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Guide to Purchasing Health Insurance

Individual or group coverage?

Employers, unions or pool sales can provide group health care. Group insurance benefits will also protect the family members of the employee. The employer also pays part of the fee. Employees would typically have to work a certain amount of hours to apply for community employer-based benefits.

Under the Federal Affordable Care Act (ACA), businesses with 50 or more workers would be subject to a levy beginning in 2015 if they do not provide full-time group health benefits. Companies of less than 50 workers are excluded from the fine.

Grandfathered or new?

Grandfathered policies are plans that entered into existence on 23 March 2010 as the federal Affordable Care Act (ACA) was passed. The goal was to encourage people, families, and employees to retain the coverage they had.

Grandfathered policies are subject to any of the amendments found in the ACA: no annual dollar liability limits on insurance coverage; no pre-existing factors of exclusion; no waiting period of more than ninety days; no lifelong coverage limits; children up to 26 years of age are considered dependent and thus are covered.

Grandfathered programs cannot offer critical benefits or restrict cost-sharing or provide preventive services without cost-sharing. Grandfathered policies will lose their status if there are significant coverage adjustments, copayments, coinsurance, company premiums, or insurance providers’ changes. If this occurs, the proposal will be subject to both the ACA and Minnesota legislation provisions.

What is the health insurance marketplace?

Under the ACA, each state will have an online platform for personal and small employer medical insurance benefits. The marketplace in MNsure is called MNsure. To shop on MNsure, you must also be a legal citizen of MN, live in the health plan coverage area where you buy, and not be imprisoned.

Support choosing and picking a health plan is available by browsers, in-person assistants, accredited application advisors, and approved policy agents/brokers, and by the MNsure customer contact center at 1-855-366-7873. Go to MNsure for more information about MNsure.

Private and small group health policies, or Qualified Health Plans (QHPs), will be sold to MNsure. MNsure can decide if they are qualified for a voucher to help pay for the medical insurance for people with reduced wages but not qualifying for Minnesota health care programs.

Subsidies are only accessible to shoppers on the MNsure website. A subsidy can be used to reduce the insurance rate. Individual person and small group insurance benefits will be sold at four metal prices depending on their actuarial value: bronze, silver, gold, and platinum.

This assumes that the package would cover from 60% to 90% of the expense of the coverage provided; the customer covers the balance in deductible, copays, and coinsurance. A contingency plan package with a reduced actuarial value can be provided to persons under 30 who cannot manage benefits otherwise.

You might not be eligible to get a short-term health plan. This temporary coverage could last up to 6 months. Pre-existing health issues are not protected. This could be a choice to explore if you’re between jobs, just graduated from college, or waiting for your group coverage to launch.

 Make sure that you understand what is covered and what is not covered. For more detail on short-term coverage, go to the Minnesota Department of Commerce.

COBRA and continuation coverage

Federal and state legislation grants you the ability to maintain your insurance benefits for a fixed amount of time after you and your dependents become ineligible for your company’s health benefit.

COBRA, or the Consolidated Omnibus Budget Reconciliation Act, was enacted in 1986 and includes clauses that encourage workers to maintain health care for themselves and their dependents once they leave their jobs.

COBRA and state legislation mandate that if your employer provides you and your dependents with community insurance benefits, your employer must then authorize you and your dependent family members to maintain that insurance at your own cost if you or your dependents lose your insurance coverage.

In most cases, both you and your dependents can prefer COBRA or state continuity coverage for up to 18 months, but the time period varies based on how you are eligible for continuation coverage. You’re more likely to have to face the full amount of coverage yourself.

Get The Best Health Insurance Today

At Health Insurance Plans, we guarantee that you will get the lowest healthcare marketplace Insurance rates of all time. We offer you affordable quotes that are suited to your needs. We assure you that you will gain more benefits for less. If you need to purchase a health insurance plan today, do not hesitate to call and speak to a licensed insurance agent on (866)358-2150. 

References and Resources

• COBRA Insurance Plans and How They Works
• Primary vs Secondary Health Insurance