If you’ve had a group health plan available for you and your family, up to now, you could not go to the Marketplace for health insurance under the Affordable Care Act. Things have changed and now there is another choice.
Up to this point, when a group health plan was available, it was deemed “affordable” so you had to accept this coverage. You therefore didn’t have access to health insurance from the Marketplace. If individuals or families came to me to find better rates from ACA health insurance, I couldn’t help them. There were no subsidies available to them to lower their monthly out-of-pocket premiums.
This situation of not being able to access better prices for family health insurance was referred to as the “family glitch.” It’s finally been addressed so families in this situation have a better solution.
The Solution to the “Family Glitch”
Now I’m able to work with families to provide them with another solution—namely, more affordable health insurance from the Marketplace. If the premium that you pay monthly at your employer for you and your family is deemed unaffordable, then you may be able to get a subsidy. You need to calculate if the coverage for yourself and your family is more or less than about 9.5% of your annual income. If you pay more, then I can help you get a subsidy to lower your premiums. That might end up being a very big help for you.
Let me make it a little clearer. There are families whose insurance might cost them $1,600 monthly for the employee, wife and children. I can keep the employee on the plan but move the wife and dependents to insurance under the Affordable Care Act. A subsidy becomes available to the family. Their monthly premium payment may come in at $500 per month versus $1600. So it makes a big difference in their expenses.
The total household income factors into this equation to some degree. If both the employee and his spouse work, that may change things a little bit.
Employers Are Struggling with High Health Insurance Costs
It’s getting harder and harder for employers to be able to pay the high percentages to make health insurance affordable for employees. That’s why the cost of insuring dependents falls more heavily on the employee. You might have to pay a hundred percent of the costs to include your wife and children in your plan. You might feel like, “I can’t even cover them, they’ll have to be uninsured.” There’s now a way out of this impasse.
How to Get Help Making the Right Choices for Your Family
This change enabling the employee to go to the Marketplace for coverage gives me a way to help families improve their coverage while reducing their costs. That’s why sometimes, you simply need an expert like myself and the others at MB Health. We work for you, the employee, not the insurance companies. We can check out your group plan and look how much it costs for you and your family. We compare that to the marketplace and help you get the most out of your health insurance and the money you pay each month. To find out how much you might be able to save, give us a call at (314) 544-5400.
