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Last Step– Having an experienced and knowledgeable agent to assist you in making the right decision Four key steps to making the right decision First.

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Presentation on theme: "Last Step– Having an experienced and knowledgeable agent to assist you in making the right decision Four key steps to making the right decision First."— Presentation transcript:

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2 Last Step– Having an experienced and knowledgeable agent to assist you in making the right decision Four key steps to making the right decision First Step – Knowing all your options Second Step - Understanding the advantages and disadvantages Third Step – Choosing the right plan for your needs and budget

3 ACA Essential Benefits for creditable coverage Maternity, pre-existing conditions, mental nervous disorders, annual wellness exam Who will Obamacare help the most? Those who qualify for premium tax subsidies and or have pre-existing conditions Who will Obamacare help the least? Those who do NOT qualify for premium tax subsidies and are in good health.

4 The majority of consumers have 5 options… Which option is yours? 5. Employer based coverage 1. No coverage 2. ACA certified Marketplace coverage 3. ACA certified Private 4. ACA non-certified coverage

5 Disadvantage – Subject to IRS fines for NO coverage (exemptions available) No Coverage Advantage – No health insurance premiums Disadvantage – Responsible for 100% of your medical care Disadvantage – Limited access to the medical system

6 Disadvantage – Limited network options ACA Qualified Market Place Plans Advantage - Premium and out of pocket tax subsidies available based on house hold AGI Advantage – Pre-existing medical conditions covered with no waiting periods Disadvantage – Limited plan options

7 Disadvantage - Paying the highest premium for health insurance ACA Qualified Private Plans Advantage – Pre-existing medical conditions covered with no waiting periods and not subject to IRS fines

8 Disadvantage – May be subject to IRS fine for not covering Essential Benefits required for ACA plans maternity, pre-existing conditions, mental nervous disorders, annual wellness exam (exemptions available). ACA Non-Qualified Plans Advantage – 25% - 50% lower premiums than qualified ACA plans

9 What happens if I don't pay the fee? The IRS will hold back the amount of the fee from any future tax refunds. There are no liens, levies, or criminal penalties for failing to pay the fee. https://www.healthcare.gov/fees-exemptions/fee-for-not-being-covered/ How you pay the fee You’ll pay the fee on the federal income tax return you file for the year you don’t have coverage. Most people will file their 2015 returns in early 2016. Learn more about the individual shared responsibility payment from the Internal Revenue Service.individual shared responsibility payment from the Internal Revenue Service

10 Employer Based Coverage Disadvantage – Dependents will not qualify for tax subsidies since group coverage is available Advantage – Employer pays part or all of the employee’s premium Disadvantage – Employee pays 100% of dependent coverage

11 What’s the best premium for your budget? Teledoc – 24/7 access to licensed physician to receive consultations and prescriptions It’s your decision… Optional low cost supplemental coverage (Essential for high deductible medical plans) What’s the best option for your situation? What’s the best plan for your needs? Accident Plan – Eliminate health insurance deductible & out of pocket expenses due to an accident Critical Illness / life plan - Eliminate health insurance deductible & out of pocket expenses due to heart attack, stroke or cancer

12 $10 will be donated to the Alamo Breast Cancer Foundation by our agency for every application submitted.


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