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Individual Marketplace

 

 

Agents who need health insurance quotes for individuals and families have multiple options based on carrier networks, benefit plans, and rates.

Swift Kennedy & Associates is appointed with all carriers who offer individual health insurance products in Pennsylvania. We can assist the agent find the right plan for their clients.

Contact SKA Producer Services if you need applications, rates, brochures, or benefit grids for individual plans.

Marketplace

Under the Affordable Care Act, all individual coverage is guarantee issue and renewability. Rates are based on location, age, and tobacco use.

One useful tool to view available plans is the Federal Facilitated Marketplace (FFM) website. Agents can use the marketplace to help individuals and families find, compare and enroll in health coverage:

www.healthcare.gov

The individual must purchase their health plan through the Marketplace in order to qualify for a tax credits (premium subsidy) or cost sharing.

 

Tax Credits & Cost Sharing

The Federal Poverty Level (FPL) is a measure of household income the government uses to determine eligibility for health insurance subsidies.

 

Tax Credits are designed to lower monthly costs of health insurance (premium subsidy). Households with income between 100% and 400% of the FPL may qualify for these tax credits.

 

Cost Sharing reductions actually increase the benefits of the health plan. If a household income is between 100% and 250% of the FPL they may also qualify for cost sharing. They must enroll in a Silver plan to get cost sharing.

 

 

Federal Poverty Guidelines 2014

Persons in Household

138% of Federal Poverty Level for Continental U.S.

Cost Sharing Eligibility (250% of FPL)

Premium Subsidy threshold (400% of FPL)

1

$16,105

$29,175

$46,680

2

$21,707

$39,325

$62,920

3

$27,310

$49,475

$79,160

4

$32,913

$59,625

$95,400

5

$38,516

$69,775

$111,640

6

$44,119

$79,925

$127,880

7

$49,721

$90,075

$144,120

8

$55,324

$100,225

$160,360

 

 

Open Enrollment

Open Enrollment is a time of year that individuals and families can purchase a health plan. Open Enrollment Dates:

 

  • 11/15/2014 – 12/15/2014                January 1st 2015 Effective Date
  • 12/16/2014 – 01/15/2015                February 1st 2015 Effective Date
  • 01/16/2015 – 02/15/2015                March 1st 2015 Effective Date

 

Special Enrollment Period

Individuals can also purchase a health policy outside of Open Enrollment periods only if they have certain events during the year. The Special Event Period (SEP) opens up a 60 days period from the loss of coverage that an individual can purchase a plan.

 

If need assistance with individual application, please contact SKA Producer Services 800-372-4607.