Here is a list of questions that ComPro answers every day:

Q.  Am I required to use the Marketplace?
A.   No.  Health insurance can be purchased directly from an insurance company.

Q. Who should use the Marketplace?
A. Individuals and families who are eligible for financial assistance must use the Marketplace to access those benefits.  If you choose not to use the Marketplace, you forfeit the right to claim those benefits on your tax return for 2014.  Small businesses must use the SHOP Marketplace to access the Small Business Health Care Tax Credit.
http://www.familiesusa.org/resources/tools-for-advocates/guides/federal-poverty-guidelines.html

Q. What is the Premium Tax Credit?
A.  A tax credit that can be used to reduce your monthly premium.  Those whose adjusted gross income is less than 400% of the Federal Poverty Level (FPL) may be eligible.
Example:  Family of 4 living in Lincoln, NE.  Mom & Dad are both 40 years old.  Family income of $60,000 equals 255% of the FPL and means they should pay 8.19% of their income for health insurance premiums.  $60,000 x 8.19% = $4,914.  The annual premium for the “base” plan in Nebraska for this family is $8,763.  The family pays $4,914 and receives a Premium Tax Credit of $3,849.  You can apply the Tax Credit to your monthly premium or choose to receive it in a lump sum with your 2014 income tax return.
http://www.irs.gov/uac/The-Premium-Tax-Credit

Q.  What is the Cost Share Reduction Subsidy?
A. A subsidy that reduces your out-of-pocket expenses on your health insurance policy.  You may be eligible if your adjusted gross income is between 100% and 250% of the FPL.

Example:  Same family of 4 with income of $45,000.  They are now at 191% of the FPL.  A Silver plan being offered in 2014 offers cost sharing of 70% / 30%.  The insurance company pays 70% of the medical expenses and the insured pays 30%.  That changes to 87% / 13% for someone at 191% of the FPL.  The silver plan has a deductible of $4,000 and total out-of-pocket expenses of $9,000.  After the Cost Share Reduction Subsidy is applied, our family’s benefits will improve to a deductible of $1,200 and out-of-pocket expenses of $2,600.
https://www.healthcare.gov/will-i-qualify-to-save-on-out-of-pocket-costs/

Q.  How can I find out if I qualify?
A.  Go to www.comproins.com and use the Subsidy Calculator to get an estimate.  The final determination is made when you enroll in the Marketplace.

Q.  My employer (or my spouse’s employer) offers health insurance.  Can we get financial assistance on the Marketplace?
A.  If the employer plan is “affordable”, you will not be eligible for financial assistance.  Affordable means that your share of the premium for employee only coverage is not more than 9.5% of your income.

ComPro wishes you a blessed Holiday Season


by Chris McPike, Vice President

402-488-5100

www.comproins.com