Exchange Subsidy Eligibility
Quotes On or Off the Exchange
Assist with Application Process
Continued Support through Plan Year
Always Deal with Same Staff and Agent
Get a PERSONALIZED QUOTE
Let's Discuss Health Insurance
Did you know that carrier commissions are built-in to all plans, whether you use an agent or not?
Individual Health Insurance
Individual Life Insurance
Individual Dental and Vision Plans
Group Health Insurance
Medicare Eligible Products
November 15, 2014 to February 15, 2015
October 7, 2014 to December 15, 2014
You have many options for health insurance in today's constantly changing health insurance market. Moreno Insurance can help you sort through all of your options to help you find the plan that best fits your needs and budget, while also making certain to keep you compliant with new healthcare reform insurance requirements. With more than twenty years of experience and having worked for one of the nation's largest Fortune 500 insurance carriers, why not choose an insurance advisor that is knowledgeable, experienced and dedictaed to serving your best interests, not only through the strength of the carriers we represent, but in providing the highest level of "hands on" personal service required to meet the needs of our clients.
What You Need to Know
What is the Exchange?
As part of new Healthcare Reform, the Federal Health Insurance Marketplace, commonly referred to as The Exchange, opened in October of 2014 to offer health insurance to Individuals and Families, as well as Small Businesses.
What Type of Plans Are Available Through the Exchange?
Offering a variety of HMOs and PPOs, all plans on the Exchange will contain the qualifying essential benefits and range in coverage from 60/40 to 90/10. For example, the 90/10 plan would have the least out-of-pocket expenses, but cost you the most in premium.
Why the Exchange?
The Exchange may contain more affordable health insurance for those individuals and families, as well as small businesses who qualify for the premium discount, which is offered as a tax credit or subsidy and only offered through the Exchange. In other words, if you qualify for the discount, you must purchase your benefits through the Exchange to receive the subsidy.
Individual Subsidy. Families earning up to $94,000 per household (this is about 400% of the poverty level) can qualify. We suggest you use our Individual Subsidy Calculator to find out if you qualify.
Small Business Tax Credit. For small businesses to be eligible, you must cover at least 50 percent of the cost of employee-only (not family or dependent) health care coverage for each of your employees. You must also have fewer than 25 full-time equivalent employees (FTEs). Those employees must have average wages of less than $50,000 (as adjusted for inflation beginning in 2014) per year. We suggest you use our Business Tax Calculator to find out if you qualify.
Healthcare Reform Affects Businesses and Individuals
Employers who have more than 100 or more full-time equivalent employees must offer those employees and their families and dependents to age 26, benefits that pays for 60% of the minimum essential benefits, as established by the ACA, or face a potential penalty. In 2016, the mandate applies to employers who have 50 or more full-time equivalent employees.
Individuals must now obtain qualifying coverage either through an individual policy or through their employer or face a potential penalty.
New Underwriting Guidelines
Dependents up to age 26 may be added to an insurance policy for both individuals and employer coverage.
Insurance companies can no longer increase rates or deny coverage because of a pre-existing condition. This applies to both individual and employer paid coverage.
Gender is no longer a factor in determining rates.
For businesses: Renewal rates are same as new business rates. Waiting period can't exceed 90 days
Individuals must purchase their health insurance during the annual open enrollment period. Failure to do so may result in penalties and having to wait until the next open enrollment to purchase coverage. Employers are able to offer benefits year round or during their normal open enrollment as usual.
To be in compliance with the new healthcare reform laws and avoid costly penalties, you must purchase Insurance coverage that pays at least 60% of the costs of the costs of the "essential benefits."
Changes in how you purchase health insurance
What Our Clients are Saying
We offer Major Medical and Short Term Health Insurance, in addition to supplemental Dental, Vision and Term Life Insurance. Our convenient Online Shop and Buy feature will give you information on premiums and allow you to purchase coverage for plans that are both on and off the Exchange.
With new healthcare reform laws, you may qualify for a subsidy which will be applied to your premium (premium discount). If so, you will be able to purchase your plan and receive your discount through the Exchange right off of our website.
Remember with new healthcare reform laws, you can’t be turned down or quoted higher rates because of a pre-existing condition. Also, you can now add your dependent children up to age 26 on your policy.
For more information the the subsidy, the Exchange or Healthcare Reform, please see the section immediately to the left and below.
If you prefer, we’d be happy to personally assist you in your search for health insurance. Whether you are purchasing benefits through the Exchange or from the open market, there is never a fee to have our expert guidance. Just give us a call or fill out the form located at the top of this page.
Below are some of the most common insurance plans available to individuals that we may recommend, depending on needs.
A Health Maintenance Organization or HMO health plan requires you to appoint a primary care physician and to use doctors and facilities that are affiliated with the HMO. If you use healthcare service providers outside of the HMO, there is a good chance those charges won’t be covered by your policy. The great thing about an HMO is that the only charges you incur, outside of your premiums, are co-pays for doctor’s visits and other services such as procedures and prescriptions.
A Preferred Provider Organization or PPO will save you money on services if you use the preferred providers within the network. Keep in mind that deductibles must be met on this plan before some services will be covered. The good thing about a PPO is they generally will allow a certain amount of services annually outside of the deductible with a small co-pay, and most often the PPO has a large network with quality care providers and excellent prescription drug coverage.
Catastrophic Plans are great for those healthy individuals who do not expect to need medical care throughout the year, other than routine preventative care (generally available for under age 30). Note catastrophic plans may or may not contain the essental benefits required by the ACA to avoid penalty.
When individuals become eligible for Medicare, they soon find out that not all their health related costs are covered under original Medicare. We offer affordable Medicare Advantage and Medicare Supplement plans, along with Medicare Part D that provide more coverage and/or help fill in that gap between your out-of-pocket healthcare expenses and your wallet.
Here’s a brief explanation of how the Advantage and Supplement Plans work.
Original Medicare (Part A) covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
Medicare Supplement Insurance policies complement your original Medicare and will pay some, if not all, of the expenses that Part A and B do not cover.
Medicare Advantage Plans are part C of Medicare and Part C plans combine Part A and Part B into one plan. Some Advantage Plans have a part D (prescription coverage) built into them.
Medicare is complex. Note that there are dozens of Supplement and Advantage plans to choose from, each plan and carrier offer different advantages over the other. The best plan for you will depend on your unique circumstances. We recommend letting us evaluate your needs by giving us a call us or by filling out the Medicare Quote form located at the top of this page.
Moreno Insurance has a rich variety of group health insurance benefits, from both the open market and the Exchange (SHOP), that are geared for the small business yet have typically only been available to larger corporations in the past.
You may also qualify for the small business tax credit which could reduce your monthly premium by as much as 50%. If so, our office can evaluate your needs and assist you in obtaining your tax credit and benefit package through the Exchange.
If you do not qualify for the small business tax credit, there are still some excellent benefits available from our top carriers on the open market.
For more information on the subsidy, the Exchange or Healthcare Reform, please see the section immediately to the left and below.
Whether you are purchasing benefits through the Exchange or from the open market, there is never a fee to have our expert guidance. Just give us a call or fill out the group quote form located at the top of this page.
Below are some of the most common insurance plans available to Small Businesses that we may recommend, depending on needs. As part of our Group Insurance services, we will market and negotiate with carriers who have competitive products tailored to your needs. We will also assist you with the application process and through implementation of your plan, in addition to offering ongoing support throughout the plan year.
A Health Maintenance Organization (HMO) requires group members to obtain their health care services from doctors and hospitals affiliated with the HMO. Generally with an HMO members are required to designate a primary care physician who treats and directs health care decisions and who coordinates referrals to specialties within the HMO network. HMOs offer access to a comprehensive package of covered health care services in return for a prepaid monthly amount (or “premium”). Most HMOs charge a small co-payment depending upon the type of service provided.
A Preferred Provider Organization (PPO) does not require group members to designate a particular provider, however, if they use providers within their network, they will save the most money on their healthcare services. If providers outside of the network are used, it is possible that those services may not be covered at all, so it is a good idea to check first with your PPO. Keep in mind that deductibles must be met on this plan before some services will be covered. PPOs generally require a co-pay for physician visits.
A Health Savings Account (HSA) combines a high deductible/lower premium health insurance plan (PPO) with a tax favored savings account. Both employer and employee can contribute, tax-free to the savings account. Money in the savings account can help fund the deductible and other qualified medical expenses. Once the deductible is met, the insurance starts paying. Money left in the savings account earns interest and is yours to keep.
Single, Dual or Triple Option Plans offer eligible employees a choice between several different types of plans as described above.