      • Our Process
      • Quote Request Form
    • Individual Benefits
      ▼
      • Info
      • Products
      • Our Process
      • Enrollment Tool
    • See our Concierge Services
  • Tools
  • Resources
    ▼
    • Marketing Guide
    • Carrier Links
    • Group Compliance Resources
    • Sales Webinars
    • Training Webinars
    • Marketing Webinars
    • Errors & Omission Program
  • About
  • Contact Us
  •  1-800-960-1371
  • Life Quoting Tool
  • Senior Quoting Tool
  • Marketing Guide
  • Blog