Individual and Family Policies (IFP)

Major medical health insurance you buy on your own- not through an employer or association- is called individual coverage. This can cover one person (an individual) or a spouse and dependents (family).

Family insurance is not to be confused with a group health insurance policy. Health insurance provided to employees by an employer or an association to its members is called group coverage. If offered, most people would prefer to have their employer provide group health insurance coverage. For those who do not have that option, there are many affordable individual and family plans available to fit any budget. Keep in mind, the more you can afford, the richer the benefit.

Health insurance can save you money on routine doctor's visits, prescription drug coverage, preventative care and other medical services. Each plan will have varying out-of-pocket costs for a monthly premium, a co-payment, co-insurance and an annual deductible.

 

Traditional medical policies can only be applied for during the Open Enrollment Period which runs from November 1st - December 15th.  The exception to this rule is a Qualifying Life Event. There are medical health share plans available that have much more lenient enrollment periods and are competitive financially.

Enrolling in dental and vision can be done year around, but please keep in mind your start date will not be immediate. The majority of carriers require that your application be submitted by the middle of the month in order to have a first of the following month effective date and there are waiting periods on most policies.

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Vision

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Life & Ancillary

 

2022 Health Spending Accounts

You can use these accounts for qualified medical expenses, such as deductibles, co-pays, prescriptions and more. Health spending accounts come in three forms:

  • Health savings account (HSA), this is the only account qualified to be used with an IFP high-deductible health plan (HDHP) or an employer sponsored HDHP

  • Health reimbursement arrangement (HRA), only available with an employer sponsored plan

  • Flexible spending account (FSA), only available with an employer sponsored plan

An HSA is an account you use to pay for qualified medical, pharmacy, dental and visions expenses and save on taxes. The key things to know about HSAs are:

  • You must be under 65 to have one

    • You can't open an HSA if you are covered by Medicare​

  • You must be covered by a HDHP to open an HSA

    • You know you have that type of plan if the deductible is at least $1,400for one person or $2,800 for plans that cover more than two people.

      • Please note: There are some family plans that have deductibles for both the family as a whole and for individual family members. Under these plans, if you meet the individual deductible for one family member, you don’t have to meet the higher annual deductible amount for the family. If either the deductible for the family as a whole or the deductible for an individual family member is less than the minimum annual deductible for family coverage, the plan doesn’t qualify as an HDHP.​

  • You own your HSA and the money in it

  • This is not a "use it or lost it account"

  • You can contribute to your HSA any time of year, up to the annual limit.

  • Anyone can deposit money into your HSA, up to an annual limit  set each year by the IRS

  • You cannot open an HSA if you're covered by Medi-Cal/Medicaid or claimed as a dependent on some else's tax return

There are several different ways you can contribute to your HSA:

  • Have a set amount taken our of your paycheck each week before taxes (if on an employer sponsored health plan)​

  • Deposit money that's already been taxed- you can deduct it from your income on your tax return no matter who it came from.

  • Your employer can put money into your HSA and save on taxes, too

  • Invest the funds in your HSA to earn interest; a minimum account balance may be required.

  • You can also move money from an IRA to your HSA once- this is called a one-time rollover

Important Details:

  • Catch-up contributions can be made anytime during the year by HSA-eligible participants who will be age 55 or older by the end of the year. Unlike other limits, the $1,000 catch-up amount does not vary from year to year.

  • An HSA is in an individual account holder's name, even when used by a spouse or dependents with family coverage to pay medical expenses. When both spouses have self-only coverage, each spouse may contribute up to the annual HSA self-only limit in their own HSA.

  • While a married couple under a family HDHP share one family HSA contribution limit, they can contribute up to that shared limit in separate accounts and, if both are age 55 or older, each make a separate $1,000 catch-up contribution to an account in their own name.

  • While the Affordable Care Act (ACA) allows parents to add their adult children who have not reached age 26 to their health plans, the tax laws regarding HSAs have not changed and children ages 19 until age 26 must be considered a tax dependent in order for an adult child’s medical expenses to qualify for payment from a parent’s HSA.

  • Contributions for a given year may be made until the individual's federal tax return due date for that year (generally April 15), without extensions. ​

  • Under the last-month rule, those covered by an HSA-eligible health plan on Dec. 1 are eligible individuals for the entire year and may contribute the entire year's contribution to their HSA instead of making pro rated contributions by month. Partial-year HDHP enrollees who take advantage of the last-month rule must remain eligible individuals covered by an HDHP through Dec. 1 of the following year or risk tax assessments and penalties on their prior-year HSA contributions.

  • The self-only annual limit on HDHP out-of-pocket expenses applies to each covered individual, regardless of whether the individual is enrolled in self-only coverage or family coverage.

Most importantly, you can treat your HSA like an IRA for healthcare. You can save the money in it and use it for qualified expenses at any time. According to recent estimates by Fidelity Investments, a married couple retiring at age 65 will require approximately $280,000 to cover medical costs such as out-of-pocket prescription drug expenses and Medicare premiums. By saving money in an HSA you can prepare for your family's future health care costs and also use your HSA as a buffer to protect your other retirement accounts from out of pocket medical expenses.

If you choose to drop your HDHP, you can no longer contribute to your HSA. You may continue to use the funds, but no further deposits can be made. 

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Health Share Plans

 

2022 Individual & Family Open Enrollment

You insure your car and your home. Why wouldn't you insure your most precious asset? Your physical being.

 

The first thing to understand about a health share plan is that it is not health insurance. It is a faith-based medical needs sharing membership. Your monthly contributions are stored in a cost-sharing account which acts as a neutral clearing house between the members. Some health share plans, such as One Share and Medi-Share, do meet the requirements of the affordable care act and you will not be penalized for not having insurance if you enroll with them.

What we like so much about the health share plans is that it gives you some control of your monthly costs. The higher the MSRA, MRA, or ISA (similar to a deductible) you choose, the lower your monthly premium. The provider networks are also quite extensive.

The health share plans do have stipulations that make them not suitable for all clients.

 

With One Share, as with most health shares, there are pre-exisiting conditions clauses that are in effect for 24 months, with no coverage until the 25th month. Pre-existing or reoccurring cancers will never be eligible for sharing. To read more about the health share plans, click on the carriers to the right which will take you to our portal for each site.

These have become a viable option for clients who are looking to save money, do not have any pre-existing conditions and are relatively healthy and not in need of frequent doctors visits.

If you have prior health conditions that you are still undergoing treatment for, enrolling in a traditional health plan would probably be the best option for you. They cannot deny treatment for a pre-existing condition under any circumstances. These plans can be more costly, unless you qualify for assistance through Covered California. 

With any sort of insurance policy or health share membership, we strongly recommend that you verify your provider takes the coverage (or that your membership will pay you back for the service) before you make a change or see them. This assures that you have the best coverage available.

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There is a set period of time each year when you are able to purchase medical insurance or make changes to your existing insurance. If you are not under an employer sponsored plan and need to purchase (or renew) an individual or family insurance plan the Open Enrollment period runs from November 1st to December 31st for a January 1st effective date

As your health insurance agent, we take steps each year to prepare for Open Enrollment and to make sure that it runs as smoothly for you as possible.

 

Covered California

 

Beginning in September letters will be sent out informing you of the Open Enrollment period with a form for you to complete and return to our office.

If you are happy with your current plan and want to stay as you are, then you can let your policy renew automatically. However, if you are on Covered California and there have been any changes in the household (address, income, dependents, etc) you must notify us of those changes before November 30th so that we have ample time to make these adjustments for you. 

To get a jump start on returning your Covered California form to us, you can download it here. Please remember forms are processed in the order they 

were received.

We generally do not make appointments for these changes/enrollments as everything can be processed online. 

Direct Enrollment

Our clients that are directly enrolled with the carrier will also receive a letter from us. If you are interested in making a change to your plan or reviewing your other plan options, please contact our office. All plan review requests are worked in the order they were received.

Are you a new client that knows what you are looking for? You may enroll through our portal with one of the following carriers:

 

 

 

 

 

 

Covered California 

Covered California is a free service that connects Californians with brand-name health insurance under the Patient Protection and Affordable Care Act. It is the only place where you can get financial help when you buy health insurance. When you apply, you may qualify for a discount on a health plan through Covered California. 

Your monthly assistance offered by the exchange is based on the ages of those applying, your yearly household taxable income, the zip code you reside in and how many tax household dependents you have. Each household is different and individual subsidies will vary.

To make changes on your own to  your Covered California account, you will go here. You can report income changes, address updates, dependent status changes and also select a new plan.

Blue Shield of California

You can access your Blue Shield of California account here . If you have not already created an account, this can be done by selecting register. You will need your ID card to do this. Not only can you update your personal information, but you can also access your claims, benefits and find providers who accept your insurance.

Your renewal information should also be view-able there once it is available. 

Anthem Blue Cross

Your Anthem account can be accessed here . If you have not already created an account, this can be done by selecting register. You will need your ID card to do this. Not only can you update your personal information, but you can also view your claims, benefits and find providers who accept your insurance.

Your renewal information should also be view-able there once it is available. 

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Dental

Most dental plans are open for enrollment year around. Some do have waiting periods that vary depending on the service and carrier.

To view the Blue Shield of California dental benefit outlines for plans available in Redding, CA and surrounding areas, you may do so here. Otherwise, please fill out the form to the right and our staff will reach out to you with pricing and outlines.

Delta Dental and other plan options are available for viewing here. Please keep in mind this site will also show you discount plans, which are not the same as dental insurance.

 

Vision

Like other non-medical products, vision insurance can be purchased at any point during the year. There are a

variety of different carriers on the market. Blue Shield, VSP and Davis Vision are the most commonly chosen 

by our clients. To obtain Blue Shield plan information, go here. For other carriers, go here.  You may also contact

our office directly.

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