Healthcare FAQ’s for Individuals

What are the important dates to know?

Oct 1, 2013 Open enrollment began.
Dec. 15, 2013 Enroll by this day for health care coverage to start Jan. 1, 2014.
Dec. 16th & Jan. 15th Enroll between these dates and coverage starts Feb. 1, 2014
March 31, 2014 Last day to enroll to avoid penalties on your 2015 tax return.
Each year afterwards, the open enrollment will be October 15th to December 7th.

What happens if I don’t enroll in the above timeframe?

You will have to wait until the open enrollment period unless you have had a Major Life Event. Major Life Events are such things as having a baby, getting married, moving out of state, losing employer coverage. In those cases, you may enroll at any point in the year. Please contact Derby Insurance Solutions to assist you with this.

When and how do I buy health insurance?

After Oct. 1, 2013 a certified, licensed health insurance agent can show you the plans so you can compare premiums, deductibles, co-insurance. At Derby Insurance Solutions we have a link you can use if you would like to shop on your own and compare plans, prices and view possible subsidies. Or you can call us at 918-451-9783 and we will help you with the process.

What’s a grandfathered plan?

A grandfathered individual health insurance plan was in place before the law was passed on March 23, 2010 and has not made certain changes to the co- insurance, co-payments, and deductibles.

What are the key benefits of the new health care?

You can get health insurance coverage even if you have a pre-existing condition.
Persons under the age of 26 can be insured through their parents’ plan.
Preventive care and annual checkups have no out-of-pocket costs.
You can’t be denied coverage based on medical conditions.

I keep hearing about subsidies. Who is eligible for a subsidy?

For the most part you will receive a partial or full subsidy if you are making between 100% and 400% of the Federal Poverty Level. Some have gotten special exceptions like Native Americans. You and your dependents will not be eligible for a subsidy if your employer offers “affordable coverage” as defined by the Affordable Care Act.

What’s the penalty/tax for not having health insurance?

The penalty in 2014 is $95.00 per adult & $47.50 per child (up to family maximum of $285) or 1% of your modified adjusted gross income(MAGI) on your tax return whichever is greater.
In 2015 it will be $325 per adult and $162.50 per child (up to a family max of $975) or 2% of MAGI whichever is greater.
In 2016 it is $695 per adult & $347.50 per child(up to a family max of $2085) or 2.5% of MAGI whichever is greater.

Can I keep my doctor?

The insurance companies we work with have great networks and you will probably not see many changes. We are not anticipating many people in Oklahoma losing their doctors. If you are concerned or want to double check, please call us, Derby Insurance Solutions at 918.451.9783.

Have the rates gone up?

Many years the rates have gone up somewhat. Although Oklahoma had a rate increase, the rates came in a lot lower than we expected.

Need Help Finding a HealthCare Insurance Plan?

Derby Insurance Solutions has been on the front line investigating how to help you make the best health insurance decision for 2014 and beyond. Call or contact us and we can answer questions, help you shop plan options and find you the lowest prices. Or go to click on “Enroll in a plan today” to shop or enroll.

We can help you find an affordable insurance plan that meets your health care needs!