A: This occurs annually from November 1 – December 15 for a January 1 effective date.

A: If you missed the enrollment deadline, it is still possible that you can qualify for a Special Enrollment Period (SEP) that will allow you to apply for health insurance. You can qualify for an SEP if you have experienced a qualifying life event. Qualifying life events can include:

• The loss of prior employer health coverage.
• Household changes such as marriage, divorce, having a baby or a death in the family.
• A change in your home address.

You have 60 days to enroll in a plan if you qualify for an SEP. If you miss that 60-day window, you will have to wait until OEP (Fall 2021) to enroll in an individual health insurance policy for 2022.

A: You will have to wait until Open Enrollment for 2022 which begins in Fall 2021.

A: Short term health insurance coverage can be purchased outside the OEP for up to 364 days, and you can reapply for short-term coverage for up to 36 months in most states. Short term health insurance plans might be a good, temporary fit for healthy people as they will not cover pre-existing conditions like Affordable Care Act (ACA) plans.

A: Short term health insurance plans have many exclusions, including no coverage for pre-existing conditions. Short term health plans are not subject to the ACA provisions and are not ACA compliant.

A: There are several options available, but we use United Health Care/Golden Rule.

A: Ambetter, Anthem, CareSource, Kaiser, Oscar Health. All carriers are HMO’s. Ambetter and CareSource are “Open Access” HMO’s which means that referrals are not required to see a “Specialist”.

A: Contact us by completing the on-line form, call our office at 678-842-0335, or follow the on-line link to HealthSherpa.

A: HealthSherpa uses Enhanced Direct Enrollment (EDE) technology which makes it easier for customers to compare plans and apply, renew, and enroll in health coverage. EDE technology allows our clients to use a single platform to complete the eligibility and enrollment process on a single website instead of www.healthcare.gov. This functionality allows us to:

• Shop and enroll for on and off-exchange products (during OEP & SEP).
• Seamlessly renew Marketplace coverage with pre-filled renewal applications.
• Report life changes and update our client information.
• Track our client's “real-time” Marketplace status.
• Submit follow-up verification documents and track their status.
• Provide our clients with their eligibility letters and 1095-A tax forms.

A: On HealthSherpa, an application takes 8 minutes on average vs 16 minutes on Healthcare.gov. No client ID Proofing required. No client log-in required.

A: If you do create or update an account on www.healthcare.gov and you want us to assist you with plan enrollment or any service issues following the sale, you will need to enter Elizabeth (Allyn) Hogue’s agent information referenced below into your Healthcare.gov Account. Please enter:

Elizabeth A Hogue FFM = ahogue60 NPN = 7482633

A: You can have the best of both worlds - a broker can help you enroll through the exchange, giving you personalized help and recommendations, but also allowing you to get any Obamacare subsidies for which you are eligible.

It does not cost you anything to use a broker! Most brokers who are certified by the exchange are also able to help you compare ACA-compliant off-exchange plans with the options available through the exchange. If your income is too high for subsidies, a broker who can help you shop on and off-exchange will be an excellent resource (this is especially true now that the cost of cost-sharing reductions is being added to premiums in most states - typically only to silver plan premiums, and often only on-exchange – ask your broker about this if you don’t qualify for premium subsidies). If you do qualify for subsidies, a broker can compare the exchange plans in your area and help you determine which one will be the best for your needs.

After you purchase a plan, the broker will continue to be your go-to resource when you have questions about your policy, network, or claims – and in our case, there’s never a charge for these services!

Brokers are paid commissions by the insurance company. You and your family pay the same price for coverage, regardless of whether you receive help from a broker or not.

A: The amount you pay is based on your age, the type of coverage you want, the amount of coverage you need, and your zip code.

A: If you do create or update an account on Healthcare.gov and you want us to assist you with the healthcare plan enrollment or any service issues following the sale, you will need to enter the information referenced below into your Healthcare.gov Account. Adding our information will ensure we are the “agent of record” AOR.

Please enter: Elizabeth A Hogue FFM = ahogue60 NPN = 7482633

Please note that while you may have talked to Callie Osborne or Susan Morris (both licensed agents), our individual business is sold under Elizabeth Allyn Hogue’s NPN.

A: Individual market plans no longer terminate automatically when you turn 65. You can keep your individual market plan, but premium subsidies will terminate when you become eligible for premium-free Medicare Part A. Bottom line: You will want to apply for Medicare Part A & Part B three months prior to the month in which you turn 65. You will have better coverage at a lower cost.

A: Health insurance plans that are offered through the Marketplace- an on-line store that is run by the federal government or state. These plans are required to provide essential health benefits and follow more guidelines as set by the Affordable Care Act (ACA). You can purchase these plans through our partner HealthSherpa or from www.healthcare.gov. With these plans, you may be eligible to receive a government subsidy depending on your household size and income, meaning that your monthly health insurance costs (your premium) might be lower.

A: Health insurance plans that are offered privately by each health insurance company. These plans offer most if not all of the essential health benefits as their on-exchange counterpart and are usually a mirror of their on-exchange plans. The names of these plans are often the same. Make sure the plans are ACA compliant and not short term medical.

A: Anthem, Ambetter, and Kaiser.

A: Contact us via e-mail or phone and we will update your information. You can also log onto your account and make these changes. However, working with us will ensure the appropriate changes are made.

A: Requests for income verification and documentation of citizenship are common. As your agent, we can upload your supporting documents to resolve these issues.

Upload client documents and view their status: Approved EDE partners provide the ability to view the status of your clients’ data matching issues and SEP verification issues and allow you to remotely upload supporting documentation to resolve these issues.

A: Allyn Hogue’s NPN is 7482633 and her GA Insurance License number is GA 629201.

A: Contact us or use the Kaiser Foundation Health Insurance Marketplace Calculator: https://www.kff.org/interactive/subsidy-calculator/

A: There are two types of subsidies available to Marketplace enrollees. The first, called the premium tax credit (PTC or APTC when paid in advance), works to reduce enrollees’ monthly premium payments for insurance coverage. The second type of financial assistance, the cost-sharing reduction (CSR), reduces enrollees’ out-of-pocket costs when they go to the doctor or have a hospital stay. To receive either type of financial assistance, qualifying individuals and families must enroll in a plan offered through a health insurance Marketplace.

PREMIUM TAX CREDIT
The premium tax credit reduces Marketplace enrollees’ monthly premium payments for insurance plans purchased through a Marketplace. Health insurance plans offered through a Marketplace are standardized into four “metal” levels of coverage: bronze, silver, gold, and platinum. Bronze plans tend to have the lowest premiums but leave the enrollee subject to higher out-of-pocket costs when they receive health care services while platinum plans tend to have the highest premiums but have very low out-of-pocket costs. The premium tax credit can be applied to any of these metal levels but cannot be applied toward the purchase of catastrophic coverage. Catastrophic health plans typically have a lower monthly premium than other Qualified Health Plans in the Marketplace, but generally require beneficiaries to pay all their medical costs until the deductible is met. To qualify for a catastrophic plan, an individual must either be under 30 years of age or eligible for a “hardship exemption.”

COST SHARE SUBSIDIES
In addition to the premium tax credits, consumers may also be eligible for a second form of financial assistance — cost-sharing reductions. Cost-sharing subsidies reduce a person or family’s out-of-pocket costs, such as deductibles, copayments, and coinsurance, when they use health care services.

Unlike the premium tax credits (which can be applied toward any metal level of coverage), cost-sharing reductions are only available through a silver metal level plan.

A: Yes. Cost-sharing subsidies are still available for eligible Marketplace enrollees. Although the federal government will no longer be reimbursing insurers for these subsidies, insurers are required by law to reduce cost sharing for lower-income enrollees.

A: People who are eligible to receive a premium tax credit and have household incomes from 100% to 250% of the federal poverty level are eligible for cost-sharing subsidies. The cost-sharing subsidies are available only to the lowest income Marketplace enrollees who meet all the other criteria for receiving the premium tax credit. Again, the eligible individual or family must purchase a silver level plan to receive the cost-sharing subsidy.

A: If you bought health insurance through one of the Health Care Exchanges, also known as Marketplaces, you should receive a Form 1095-A (also called the “Health Insurance Marketplace statement”) which provides information about your insurance policy, your premiums (the cost you pay for insurance), any advance payment of premium tax credit and the people in your household covered by the policy. The IRS also gets a copy of the form.

Insurance companies in health care exchanges provide you with the 1095-A form. This form includes:

• your name
• the amount of coverage you have
• any advance payment of tax credits you were entitled to
• if you used the tax credits to pay for your health insurance and the amount you paid for coverage

You will use this information to complete your income tax filing, adjust any tax credit payments, and claim any premium tax credits that may be due or are required to be paid back if too much advance premium tax credit was received during the year.