Individual and Family Insurance

Insurance Solutions For You

The Affordable Care Act (ACA) has dramatically changed the affordability and availability of individual and family (non-employer-sponsored) health insurance.  Many of what used to be barriers to getting individual insurance have gone away; you now cannot be declined for coverage, or have your premium raised, due to health conditions. Also, there are no exclusions for pre-existing health conditions.

family insurance

Why You Need Insurance

If you do not have qualified coverage (either individually or through an employer), you may be liable for an individual tax penalty (often called the “individual mandate”), which for 2016 is $695 per adult or 2.5% of household income, whichever is greater.  The government wants you to be insured!

When You Can Enroll

Federal law provides for enrollment in individual coverage only at those times. We can help you explore coverage to meet your budget while giving you access to the providers and facilities you want.  We can also find out if you’re available for a premium tax credit through HealthCare.gov, which could make your premium more affordable, depending on income.

Enroll In A Health Insurance Plan

You can only enroll in an individual or family insurance plan at two times:

1. During annual Open Enrollment

2. Because of a Special Enrollment Event

Do any of the following apply to you? Did you:

  • Lose qualifying health coverage in the past 30 days?
  • Get married?
  • Have a baby?
  • Gain other coverage?
  • Get divorced or legally separated and lost health insurance?

Short-Term Insurance Solutions

If it’s outside of Open Enrollment and you don’t qualify for a special enrollment period, you could still get a transitional (short-term) policy, which provides scaled-back benefits to tide you over.

Transitional policies do not count as “qualified coverage” under the ACA, and will not protect you from the individual tax penalty; they do not cover maternity, prescriptions, or pre-existing conditions (any condition how have been treated for, or should have been treated for, in the past 12 months), but they can be a valuable protection in case of unforeseen injury, accident or illness.

Encore Benefits also provides individual life insurance policies. If you have not purchased a life insurance policy for yourself or your spouse, or if your life circumstances have changed significantly since purchasing a policy, contact us to see how this coverage can best serve the needs of yourself and your loved ones.

Insurance Carriers

We work with more than 40 different carriers to provide you with the best options with the best coverage for your needs.

Helping You Deliver Success

At Encore Benefits, we focus on providing value for your healthcare dollar. We promise to exceed your expectations with a complete array of value-added services.

Articles

COBRA Continuation Deadlines During the Pandemic 150 150 Encore Benefits

COBRA Continuation Deadlines During the Pandemic

During the economic instability surrounding the COVID-19 pandemic, terminated or furloughed employees should understand some new federal regulations governing COBRA continuation. What Hasn’t Changed If you were enrolled in group medical, dental or vision benefits sponsored by a COBRA-subject employer (addressed later) and lost eligibility for that coverage (through termination, loss of hours, etc.), you…

read more
Cheap Medical Insurance: If It Sounds Too Good to Be True… 150 150 Encore Benefits

Cheap Medical Insurance: If It Sounds Too Good to Be True…

The average premium for individual health insurance coverage has more than doubled in the past five years. So if you’re paying for your own insurance, unless your income has also doubled, you’ve felt the sting.  If you’re ineligible for a subsidy, your monthly premium can rival your mortgage payment. “There’s GOT to be something cheaper…

read more
HIPAA For Employers 150 150 Encore Benefits

HIPAA For Employers

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) obligates employers, health care providers, insurance agents, insurance carriers and others to respect the confidentiality of the Private Health Information (PHI) of employees and their dependents. This is a quick overview of what employers should and should not do with PHI. You, the employer, must…

read more