Benefit Exchange

Health insurance can be very confusing. We will help you simplify the process to choose the correct plan for you: First – Identify important elements you want in your plan

+ Copays

  • What you pay for an office visit, an urgent care visit, or a prescription.

+ Deductible

  • What you pay for anything outside of the doctor’s office. Has limit options, i.e. $1,000, $2,000, $5,000, etc.

+ Co-insurance

  • After deductible is met, the portion of your expenses you choose to pay . Usually 20 % or 30%.

+ Maximum Out of Pocket (OOP)

  • When your portion of the co-insurance reaches a certain amount, the insurance company will pay for the rest of your bills. Ususally from $0-$10,000.

+ Network

  • The providers (doctors and facilities) that are contracted by an insurance company to provide services to their customers. Best reimbursements for care are when you get your services within your network.

+ Subsidy

  • The portion of your premium paid by the Federal Government.

 

Do I qualify for a Federal subsidy?

When applying through the Federally-Facilitated Marketplace (FFM), be sure to enter our National Producer # 1594443 and FFM User ID bda85258. Contact our office with questions.

What individual consumers need to know:

Consumers purchasing insurance in the marketplace (like Benefit Exchange) will be guaranteed coverage for pre-existing conditions and premiums cannot change based on your medical history or gender. You have several options for benefits:

Keep Your
Grandfathered Plan

No change since March 23, 2010

Buy a plan in the
marketplace

Like Benefit Exchange

Go Uninsured

Pay a penalty