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Archive for the ‘special enrollment’ Category

Five Reasons to Talk with an NC Health Insurance Agent

Friday, August 24th, 2018

Navigating the insurance market as a first-time buyer can be overwhelming. Customers often call us lost and confused after they have attempted to understand the process of applying for health insurance, especially if it is their first attempt doing so. At NC Health Plans/Jerry Ballard & Associates Inc., we know that this process can seem daunting and stressful, but we are here to help! Our professional agents are not only helpful guides to choosing your best plan, but are also here to assist you with the entire application process. Lastly, they can provide you with important information regarding the details of your coverage. Here are five reasons why you should talk with an agent when applying for NC health insurance:

Find Out When You Can Apply:  An agent will be able to determine the time frame in which you are able to apply for insurance. These times frames include Open Enrollment Period and Special Enrollment Period. During the Special Enrollment Period, you must have had a Qualifying Life Event occur within the last 60 days to enroll in an ACA-compliant plan. Talking with our agents can verify that you meet the requirements to enroll during special enrollment.

Determine Your Eligibility for Savings: Federal tax credits, also known as subsidies, are an amenity of the Affordable Care Act that are designed to lower the cost of health coverage. Talking with an agent can help determine if you are subsidy-eligible and meet the requirements set by the federal government. GENERATE YOUR QUOTE to determine if you are eligible for a subsidy, that could significantly reduce your monthly premium!

Get Help when Applying Online: Applying for coverage through the Health Insurance Marketplace can be tricky. Having an agent help you submit your application can avoid confusion during this process and ensure that your application is complete and submitted correctly. Our agents can help you submit your application right over the phone, it could take as little as 15-20 minutes!

Gain Knowledge About Your Coverage: Not only can agents provide insight about your plan’s benefits, they can also help you understand the details of your coverage. With so many options, such as Gold, Silver, and Bronze plans it can be confusing to determine which BCBSNC plan is best for you. It is also very important to know if your healthcare provider is “in-network.” Since it can be more costly to seek “out-of-network” coverage, knowing which doctors and hospitals accept your plan is one of the best ways you can manage your healthcare costs.

Ensure You Get Coverage When Needed: While applying for health insurance, customers may find that they have a lapse in coverage before they are able to enroll in a Blue Cross Blue Shield of North Carolina plan. It is important to avoid any gaps when you may go without coverage! Speaking with an agent can ensure that you are enrolled in the correct effective date so you won’t go without the protection and quality coverage that you need to maintain your health. We can’t wait to hear from you!

For more information on North Carolina Health Insurance coverage, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.

Learning about North Carolina Health Insurance

Thursday, August 16th, 2018

North Carolinians already know that we live in a wonderful and special place. It is not often that you can make a trip from the most beautiful mountain tops to the crystal clear waters of our coast in just a day. With North Carolina having so much to offer, it is not surprising that our population is growing, and more and more people are choosing North Carolina to call home.

Because the health Insurance industry is regulated partially at the state level, living in North Carolina can directly affect the health insurance that is available to you, and how and when you can apply. Whether you have deep roots or have just become a resident of “The Old North State”, these are some things that all North Carolinians should know about North Carolina Health Insurance:

What Types of Coverage are available to me in NC?
Residents of North Carolina have two major types of individual/family insurance available to them, Affordable Care Act (ACA) compliant, also referred to as “Obamacare”, and other alternatives like Short Term coverage. ACA-compliant plans are required to cover the same set of essential health benefits under the Affordable Care Act laws. Blue Cross Blue Shield of North Carolina offers the broad majority of these plans across the entire state. Short Term plans are not ACA compliant, but allow individuals and families to enroll outside of Open Enrollment Periods without a Qualifying Event. These plans do not cover pre-existing conditions, but are often more affordable than ACA compliant plans.

When Can I Apply?
The Open Enrollment Period is a yearly period when individuals and families can enroll in health insurance. Open enrollment for 2018 will begin on November 1st and last until December 15th. Open Enrollment is a very important time period because all individuals are eligible to enroll. If you miss Open Enrollment, you must qualify for a Special Enrollment Period. To qualify for Special Enrollment, you have to experience a Qualifying Life Event. Qualifiers such as getting married, having a baby or losing coverage provided by an employer could make you eligible to enroll during Special Enrollment, as long as you enroll within 60 days of the life altering event.

Is it Affordable?
One of the amenities of the Affordable Care Act is federal tax credits, also known as subsidies. Subsidies are designed to lower the cost of health insurance for low and middle income individuals or families. If you are eligible for a subsidy, it could greatly reduce the cost of your monthly premium. Generate a Blue Cross Blue Shield of NC health insurance quote to find out more about whether you are eligible for a subsidy.

At NC Health Plans/Jerry Ballard & Associates Inc., we love living in North Carolina and take pride in serving North Carolinians statewide. Our website allows you to generate quotes, shop for plans, and apply online at your convenience. If we can assist you in selecting a health insurance plan, please call us at 888-765-5400. We are North Carolinians serving North Carolinians!

For more information on North Carolina insurance coverage, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.

North Carolina Health Insurance when Turning 26

Wednesday, August 1st, 2018

If you were born in ‘92, we want to wish you a happy 26th birthday! Another trip around the sun is always something to celebrate and be thankful for, and we hope that this upcoming year is your best one yet! Adults in their mid-twenties find themselves in many different walks of life. Whether you have gotten married, had children, graduated, or simply having fun, there is something all 26 year-olds have in common. That is, that you’re aging out of your parents’ insurance plan!

Health Insurance shoppers at this age often call us with concern, saying, “I have never shopped for insurance before and don’t know what to do or where to start!” We realize that navigating this transition and the insurance market can be stressful and overwhelming.  However, it is not something to put on the back burner or avoid! Here are some helpful things you should know about applying for insurance:

  • You have 60 days!

Turning 26 and aging out of your parent’s health insurance plan is considered a Qualifying Life Event.  This qualifying event will provide you a 60 day window outside the Open Enrollment Period to enroll in a new plan.  Make sure you know when this starts and stops in order to avoid any lapse in coverage.

  • You can save money!

Based on your household income, you may be eligible for a federal subsidy which can greatly reduce the cost of your monthly premiums. Generate a Blue Cross Blue Shield of NC health insurance quote to find out more about whether you are eligible for a subsidy.

  • Don’t go uninsured!

Did you know that under the health care law, you must have qualifying health coverage? Without it, you may face a penalty on your next tax return. In addition, it is important to have protection and quality coverage to maintain your health, or in case of sickness or an accident!

  • Don’t stress! It’s easier than you think!

This process can seem overwhelming. However, it is easier than you think. We are here to help you through the entire application process right over the phone, and it only takes about 25 minutes to apply for health insurance!

As you are thinking about your 26th birthday celebration, remember your health insurance – and don’t let those 60 days slip away! Here’s to many more years of health and happiness!

For more information on North Carolina insurance coverage, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.

NC Health Insurance – Fill Coverage Gaps and Add Value to Your Existing Plan

Monday, July 18th, 2016

Old Calculator On White Background Showing Text "win - Win"Open Enrollment 2017 will not begin until November, but you still have options available to help fill gaps in coverage and add value to your existing coverage.  At NC Health Plans, we offer Critical Illness, Accident and Hospital Indemnity plans that can significantly reduce the out of pocket expense you could potentially incur because of high deductibles and coinsurance.  Because of the nature of the ACA and the rising cost in health insurance, many people chose health plans with high deductibles in order to reduce monthly premiums.  Although providing some relief on a monthly basis, these plans can create enormous financial stress should something unexpected happen.

Having an Accident, Critical Illness or Hospital Indemnity plan that pays directly to you a flat sum of money should you face one of these unexpected events can save you from potentially catastrophic health costs. In addition, none of these plans are connected to any specific network of providers so they will complement any traditional health insurance plan and you can receive care from any doctor or hospital you choose.

The application process is simple and each of these plans offer great benefits at a low price to help reduce your financial risk should you be faced with an unexpected illness, accident or hospitalization.  Traditional health insurance is a must, both in terms of the law and in order to ensure you are properly covered for illnesses, preventive care and other medical procedures, but traditional health insurance is not always enough.  At NC Health Plans, we offer a wide variety of insurance products to help fill the gaps left by traditional insurance and add value to your current health plan. (more…)

Can I Enroll in Health Insurance? – Understanding Special Enrollment

Thursday, September 10th, 2015

Student thinking with question marks on blackboard. Asian femaleBy now, most of us have heard the terminology, but what exactly is a Special Enrollment and what constitutes a Qualifying Life Event?

Under the Affordable Care Act, there are two different periods in which an individual may apply for health insurance.  The first is referred to as Open Enrollment and during this time any person may apply for health coverage for any reason, as well as make changes to any existing health insurance policy.  During Special Enrollment, however, there are more restrictions and a person is required to have what is referred to as a Qualifying Life Event (QLE) in order to acquire health insurance.  (more…)

Want to Opt out of Group Insurance? – Now you Can!

Monday, August 3rd, 2015

Everyday Winner.One of the major concerns for Americans with the initiation of the Affordable Care Act was whether or not individuals would be able to stay with their employer’s group plan if they so desired.  The answer is yes.  The ACA did not mandate individual coverage versus group coverage, but simply mandated minimum essential coverage for every individual.  Oftentimes, that coverage can be obtained through an employer or a group health plan.

However, with the rise in the cost of insurance, many Americans are now asking the opposite question:  must I continue with my group coverage or can I pursue a more affordable individual option for either myself or my family members?  (more…)

A Baby Changes Everything – BCBSNC Coverage for new Dependents

Friday, July 24th, 2015

For anyone who’s ever had a baby or anyone who is expecting to have a baby, you know all too well.  A baby changes everything!  There are so many new things to think about and determining the proper amount of health coverage for your new bundle of joy is one of the most important.  (more…)

Turning 26? – Get an Individual BCBSNC Health Plan

Thursday, July 16th, 2015

Birthday cake with burning candle number 26Under the Affordable Care Act, young adults are now eligible to remain on their parents’ Blue Cross Blue Shield of NC health insurance policies up to age 26, even if they are not full time students.  (more…)

Get BCBSNC Insurance during SEP – Federal Marketplace Extends List of Qualifying Life Events

Thursday, June 11th, 2015

Health InsuranceBy now, most Americans are aware of the changes instituted by the Affordable Care Act and the impact this law has had on health insurance.  Terms like “premium tax credit,” “federal subsidy,” “Health Insurance Marketplace,” and “individual mandate,” however, are still often unfamiliar to consumers now navigating a system reorganized under completely different criteria and governed by federal law.  Understanding the new terminology is paramount in understanding much of what constitutes the Affordable Care Act and is a key part of being able to successfully choose, enroll and manage a health insurance policy.

That being said, perhaps one of the most confusing aspects of the Affordable Care Act is the Special Enrollment Period and why you must have a Qualifying Life Event in order to enroll in health coverage.  Prior to the Affordable Care Act, consumers had the benefit of enrolling in individual health insurance or making changes to their existing policies at any time during the year.  On the flip side, insurers had the right to practice medical underwriting and charge more for, or deny coverage to, consumers who had serious or preexisting health conditions.  Under the new law, these conditions have changed.  Insurers may no longer ask consumers any health questions (with the exception of whether or not you are a smoker) and no consumer can be denied health insurance based on a preexisting condition; however, consumers may not enroll or make changes to their health policies whenever they choose, but are now subject to the rules of Open Enrollment, Special Enrollment and Qualifying Life Events (QLE’s).

For 2015, Open Enrollment will begin November 1st and end January 31st.  During Open Enrollment, you may purchase health insurance or make changes to your current policy for any reason.  Currently, however, we are in the Special Enrollment period, which means consumers are required by law to have a Qualifying Life Event in order to purchase insurance.  A Qualifying Life Event is some special circumstance, such as a recent move or the loss of access to minimum essential coverage, that allows the consumer to purchase insurance outside of Open Enrollment.  Although this does limit your ability to enroll in health coverage, the good news for 2015 is that the list of Qualifying Life Events has been expanded and the Healthcare Marketplace is offering more opportunities for consumers to get insured during Special Enrollment.

In order to determine whether or not you may have a Qualifying Life Event, it is important for you to take a look at the list provided on your Blue Cross Blue Shield of North Carolina health quote.  Reading the list of QLE’s will help you to determine if one of these special circumstances applies to you.  Although the process of obtaining health insurance has changed under the ACA, the expansion of these QLE’s allows you greater freedom outside of Open Enrollment to manage your current health plan or enroll a new health plan according to your life circumstances.

For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov  to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.

 

 

 

Last Chance for 2015 – Federal Marketplace SEP Ending April 30th

Friday, April 24th, 2015

last chance or opportunity time on clock is ticking away now orThe Special Enrollment Period the federal Marketplace granted for those individuals who did not meet the February 15th deadline for Open Enrollment is ending April 30th.  This could be your last chance to enroll in a health insurance policy until January, 2016.  This Special Enrollment Period is not for everyone, but if it applies to you, you could have one last opportunity to get insured.

In an effort to enroll as many Americans as possible, the federal government installed this Special Enrollment Period for people who meet the following three criteria:  1) you were not insured in 2014; 2) you had to pay a tax penalty when you filed your 2014 taxes; 3) you will attest to the fact that you were unaware of the tax penalty or did not fully understand the implications of that penalty.  If these criteria apply to you, you have 6 more days to complete an application for health insurance with the federal Marketplace.  Keep in mind, your application must be completed and submitted by midnight April 30th, meaning you have selected a health plan and your application has been sent to Blue Cross Blue Shield of NC.  Depending on your effective date, however, you may still have a period of time before you will need to make your first premium payment.

Once this Special Enrollment Period ends, your opportunity to enroll in health insurance becomes much more limited.  Under the rules of the Affordable Care Act, for the remainder of 2015 you will need to have a Qualifying Life Event in order to purchase health insurance.  If you do not have a Qualifying Life Event, you will have to wait until Open Enrollment 2016 begins in November and you will not have health coverage until January 2016.  Also, don’t forget that the tax penalty, sometimes called the “individual mandate,” for being uninsured is increasing in 2015 and instead of paying $95 per person or 1% of your household income (whichever is greater), next year you will pay $325 per person or 2% of your household income (whichever is greater).  The tax penalty will increase again for 2016.

The bottom line is it doesn’t pay to be uninsured.  Not only are you running the risk of incurring potentially devastating health care bills, you are also not able to maintain your health and wellness through regular preventive care physicals and health maintenance.  If you are one of the many Americans who are still able to enroll in health coverage under the Special Enrollment Period ending April 30th, take advantage of this opportunity to get insured!  Instead of throwing money away on tax penalties, make an investment in your wellness and peace of mind.  Blue Cross Blue Shield of North Carolina is pleased to provide the residents of NC with quality health coverage at a competitive price.  Don’t wait another minute!

For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov  to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.

 

 

 

 

 

Suprised by Tax Penalties? – CMS Offers Special Enrollment Period

Friday, March 13th, 2015

Shocked male office workerFor individuals and families who did not have health coverage in 2014 and are subject to the tax penalty when they file 2014 taxes, a special enrollment period (SEP) has been announced.  This SEP has been created for those individuals who were unaware of the tax penalty or failed to fully understand the implications of the penalty for not enrolling in coverage during 2014.  From March 15th to April 30th, CMS is providing consumers with another opportunity to purchase health insurance; however, if consumers do not purchase during this enrollment period, they may have to pay the penalty when they file their 2015 income taxes.

The special enrollment period will begin on March 15, 2015 and will end at midnight Eastern Standard Time on April 30, 2015.  If a consumer enrolls in coverage before the 15th of April, coverage will begin on May 1st and if a consumer enrolls between April 16th and April 30th, coverage will begin on June 1st.

Because this year’s tax season is the first time individuals and families are required to provide information about their health coverage on their tax returns, CMS recognizes that there may be an adjustment period.  Administrator Marilyn Tavenner stated regarding this special enrollment period, “Our priority is to… provide those who were not aware or did not understand the requirement with an opportunity to enroll in affordable health coverage this year.” Further, those who could not afford coverage or met other certain conditions may be eligible to receive an exemption from the tax penalty.

The majority of taxpayers will only be required to indicate on their tax return that they had health coverage in 2014, either through an employer, Medicare, Medicaid, or other health coverage that meets the requirements of minimal essential coverage.  Other taxpayers will be granted an exemption from the tax penalty and still other taxpayers will pay a penalty for choosing to remain uninsured.  Americans who do not qualify for an exemption and who are required to pay the penalty will be paying a fine of $95 per adult or 1% of their income, whichever is greater.  This special enrollment period is designed to allow such individuals one final opportunity to get coverage and avoid having to pay other penalties in 2015.

Those eligible for this special enrollment period must meet ALL of the following requirements:

  • Live in states with a Federally-facilitated Marketplace
  • Attest that when they filed their 2014 tax return they paid the tax penalty for not having coverage
  • Attest that they first became aware of, or understood the implications of, the Federal Tax Penalty after the end of Open Enrollment

For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov  to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.

All information contained herein is subject to change, from time to time, if the Federal Government or Blue Cross Blue Shield of North Carolina implement any new updates and/or changes that can impact information provided in this blog.

Can I Purchase Health Insurance Now? – Understanding Special Enrollment

Tuesday, March 3rd, 2015

bigstockphoto_teens_with_thumbs_up_6006256

 

Open Enrollment 2018 has officially ended and the Special Enrollment Period has begun.  Contrary to what so many people believe, this does not mean that no Americans are able to purchase health insurance.  It simply means that those purchasing or making changes to existing health insurance plans are subject to a different set of rules that apply to the Special Enrollment Period.

The most distinguishing factor of Special Enrollment is that in order to purchase or change a health insurance plan you must have what is called a Qualifying Life Event.  This means you must have a special circumstance in your life that would qualify you to purchase or change insurance outside of Open Enrollment.  People often experience Qualifying Life Events without even realizing the opportunities presented as it relates to health insurance.

 

The following is a list of common Qualifying Life Events:

  • Loss of minimum coverage (through an employer, government plans, Medicaid, etc.)
  • Adding a dependent through birth, adoption or marriage
  • Gaining United States citizenship
  • Enrollment/non-enrollment errors by the federal Marketplace or the United States Department of Health and Human Services
  • Newly eligible for a subsidy or a change in the amount of subsidy for which you are eligible
  • Move to North Carolina or a new county within North Carolina
  • Other exceptional circumstances

Although this is a list of a few qualifying life events, this list is not exhaustive.  Ultimately, the only way to really determine if you are eligible to change or purchase health insurance during Special Enrollment is to complete an application.  Keep in mind that you can apply for health insurance without any obligation to purchase and the application itself will help you determine subsidy eligibility.

For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the existing regulations of The Affordable Care Act, also known as Obama care.

All information contained herein is subject to change, from time to time, if the Federal Government or Blue Cross Blue Shield of North Carolina implement any new updates and/or changes that can impact information provided in this blog.