aca healthcare reform

Qualifying Events

Open Enrollment Guidelines of the ACA Healthcare Reform

ACA Healthcare Reform laws require all individuals have health insurance, or face a potential penalty.  Accordingly, this mandatee can be satisfied either through an individual policy or throughan employer paid policy.  However, individuals can only purchase policies during the annual open enrollment of November 1st through December 15th of each year.

Did you miss the deadline?  You can still enroll if you meet any of the following qualifying events:

  • change in legal marital status
  • a change in the number of dependants
  • a change in place of residence and the current carrier is not available
  • significant cost or coverage change
  • a change in coverage of a spouse or dependant
  • a COBRA qualifying event
  • legal judgements, decrees and orders
  • entitlement to Medicare or Medicaid

The ACA Essential Benefits

What your policy must cover, as mandated by the ACA Healthcare Reform

To be in compliance with ACA healthcare reform laws and avoid costly penalties, you must purchase insurance coverage that pays at least 60% of the costs of the following “essential benefits.”

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Prescription Drugs
  • Mental health and Substance Abuse disorder services
  • Rehabilitative and habilitative services and devices
  • Pediatric services, including oral and vision care
  • Preventive and wellness services, and chronic disease management

Do You Qualify for a Tax Subsidy?

Important

If you qualify, and plan to use the Premium Subsidy, you must purchase your benefits through the Federal Health Insurance Marketplace.  We are certified to help individuals secure health insurance and their tax subsidy through the Marketplace, if qualified, and would be happy to assist you. Please call us at 305-519-8141 or click the button below to get quotes.  If you qualify for a subsidy, you will be directed to the Marketplace to secure your health insurance.

Agent:  Geronimo Schmidt
NPN#:  7266629

Premium Subsidy Disclaimer:

The premium and subsidy amounts displayed on Healthcare.gov, including the Subsidy Calculator, are estimates only and the actual premium and subsidy amounts may differ. Please do not rely on the Subsidy Calculator for legal or tax advice. The information on Healthcare.gov, including the Subsidy Calculator, is based on the Affordable Care Act and subsequent regulations issued by Health and Human Services and the Internal Revenue Service; and the law and regulations are subject to change.

It is the insured’s responsibility to notify the Marketplace (800-318-2596) or via your Marketplace Account) within 30 days of any changes to household income and family size that may affect the premium or subsidy amount as such changes can result in a difference in the amount. Actual premiums may vary depending on plan availability and numerous other factors and penalties could be assessed for failure to provide accurate data or failure to update changed data.

Broker Disclaimer:

Friends With Benefits LLC. its employees, agents and representatives (collectively “Broker “) make no independent representations with respect to subsidies owed and/or premiums to be paid for coverage. Any information provided to you by broker may not be construed as tax or legal advice. Consult with your attorney and/or tax specialist for such advice.

Broker relies on the information you provide the Healthcare.gov and the information provided by this site in order to advise you on expected and actual premiums, subsidies and/or premium tax credits. Broker accepts NO responsibility or liability with respect to premium calculations, subsidies/ premium tax credits owed, penalties assessed, and/or recoupment of subsidies/premium tax credits. Further, Broker is in no way liable for any information provided through Healthcare.gov including the Subsidy Calculator and makes no warranties or representations as to the accuracy of said information.