Open Enrollment Is Here, Make It Work For You!

We’ve just entered the Open Enrollment period (Nov. 15 - Feb. 15) for Individual and Family Health Insurance with the Affordable Care Act (ACA). If you haven’t taken advantage of it yet, there is something to consider –penalties. None of us like them, especially when they’re being levied by the IRS. For those of your who are currently without medical insurance for whatever reason, these are the penalties you face on April 15:

For 2014, the penalty is either a flat amount or 1% of your income, whichever is greater. The flat amount is $95 per adult, and half that for children under 18, with a cap of $285 per family. As with the flat penalty, there is also a cap on the maximum payment. It rises no higher than the average cost for a family of five under a bronze-level Affordable Care Act-approved plan. The maximum penalty if calculated as a percentage of income is $12,240.

For 2015, the percentage-of-income penalty rises to 2%. The flat amount increases to $325 per adult, and $162.50 per child up to a maximum of $975. The maximum percentage penalty would be approximately $13,400.

For 2016, the percentage of income increases to 2.50%. The flat amount rises to $695, and $347.50 per child up to a maximum of $2,085. The maximum penalty could be as high as $14,800.

And what makes these penalties worse is you get nothing for them. You’re still faced with spending the necessary funds to keep yourself healthy in the coming year.

Let’s turn this to the positive. The ACA, particularly for families struggling in this economy, does make healthcare more affordable. Let’s look at an example. While having lunch at the Apple Shed yesterday I saw a very sweet family of six. The parents looked in their mid-thirties and the kids seemed to range in age from 2 to 13. Let’s say they have a family income of $45,000 a year. They would have their whole family covered with an Anthem PPO for less than $120 a month and would only be responsible for 6% of their total healthcare costs.

But let’s say you have coverage already and you’re very happy with it. However, a few weeks ago you received a notice that your premium is going up – a lot! You need to look to see what’s available for less, but also, to find out if what your being told by the insurance company truly reflects your situation. I’ve had clients who’ve been told their premiums are going to soar next year to find out that with just some minor tweaking, they will actually have a lower premium next year.

For those of you who are eligible for Medi-cal, or think you might be, we can help you get through the enrollment experience, too.

Whatever your health insurance questions or concerns, give me a call, or send me an email and we’ll get you taken care of quickly and respectfully.

William Kritlow is a license insurance broker, CIL#0A93013, cell: 949-394-4525; email: [email protected].

William Kritlow, Phone (cell) 949-394-4525 or 661-821-0262, CA Insurance License#0A93013

Stacy Segal Neuland, 714-536-1812, CA Insurance License#0E45244