Individual Business FAQ's
What is Health Insurance Marketplace?
The Affordable Care Act (ACA) created an online website, www.healthcare.gov, called Marketplace. It is also commonly referred to as “Exchange”. This is just another option where you can shop, compare and enroll in health insurance. You can still purchase insurance through an insurance agent or private health insurance company.
What do plans in the Marketplace cover?
Plans offered through the Marketplace all cover the same core benefits called, Essential Health Benefits. Beginning in 2014, most insurance plans will include a comprehensive set of benefits:
Can I be declined based on health conditions?
No plan can turn you away or charge you more because you have a health condition or illness.
What are "Metallic" plans?
Four levels of plans are offered on the Marketplace based monthly costs and costs when you receive medical care:
Bronze - This level represents the lowest monthly costs but higher costs when you receive medical care
Silver - This is the next level up with slightly higher monthly costs and associated lower costs when you receive medical care
Gold - Monthly costs are higher than the Silver plan and costs when you receive medical care are lower than the Silver plan
Platinum - This plan has the highest monthly costs and the lowest costs when you receive medical care
Can I get help paying for health insurance?
Based on your income and family size, you could qualify for tax credits, also referred to as “Subsidy”. There are two ways you can get help:
How do I apply for the Tax Credit or Cost Sharing Assistance?
You will need to complete a Marketplace application and provide information on your family members and income. There is a cost estimator when you start a quote through our links under “Shop for Coverage”. Contact us at any time you have questions or need assistance.
What is the Tax Penalty for not having health insurance?
Currently the tax penalty is $95 per adult and $47.50 per child – OR – 1% of your annual household income (whichever is greater).
How do I get health insurance in Texas?
We can help you with an individual insurance quote to provide you or your family with health insurance. The Deadline is March 31, 2014.
Individuals who don't purchase health insurance for themselves or family by the March 31 deadline will have to pay a tax penalty. However, some individuals are exempt from paying the penalty such as low income but you must apply for subsidy to know if you are exempt. To find out if you qualify for an exemption, visit healthcare.gov/exemptions.