Health Insurance

Insurance is confusing and is never fun to deal with. At Sagacity Benefits it’s our goal to make insurance options easy to understand. In fact, most of our clients comment that nobody has ever explained insurance the way we do and now they understand it better. Let us make it easy to understand your coverage choices, review carrier options and evaluate network differences for a plan that fits you and your family. We will outline options both on the exchange or the private market.

family insurance

Important Information:

With the implementation of the Affordable Care Act, there are several changes that affect how you may purchase your health insurance.

  • Pre-existing conditions or ryders are no longer permitted by insurance companies. Insurers must also offer all products sold to individuals and accept every individual that applies.

  • There is an open enrollment period annually that allows for enrollment/disenrollment of coverage. You will only be allowed to enroll/disenroll in medical coverage during the open enrollment period unless you have an “event”, which provides for a special election period. A list of events includes birth, adoption, loss of coverage, turning 26, divorce, marriage, loss of subsidy, move away from plan area, exhaustion of Cobra coverage, return from active military service or any court order. In most cases a 60 day window is provided to elect new coverage.
  • The Affordable Care Act mandates that every person must be enrolled in some form of qualifying insurance coverage or receive a tax penalty for non-compliance. The tax penalty will index up annually for non-compliance.

  • Financial assistance is available in the form of an insurance subsidy which is determined by a family’s income as related to the federal poverty level. This tax subsidy is only available through the public exchange. If your employer offers a plan that provides minimum value and is deemed affordable, defined by the ACA, then no subsidy is available regardless of your income level.