Frequently Asked Questions

FAQs

What Is the Health Insurance Marketplace (A/K/A Exchange)?

The Health Insurance Marketplace is an internet “hub” or website where people who are uninsured or who buy insurance on their own can go to buy health care coverage in the future. They will be able to compare plans and insurance carriers. They will also be able to find out if they are eligible for financial assistance (a/k/a subsidy or APTC). There will also be a Small Business health Options Program (SHOP) website where small group employers can also shop and purchase health coverage to offer to their employees.

Do I Have to Buy From the Marketplace?

No. The Health Insurance Marketplace is just one of the ways you can shop for health coverage. You can still purchase through your employer or directly from FHCP. However, in order to receive any financial assistance, you must purchase through the Marketplace. To find out if you may qualify for financial assistance (subsidy) or not, please click here to be taken to a calculator that will estimate the amount of financial assistance you may qualify for. Keep in mind this is just an estimate and the actual amount of financial assistance is dependent upon many factors to include your age, where you live, the plan you purchase, and your total household income.

How Can I Be Exempted From Having to Buy Insurance?

The ACA requires most US citizens and legal immigrants to have insurance starting January 1, 2014. People with certain religious beliefs, members of Native American tribes, undocumented immigrants and individuals in prison are exempted. Also, individuals below a certain level of income are also not required to purchase insurance.

What Do I Do If I Don’t Think I Can Afford to Buy Insurance?

You and your dependents may be eligible for financial assistance (called subsidy) to help you pay for your insurance. This will be determined by the Health Insurance Marketplace, beginning in October 2013. Below is an example of the income ranges that may qualify for assistance.

• Between $15,282 and $45,960 if you are SINGLE with NO dependents.
• Between $20,628 and $62,040 if you are MARRIED with NO dependents.
• Between $31,322 and $94,200 if you are a FAMILY of four.

What Will Happen If I Don’t Buy Insurance in 2014?

You will be charged a tax by the government. The 2014 tax is the greater of $95 or 1% of your household income. If you are single and make $30,000 annually, your tax would be $300.

If I’m Currently Undergoing Treatment and Have to Change Plans, How Will That Affect Me?

You can purchase one of the new 2014 plans even if you are currently sick or have any pre-existing conditions. Everyone who applies for coverage is guaranteed to receive coverage. Once your coverage begins, it cannot be canceled due to your health status.

Will My Insurance Premium Go Up?

As the new law goes into effect, the amount you pay for your insurance may change.

There are many reasons for this, including:

• The type of insurance you choose to purchase
• The number of family members you choose to cover
• Whether or not you qualify for financial assistance (subsidy or APTC)
• Whether or not you are a smoker
• Whether you are purchasing individual coverage through your employment or not

What New Plans Will FHCP Be Offering In 2014?

We cannot sell our new plans until open enrollment, which begins on October 1, 2014. We have many different plan options that will offer you flexibility in coverage. You can choose a plan with free access to over 40 gyms or forgo that option for a lower premium plan. We will also have plans that include dental for children and those without as well.

What Are the Different “Metal” Level Plans What Does That Mean to Me?

FHCP will offer plans in all four metals levels. The metal levels are:

• Bronze - minimum 60% actuarial value - which pays for 60% of all medical costs.
• Silver - minimum 70% actuarial value - which pays for 70% of all medical costs.
• Gold - minimum 80% actuarial value - which pays for 80% of all medical costs.
• Platinum - minimum 90% actuarial value - which pays for 90% of all medical costs.

One other option for individuals under age 30 is called a Catastrophic Plan. These plans primarily cover preventative benefits and have higher deductibles for those times that you are sick and require more services.

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