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Emergency Case

If you need a doctor urgently outside of medicenter opening hours.
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Health Insurance For Individuals / Families Under 65

Health insurance has become difficult in the past 4 1/2 years. The prices have skyrocketed and I do not know anyone who has not been affected by the results. Some of the “pros” of the Affordable Care Act have been:

All preventative is covered by “no money out-of-pocket”. (However, for instance, if you are going in for a colonoscopy and they find an issue, then that procedure is now curative rather than preventative. That means you will have to pay your co-pay or coinsurance for that procedure. As long as your test results come back normal the preventative procedure is “no money out-of-pocket.” This scenario is true of all insurance, whether it is individually purchased or purchased through the state health care website.)

There are no longer health underwriting issues to deal with. As long as you purchase insurance during the open enrollment period or under a special enrollment period, it does not matter if you have past or current medical issues. You do not pay any more for insurance than somebody who is perfectly healthy at your age. Gender is no longer a premium factor, in the past men were cheaper to insure than women up until the age of 50/55. Then women became cheaper to insure.

The Affordable Care Act has a rule that it is mandatory to purchase insurance. That part of the law has been rescinded, so in 2019 there will no longer be penalties if you do not purchase individual health insurance for January 2019.

Under the Affordable Care Act many health benefits were made mandatory . When these benefits were made mandatory for all insurance companies to offer it greatly increased the cost of providing health care. The companies have had to make a lot of changes in order to be compliant.

Under the Fed/State regulated healthcare when people choose to purchase the insurance with subsidies, you must estimate what you are going to earn the year before you earn it. If you are in a job where you get a paycheck every week and your hours are stable, then that is probably not a big issue. However, many of the people who use the subsidies are small business owners who may not be able to predict what they are going to be earning the following year. If they end up earning several thousand dollars more than they thought, it is very important to report the additional income. The insurance company will adjust your premium so you can avoid any end of the year expenses.

Under Access Health Connecticut with subsidies if you are 55 or older and a lot of money is paid out on your behalf for medical issues, at your passing the state of CT may be reimbursed on your behalf out of your estate. Many people are unaware of these rules when they purchase the plan. We, at Hourglass, do our best to inform you of the rules and regulations.

You may, however, purchase health insurance through Access Health Connecticut without subsidies and then the 2 scenarios directly above do not apply. I have helped almost all of my clients use AHCT without subsidies this past year, beginning January 2018, because it saved them literally hundreds of dollars a month. In order to do this, I had to take a cut in commissions, but I would not be able to sleep at night if I didn’t offer this option. I get paid $10 a month per person up to a maximum of 2 people with ConnectiCare and $5 with Anthem Blue Cross and Blue Shield a month per person, Max 2 on a policy. Before I was getting $16 a month per person. But it would cost my clients $200, $300 or more a month. This is why I ask everyone to please refer me to your friends because that is the only way I can make up this loss in commissions. Not all agents are willing to work with Access Health Connecticut because of these cuts in commissions. But I am very dedicated to my clientele and I still go through the process of getting recertified every year so that I can help my clients if they ever have an issue. I am their advocate when it comes to their health insurance. I even got recertified last year (2017) when Access Health was not paying any commissions at all to agents. Money is not my motivator. I truly believe this healthcare situation is going to turn around and these people will stay loyal to me because I have been there with them through the trenches. I recently heard of some agents who charge a monthly fee to their clients who buy health insurance. That's a new one to me.... we do not do that.

There are multiple ways you can purchase individual health insurance for instance from a privately owned company, i.e. ConnectiCare, Anthem Blue Cross and Blue Shield, United Healthcare, who are the major players in Connecticut. You can purchase ConnectiCare or Anthem Blue Cross and Blue Shield through Access Health Connecticut.  You can also purchase some ERISA Based Plans if you are a business owner or work for a small business owner. Remember each state is different. Most of my clients are in CT. When my clients move, I often get licensed in their new state so I can keep them!

You can only purchase individual health insurance during an open enrollment period or if you have a special enrollment period. For instance, you just moved to the area, you recently lost insurance through a divorce or you got married, changing jobs, getting laid off, your COBRA Plan ending, etc.

Each state may have different insurance companies, we are licensed in 8 states.

If you have any questions please call the office, we are here for you. 860-464-0121

Group Health Insurance

We can also help companies put in place group health insurance for their employees. The Affordable Care Act also put a big burden on employers who own businesses of 50 or more employees. It is costly to get health insurance for groups with less than 50 employees also. People who own businesses who have less than 50 employees, please send your employees to us, we can help them get individual insurance even though they work for your company.  See the information above regarding individual health insurance.