FAQs - Frequently Asked Questions

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FAQs

FAQs

Will using a certified agent like Rocky Mountain Insurance cost me extra?

No, our commission is built into your premium whether or not you use Certified Agents or not. Our consultation is free and could save you thousands of dollars. DO NOT risk thousands of dollars in potential tax penalties because you assumed the plan bought through Healthcare.gov complied with the law.

Who’s not covered?

  • Not a U.S. citizen or legal resident.
  • Offered enrollment with eligible employer sponsored plan providing “minimum value and affordable”. Minimum value is at least 60% of the actuarial value (bronze plan). Affordable is no more than 9.5% of employee’s W-2 income.

When can I enroll?

  • Individuals or Families Open Enrollment begins NOVEMBER 1 – DECEMBER 15, 2019 deadline – Health Insurance Annual Enrollment.
  • Employers on their anniversary date.
  • Small Business-anytime.
  • Medicare Beneficiaries begins October 15-December 7.
  • Coverage begins January 2020.

Are pre-existing health conditions covered?

Beginning 2014, health insurers can no longer be able to charge more or deny coverage to anyone because of a pre-existing condition.

Will the definition of pre-existing conditions change by 2014, when the Affordable Care Act goes into full effect?

A pre-existing medical condition is commonly considered an illness or disability a person has prior to applying for health insurance coverage. Yet, the definition change on states and even by insurance plans.

However, when the law takes full effect in 2014, that definition will lose its importance. Under the law, no one can refuse health care insurance for any reason, including an existing medical condition.

How can Rocky Mountain Insurance help me?

We are experienced licensed agents in the Health, Life, Property and Casualty markets.

We also have Errors and Omissions insurance to help protect our clients.

We are certified and trained with Federal Health Insurance Exchange.

People of Utah can now get health coverage, even with pre-existing health conditions as well as access to financial help if you qualify.

What are the different tiers on ACA/OBAMACARE health plans in Utah?

  1. Bronze plans are the cheapest because insurers pay only 60 percent of a policyholder’s covered health expenses, and the policyholder must come up with the other 40 percent.
  2. Silver plans split covered expenses 70-30%. 70% of policyholder’s covered health expenses.
  3. Gold plans split covered expenses 80-20%. 80% of policyholder’s covered health expenses.
  4. Platinum plans split covered expenses 90-10%. 90% of policyholder’s covered health expenses.

What is the cheapest ACA/OBAMACARE health plan I can buy in Utah?

Bronze plans are the cheapest plans that at a minimum is required so you won’t face any penalty. This health plan offers really high deductible and co-insurance that’s why it’s the cheapest.

How do I get financial assistance or tax credits through Affordable Care Act or OBAMACARE?

To qualify for tax credit or financial assistance, we need basic information about yourself, family and or business. Any type of financial assistance is always based on the annual income of an individual, family or business.

The process may feel like filing for your tax return. It’s very important to put your expected income so you will get the most accurate financial assistance. Financial assistance is also set up in a sliding scale of commercial premium tax credits for people making under 400% of the poverty level which $94, 200 for a family of four or $45, 960 for an individual.

Small business also gets more tax credits for small business with less than 25 employees. And for people that makes less than 250% of the poverty level are eligible for cost-sharing or co pay reductions which means less out of pocket expense.

Do I need my most current tax return to get tax credits?

You should have your most recent tax return to based on your income on and also your projected income estimate for 2020.  If you can’t provide any documents then, the state will adjust your tax credits accordingly.

Sometimes it maybe hard to project how much your income is going to be especially if someone is in sales or any job with commission or bonuses.

So if you make more than your estimated income you’ve put in on your application, your estimated tax credit will be reconciled accordingly.

I’m under my parents health insurance plan, do I need to get my own insurance?

The law allows people 26 and under to stay on their parent’s insurance policy.

What if I’m on COBRA or have a Portability Plan?

If you’re on COBRA, you can choose to keep it but you may find it cheaper to shop in the open market or on the exchange because all portability plan are going away next year. You may qualify for financial assistance to help pay for your medical coverage.

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