"Your Health Insurance Specialists"
- Individuals may only purchase new health coverage during open enrollment or through a "Qualifying Event."
- Requirement to purchase health insurance or pay a penalty
- Availability of Tax Credits / Subsidies
- New ways to purchase health coverage
- No longer pre-existing conditions to qualify
Open Enrollment - When Uninsured / Insured Individuals may Purchase a New Individual Health Plan.
There are many changes with Health Care Reform and it is important to have a licensed broker help explain your options. Whether you are starting new coverage in Colorado or would like to look into lowering costs, our agents can be an invaluable tool. If you have a question or would like the assistance of one of our agent please use the form or simply call us direct at 303.425.4466.
Health Shop ® 7823 W 38th Ave, Wheat Ridge, CO 80033 Phone (303) 425-4466 Fax (303) 420-8988
Tax Penalty - Requirement to obtain health coverage or pay a tax penalty
Copyright 2013: Health Shop | Insurance Agency Denver | All rights reserved.
- If an individual qualifies for a tax credit, you must purchase a qualified health plan through the marketplace in order to receive it.
- Carriers will offer a portfolio of individual qualified health plans available only from the carrier direct.
While each situation is unique, if a Coloradoan has a life change event, "qualifying event" such as birth, marriage or change in job, this could open a special enrollment period to enroll in health coverage.
Individuals will be allowed to purchase and/or change coverage during Open Enrollment Periods. Generally open enrollment will begin November 1st to December 15 for a January 1, 2017 effective date. January 15th will be the deadline to receive a February 1st effective date. January 31st is the last day for application submissions for a March 1, 2017 effective date. If individuals do not enroll / change health coverage at this time they will only be allowed to enroll in health coverage through a Special Enrollment Period if they experience a qualifying event.
Beginning January 1, 2014 all individual and family medical premiums will be calculated for each person, including dependents. Plan rates will be rated by each member's age, tobacco use and zip code. For families, children are rated individually (Up to 3 children.)
Tax Credit / Subsidies for Individuals
The Colorado Health Exchange is a federally mandated marketplace where individuals will be able to purchase minimum required health insurance starting January 2014. Colorado has developed "Connect for Health Colorado" for our states individual marketplace opening October 1, 2013. Certified brokers will be qualified to assist consumers compare and enroll through the marketplace or direct from the carrier.
New Ways to Purchase Health Insurance
- Plans are required by law to be the same price on the exchange or direct from the carrier.
An agent can help you to determine if your circumstances may be considered a qualifying event, allowing you to enroll or change a plan off the open enrollment period. Contact us at 303.425.4466 or via email.
- Compare all health plans on and off the exchange.
- Provide best options for carrier and plan selection.
- Direct contact for personalized assistance.
- Reassess each year to ensure you stay ahead of the current market trends.
- We are your advocate and assist with coverage, claims, and billing.
- Help determine tax credit qualification.
- No added cost to utilize the services of a licensed broker.
- Can assist you with dental, life, disability, critical illness etc.
Health Care Reform has brought many changes to our healthcare system and there is a lot to consider when shopping for a quality health plan. We listen to you, what your health care needs are and the budget you feel comfortable with. We compare hundreds of health plans from all major carriers, and find the right plan so you can get the most out of your coverage at the best possible price.
Finding the Right Health Plan
Health care reform brings many changes to our health care system and we want to make it easy for individuals and families to understand their options.
The Most Significant Changes to Individual Health Coverage
The effective date of coverage for "Qualifying Events" will be on the first day of the following month, regardless if the individual decides to stay on the same plan or choose a new one.
Length of Special Enrollment
Changes must be submitted within a specific time frame from date of qualifying event. Individuals in the Group market have up to 30 days while the individual market have up to 60 days from the qualifying event.
Call one of our brokers or send us a quick email so we can begin researching your options today!
On March 23, 2012, the Patient Protection and Affordable Care Act, ACA, was signed into law. Beginning January 1, 2014 all US citizens and legal residents are required to have a qualified health plan with minimal essential coverage or pay a penalty tax.
Under the new law, called the Affordable Care Act, individuals are no longer medically underwritten. An individual / family will no longer be rated up or declined due to medical conditions to qualify for health coverage.
No Pre-existing Conditions to qualify for Health Coverage
Our Health Shop brokers have worked in the health industry for nearly 20 years and stay on top of Colorado's current market trends. There are no fees for our services and monthly premiums are not affected. Rates are regulated by the Colorado Department of Insurance, therefore premiums are required to be the same whether you purchase coverage through a licensed broker, through Colorado's health exchange or directly from the health insurance carrier. Receive the convenience, experience and personal service from one of our Health Shop brokers and rest assured you are getting the most value for your specific needs at the best possible price, guaranteed.
Example of Qualifying Events
- Loss of minimum essential coverage
- Employer sponsored coverage becomes unaffordable
Special Enrollment Periods
- Change in incarceration status
- Gain or loss of eligibility for APTC (Advanced Premium Tax credits)
- Change of residence (Move out of a service area)
- A consumer demonstrates their health plan substantially violates a provision of its contract
"We help you find the right plan for you at the best possible price."
- 2016 - 2017 Individuals who do not obtain minimal essential coverage will be penalized the greater of $695.00 per Adult, $347.50 per child ($2085.00 Maximum for family) or 2.5% of taxable household income.
- The amount for a household is capped at $2,085. The fee called the “individual shared responsibility payment” on healthcare.gov will remain the same, with adjustments for inflation.
- If you lack coverage for only part of the year, the fee is prorated. For example, if an individual is without health insurance for six months you will be assessed 50 percent of the fee.
- If you owe the fee this year, it be assessed as part of your income taxes. Exemptions are available in certain situations, such as if you were without health insurance less than three months or the cost of the cheapest plan in your area exceeds 8 percent of your income.
Start by answering these 3 questions:
•Does your employer offer health insurance? •Do you receive Medicare / Medicaid? •Do you or your family make more in a year than chart shown.
If you answered “No” to all three questions, you may qualify for the new tax credit.
Do I qualify for the tax credit / subsidy?
The tax credit is designed to help lower the amount you pay for health insurance. The premium tax credits are based on household size and annual income. Generally the tax credit will be claimed when filing your annual tax return. This credit will be applied against taxes owed or will be refunded if no taxes are owed. However, if you qualify, you may choose to take the tax credit in the form of advanced premium payments to help pay monthly for health premiums.
Family Size Annual Household Income
Health First Co
APTC & CSR
$47,521 and above
$64,081 and above
$80,641 and above
$97,201 and above
$113,761 and above
$130,321 and above
400% and above