FAQs

Q: Is it more expensive to buy through a broker versus going through the carrier directly?

No. The price for a plan is the price. There is no upcharge going through a broker.

Q: Is there an additional cost for buying health insurance through a broker instead of applying on my own? Why?

No. We are paid by the carrier. The insurance is priced the same whether you use a broker or not. You do not incur any additional costs by purchasing insurance through us, but you do get the benefit of using our extensive services such as claims, compliance and administrative support to assist you with your healthcare needs.

Q: Are all of my employees eligible to receive a government subsidy to buy health insurance through the federal or state “Marketplace”?

Not necessarily. If they are offered coverage through their employer that meets the minimum standards and is “affordable” (no more than 9.5% of their income for single coverage) then they CANNOT get a subsidy to pay for their coverage.

Q: If my employees don’t have access to “affordable” coverage through work, then which ones will get a government subsidy to help pay for their coverage?

Only people that have an annual income between 133% and 400% of the Federal Poverty Level will be eligible to receive a subsidy. Subsidies are paid on a sliding scale and once a person is over 300% of the FPL the subsidy is very small.

Q: Since there is no restriction for pre-existing conditions, can’t people just wait until they are sick to buy the coverage?

No. They will only be allowed to enroll in coverage in the marketplace or through their employer during open enrollment periods or if they have a verifiable life event. Open enrollment in the Marketplace will be starting in October for January enrollment. If they don’t enroll at the appropriate time, they must wait with no coverage until the next open enrollment.

Q: What is the penalty for people who do not purchase coverage?

The penalty for 2014 is $95 per person, or 1% of their household income, whichever is GREATER. In 2015 the penalty goes to $325 or 2% of income. It will be added to their tax liability when they file in April.

Q: What is the penalty to my small business if I decide to cancel my group health plan?

There is no penalty from the federal or state government if you decide to cancel your company sponsored health plan. The company would lose the tax deduction for the premiums that are currently paid.

Q: As a business owner would it be cheaper for everyone if I stopped offering a plan and gave everyone a raise that would permit them to buy it on their own?

Not necessarily. The premium you currently pay for employees is now a tax deduction for the company. Premiums that the employees pay on your company plan are generally done on a pre-tax basis, which saves them at least 25%. If they are given a raise to make up the lack of a company health plan, they will be taxed on the additional income and that will likely hurt their chance of a subsidy. Also, any plan purchased through the Marketplace will be paid with after-tax dollars, thereby increasing the overall cost of the plan.

Q: What do we tell our employees who are not eligible for our company sponsored plan, or those that decide not to take it?

Every broker/consultant at Hafetz is certified to sell plans in the Marketplace. We can assist your employees that don’t have your group coverage either one on one or in a group setting to go over their options and assist them in enrolling in the plan in the Marketplace that best fits their needs.

Q: Why do I have an ID card that says PPO Young Grins?

It’s a card for pediatric dental. This is a component of the healthcare law. Every employee will received a card regardless of whether they have children. Only people who have children under age 19 will be billed. You don’t need to distribute id cards to employees for whom it does not apply.

Q: Why did I receive a term letter?

Technically your plan is being terminated but in reality they are going to move your plan to the new version of it. The plans are similar to the old plans. There is no action necessary unless you would like to change your plan.

Q: Where can I find forms?

Please visit our home page and look on the right side bar where a button will provide you with links to the individual carriers and their forms.