Individual Health Basics – 3 Types of Americans

July 29, 2018 Written by Abby Janca

In today’s data-rich world, it might be hard to believe that a large number of Americans are misinformed (or under-informed) when it comes to Health Insurance.  In this post, we’ll separate fact from fiction so you’re prepared for 2015 Open Enrollment!

Most Americans fit into one of 3 groups:

  • I have health insurance through my Employer
    (or spouse’s Employer) on a GROUP Plan
  • I have an Individual or Family Policy right now
  • I do NOT have coverage right now


If you currently have coverage through an Employer (or a spouse’s/parent’s Employer), congratulations!  You shouldn’t have to worry about deadlines, mandates or penalties for not having coverage in 2014.


If you currently have an Individual or Family health (Major Medical) policy, congratulations!
How’s your plan working out for you?  Do you want to look at a new plan for 2015?  Maybe you’d like a plan with a Doctor Copay or lower Deductible—or maybe you’d rather find a plan with a lower monthly premium.  In the past, you had the freedom of changing plans at your convenience during the year.

NEW:  you only have a brief window for changing your plan for 2015. 

  • This window is called “Open Enrollment” and it will last from November 5, 2014 until Feb. 15, 2015.
  • During Open Enrollment, you can change your policy or switch to a different Carrier.
  • Changes you make during this Open Enrollment will go into effect as of January 1, 2015.

NOTE:  This is a great time to see if you qualify for a Tax Credit to help lower your monthly premiums.  The savings apply only to plans purchased through the US Government “On the Marketplace” (Healthcare.gov).

If you don’t have coverage, the only way for you to get 2014 coverage is to have a “Qualifying Life Event” (QLE) to be eligible for a “Special Enrollment Period.”  Here are some QLE examples:

  • Loss of health insurance due to employment status change, termination of employment, death of a parent or spouse, or dependent status (dependent child turning 26 years old)
  • Gaining or becoming a dependent due to Marriage, birth of a child, adoption of a child, placement for adoption of child, or guardianship/court-ordered dependent
  • Permanently moving to a new state or gaining citizenship or valid immigration status

If you have a QLE and need coverage, please contact us as soon as possible. 

Don’t have a Qualifying Life Event?

You’ll be able to apply for an Individual or Family health policy during the 2015 Open Enrollment Period.  Open Enrollment starts Nov. 15, 2014 and ends Feb. 15, 2015.  The earliest effective date for your new coverage would be January 1, 2015.  This goes for ALL new Individual and Family health policies—both through the Marketplace (Healthcare.gov) AND directly through the carriers (Humana, BCBS, etc.).

In any case, you can always get quotes online by clicking here…and if you have any questions, click here to contact us.

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