Buying Insurance via the ACA Exchange

[bean29]

I need to get insurance quotes for DS because he is rolling off the family plan.

He works full time for my DH and makes just over $40,000/year right now. I am not sure if we will qualify for a group plan - as DH is on my insurance, and he will not add a second employee until next year.

Anyways DS needs insurance as of November 1. DH is supposed to give me a quote, but if I wait for him to get around to it, we will be scrambling at the end of October to figure out what we are doing.

I also can get a quote from the agent that does the company plan, but I am waiting for DH to figure out how much it would be and who the plan would be through if he writes it. I think it would be Golden Rule (UHC).

So, I need to know, what web site do you use?  Right now I am at Healthcare.gov.   I was on a different site earlier and it was not the official gov't site.  DS lives with his GF.  She also makes around 36,000-40,000 so maybe he would not qualify at all?  If so, I will just skip the ACA route and have individual and group plans quoted and see how we come out best.

DH and DS are insurance agents, but they mostly sell property and casualty and a little (very little bit) of life.  They can sell health insurance, but really never do, what thye can sell is limited to whatever the company allows as DH is a captive agent. 

[NastyWoman]

I thought anyone could buy insurance through the ACA but subsidies (lowering cost) are linked to income. I may be wrong though. 

[resolution]

The girlfriend shouldn't be a factor in qualifying for subsidies. His income and family size would include a spouse and and tax dependents, but not anyone unrelated that isn't claimed on taxes.  If his employer offers him health insurance that costs less than approximately 10% of his income, then he also won't be eligible for subsidies.

The subsidies are on a sliding scale, so the higher his income is, the lower the subsidies will be. At 400% of the federal poverty level the subsidies end.  If he is ineligible for subsidies, he should still be able to buy any of the plans for full price. 

I think it would be worth looking at the plans on healthcare.gov even without the subsidies so you have a basis of comparison for the ones that your agent quotes.

[bean29]

Sept 18, 2019 12:47:01 GMT -5 resolution said:

The girlfriend shouldn't be a factor in qualifying for subsidies. His income and family size would include a spouse and and tax dependents, but not anyone unrelated that isn't claimed on taxes.  If his employer offers him health insurance that costs less than approximately 10% of his income, then he also won't be eligible for subsidies.

The subsidies are on a sliding scale, so the higher his income is, the lower the subsidies will be. At 400% of the federal poverty level the subsidies end.  If he is ineligible for subsidies, he should still be able to buy any of the plans for full price. 

I think it would be worth looking at the plans on healthcare.gov even without the subsidies so you have a basis of comparison for the ones that your agent quotes.

I was confused b/c it says "household income"?  last year (2018) he was about $35,000 income, but 2019 he will be over 40,000 so for next year, I don't think he qualifies for a subsidy at all.

[NomoreDramaQ1015]

Be forwarned once you get on the exchange and make an account to look up quotes they will NEVER stop calling or emailing you.  I looked in 2015 when I lost my job and I am still getting  robo reminders that I need to sign up for insurance.

[Deleted]

Sept 18, 2019 15:15:13 GMT -5 bean29 said:

Sept 18, 2019 12:47:01 GMT -5 resolution said:

The girlfriend shouldn't be a factor in qualifying for subsidies. His income and family size would include a spouse and and tax dependents, but not anyone unrelated that isn't claimed on taxes.  If his employer offers him health insurance that costs less than approximately 10% of his income, then he also won't be eligible for subsidies.

The subsidies are on a sliding scale, so the higher his income is, the lower the subsidies will be. At 400% of the federal poverty level the subsidies end.  If he is ineligible for subsidies, he should still be able to buy any of the plans for full price. 

I think it would be worth looking at the plans on healthcare.gov even without the subsidies so you have a basis of comparison for the ones that your agent quotes.

I was confused b/c it says "household income"?  last year (2018) he was about $35,000 income, but 2019 he will be over 40,000 so for next year, I don't think he qualifies for a subsidy at all.

The income limit for subsidy is $48,650 for single in 2019.

[alabamagal]

Is he living with gf? Are they in a serious relationship? When I kicked DS off my insurance he got on his live on gf plan. They had to sign paperwork saying they were domestic partners. Didn’t know you could do this if not same sex. Her plan covered him for no cost. He had plan through his work but it was costlier.

[bean29]

Sept 19, 2019 6:19:54 GMT -5 alabamagal said:

Is he living with gf? Are they in a serious relationship? When I kicked DS off my insurance he got on his live on gf plan. They had to sign paperwork saying they were domestic partners. Didn’t know you could do this if not same sex. Her plan covered him for no cost. He had plan through his work but it was costlier.

That is interesting. I am not sure I want them to go there. I will think on it.

[jelloshots4all]

I have a short term policy off the exchange.  It's for me and 2 kids.  The company is Aspen I believe.  The rates and deductibles are reasonable.  Send me a message and I can pull the information tomorrow.