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Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
Individual Health Insurance Marketplace Overview
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Individual Health Insurance Marketplace Overview

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What the individual marketplace is, and why it matters to you: http://offers.zanebenefits.com/individual-health-insurance-marketplace-overview …

What the individual marketplace is, and why it matters to you: http://offers.zanebenefits.com/individual-health-insurance-marketplace-overview

Starting in 2014, the Individual Health Insurance Marketplaces will make it simple and more affordable for employees to get health insurance that can't be canceled or denied because of pre-existing conditions.

Your state's Individual Health Insurance Marketplace will provide access to coverage that will start in January 2014. Starting in October, you’ll be able to get information about all the plans available in your area, and you will be able to enroll yourself, directly through the website.

Purchasing insurance through a Health Insurance Marketplace will have several advantages including the ability to receive enormous tax credits that lower your health insurance costs.

Anyone interested in understanding how the Individual Health Insurance Marketplaces will work in 2014 should attend this webinar.

During this 30 minute webinar, you will learn:

What is the Individual Health Insurance Marketplace?

How much will Individual Health insurance Cost in 2014?

Advantages of the Individual Health Insurance Marketplace

Why the Individual Health Insurance Marketplace matters to you

When can I access the Individual Health Insurance Marketplace?

Watch the recorded webinar here: http://offers.zanebenefits.com/individual-health-insurance-marketplace-overview

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  • 1. Individual Health Insurance Marketplace Overview"Helping individuals compare standardindividual health insurance options"
  • 2. The ZaneHRA Software provides a 100% paperless administration experience to employers and insuranceprofessionals that want to offer better health benefits without a traditional group health insurance plan at lower costs.For more information about ZaneHRA, check out our Software.Employers use ZaneHRA to open and manage their own stand-alone HRA or defined contribution health plancompletely online, electronically enroll participants and print welcome kits, and monitor expenses andreimbursements in real-time.Employees obtain their own individual health policies from a designated health insurance broker (see below),submit premium and medical expenses online, via fax, or mail, and receive same-day reimbursement via check,payroll addition, or direct deposit. Zane Benefits does not sell health insurance.Insurance Professionals partner with Zane Benefits and use ZaneHRA to provide clients with a cost-savinghealth benefits option. Insurance brokers earn compensation on ZaneHRA referrals and retain 100% of the healthinsurance compensation from carriers. ZaneHRA is distributed by leading health insurance carriers, agencies,brokers, and accountants. DISCLAIMER The information provided herein by Zane Benefits is general in nature and For additional resources on should not be relied on for commercial decisions without conducting Health Care Reform, visit independent review and analysis and discussing alternatives with legal, accounting, and insurance advisors. Furthermore, health insurance www.zanebenefits.com/blog regulations differ in each state; information provided does not apply to any specific U.S. state except where noted. See a licensed agent for detailed information on your state. www.ZaneBenefits.com
  • 3. Agenda 1. What is the Individual Health Insurance Marketplace? 2. Advantages of the Individual Health Insurance Marketplace 3. Individual Health Insurance Costs in 2014 4. Why the Marketplace Matters to You 5. Accessing the Individual Health Insurance Marketplace
  • 4. What is the Individual Health Insurance Marketplace?
  • 5. What is the Individual Health Insurance Marketplace?Earlier this year, the government re-branded health insurance exchanges as HealthInsurance Marketplaces.The Individual Health Insurance Marketplace is the ACAs health insuranceexchange ("AHBE") for individuals, which provides: 1. Individual Plan Standardization (standardizes individual health insurance products within specific metal tiers) 2. "Unbiased" Individual Plan Comparison (allows individuals to compare all plans in one "unbiased" place) 3. Tax Credit Administration (determines tax credit eligibility/amount and facilitates advanced payment) "Helping individuals compare standard individual health insurance options"
  • 6. Understanding How the Health Insurance Marketplace WorksStep 1: Individual goes to his or her states Individual Health Insurance Marketplacewebsite (e.g. www.coveredca.com).Step 2: Individual completes 1 of 2 applications: i. Application for Insurance with Tax Credit (e.g. sample). ii. Application for Insurance without Tax Credit (e.g. sample).Step 3: Individual health insurance marketplace displays all available plan optionswithin metallic tiers and displayed cost will factor in tax credit.Step 4: Individual selects plan.Step 5: Individual health insurance marketplace bills individual for his or her portion ofpremium (i.e. the total premium minus tax credit) and forwards payment to the carrier
  • 7. Advantages of the Individual Health Insurance Marketplace
  • 8. Advantages of the Individual Health Insurance MarketplaceThe Individual Health Insurance Marketplace will have thefollowing 4 key advantages 1. Choice 2. Portability 3. 1 Stop Shop / Convenience 4. Tax Credits
  • 9. #1 ChoiceIndividuals will be able to choose the health insurance plan that best fits their familiesneeds based on standard metallic levels:Within each metallic level, Individuals will be able to choose different combinations of: ● co-pays ● deductibles ● co-insurance ● networks
  • 10. #2 PortabilityIndividual health insurance is not tied to employment, meaning they will be able to taketheir health insurance with them when they switch jobs.This is a major advantage over traditional employer-sponsored health insurance.Portable Memory Analogy
  • 11. #3 1 Stop Shop / Convenience1 Website and 1 Application gets individual access to: ● All available plan options, and ● Premium tax credits.Best of all, it will be "unbiased" (unlike sites like ehealthinsurance.com).
  • 12. #4 Tax CreditsSPECIAL INCENTIVE:Massive tax credits* will be available for households earning up to400% of the FPL (majority of Americans).Individuals can only access the premium tax credits throughthe INDIVIDUAL health insurance marketplace.(Requires Your Employer to Drop Coverage)
  • 13. Household Income & Size are Key Variables for Individuals 2013 FPL Guidelines Household Size 100% of FPL 400% of FPL Premium Cap Range Average Group Single 1 $11,490 $45,960 $0 - $363.85 / mo Premium in 2011 was: 2 $15,510 $62,040 $0 - $491.15 / mo $435.17 3 $19,530 $78,120 $0 - $618.45 / mo Average Employee +1 Premium in 2011 was: 4 $23,550 $94,200 $0 - $745.75 / mo $860.75 5 $27,570 $110,280 $0 - $873.05 / mo Average Group Family of 4 Premium in 2011 6 $31,590 $126,360 $0 - $1,000.35 / mo was: 7 $35,610 $142,440 $0 - $1,127.65 / mo $1251.83 8 $39,630 $158,520 $0 - $1,254.95 / mo Tax credit calculator coming soon at http://navigator.zanebenefits.com
  • 14. Individual Health Insurance Costs in 2014
  • 15. Individual Health Insurance Costs in 2014Actual individual healthinsurance premiums areTBD.BUT, you can estimateyour costs using a taxcredit calculator.For example, see CoverCalifornia Cost Estimator
  • 16. Why the Marketplace Matters to You
  • 17. Why the Health Insurance Marketplace Matters to You1. EmployeesIf your firm does not offer health insurance, you may be eligible for a tax creditstarting in 2014.If your firm does offer health insurance, you may be able to get equivalent individualhealth insurance for less money (with portability).2. EmployersIndividual Insurance + Defined Contribution = BETTER BENEFITS FOR LESS?3. Insurance BrokersNew solutions to offer employers, employees and individuals.**Many states (e.g. NY, WA) are allowing commissions to be paid directly fromcarrier.
  • 18. Individual Insurance + Defined Contribution Link to Health Insurance Marketplace
  • 19. Accessing the Individual Health Insurance Marketplace
  • 20. Accessing the Individual Health Insurance MarketplaceYou can only access coverage during designated Enrollment Periods ● Initial Enrollment Period, October 1st, 2013 - March 31st, 2014 ● Annual Enrollment Periods, October 15th - December 7th ● Special Enrollment Periods, similar to cafeteria plan rulesWhy Enrollment Periods?Annual enrollment periods ensure that individuals and families don’t wait until they getsick to enroll in coverage.
  • 21. Summary/Next Steps
  • 22. SummarySummary● Starting in 2014, the Individual Health Insurance Marketplace will allow individuals to compare/purchase standard individual plans.● The Marketplace facilitates the calculation and advanced payment of an individuals premium tax credit (if applicable).● Employees are only eligible for the premium tax credit if employer drops coverage.● Employers, Employees and Insurance Brokers need to understand the Marketplace because it may be a better solution than group health insurance.
  • 23. The ZaneHRA Software provides a 100% paperless administration experience to employers and insuranceprofessionals that want to offer better health benefits without a traditional group health insurance plan at lower costs.For more information about ZaneHRA, check out our Software.Employers use ZaneHRA to open and manage their own stand-alone HRA or defined contribution health plancompletely online, electronically enroll participants and print welcome kits, and monitor expenses andreimbursements in real-time.Employees obtain their own individual health policies from a designated health insurance broker (see below),submit premium and medical expenses online, via fax, or mail, and receive same-day reimbursement via check,payroll addition, or direct deposit. Zane Benefits does not sell health insurance.Insurance Professionals partner with Zane Benefits and use ZaneHRA to provide clients with a cost-savinghealth benefits option. Insurance brokers earn compensation on ZaneHRA referrals and retain 100% of the healthinsurance compensation from carriers. ZaneHRA is distributed by leading health insurance carriers, agencies,brokers, and accountants. DISCLAIMER The information provided herein by Zane Benefits is general in nature and For additional resources on should not be relied on for commercial decisions without conducting Health Care Reform, visit independent review and analysis and discussing alternatives with legal, accounting, and insurance advisors. Furthermore, health insurance www.zanebenefits.com/blog regulations differ in each state; information provided does not apply to any specific U.S. state except where noted. See a licensed agent for detailed information on your state. www.ZaneBenefits.com

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