Affordable Care Act

What is the Affordable Care Act?​

The Patient Protection and Affordable Care Act was officially signed into law in March 2010. The Affordable Care Act is also known as the ACA or Obamacare. It was created to make healthcare more affordable and easily accessible to a wider range of Americans. Since the law took effect, more than 20 million previously uninsured Americans have signed up for health insurance! We help people in the Durham area with affordable care act plans offered in the individual and small group markets. These plans are required to cover ten categories of essential health benefits: ambulatory care, emergency care, hospitalization, maternity and newborn care, mental health and substance use care, prescription drugs, rehabilitative and habilitative services, laboratory services, preventive care, chronic disease management, and pediatric dental and vision care. If your current health insurance provider in Durham is not ACA compliant it’s really not health insurance! ClearBenefits Group, LLC will show you unbiased comparisons of affordable care act plan costs and benefits in the Durham, NC area across all carriers. We’ll help find the most affordable plan that’s right for you. Customer support from ClearBenefits Group, LLC continues even after you sign up. Talk to our licensed insurance agents to understand your available affordable care act plan benefits, premiums, and more in Durham, NC. Our service is always 100% FREE to the customer!

General Information to Know

The COVID-19 pandemic has wreaked havoc in the lives of Americans of all ages across the country. The American Rescue Plan Act (ARPA) was signed into law to help combat some of the negative effects the pandemic has had on peoples’ health and wallets. One impact that will be felt by many Americans is the improved affordability of health insurance coverage. 

The ARPA is a $1.9 trillion, multi-level act designed to address a variety of problems that have surfaced during the pandemic. Some of the key components of the plan include: Stimulus checks for individuals, couples, and families Extended unemployment benefits National vaccination program Scaled-up COVID testing Safe reopening of schools Protection for frontline workers from COVID Expanded paid leave to reduce virus spread In addition, ARPA will affect new and existing health insurance plans, making premiums more affordable for millions of Americans nationwide.

According to whitehouse.gov, between two and three million people lost employer-sponsored health insurance between March and September of 2020. Families who have maintained coverage may also be struggling to pay premiums and afford care with the economic strain of the pandemic impacting most of the country. Whether you have private health insurance, lost coverage due to job loss, or are unable to afford a plan, the ARPA may benefit you.

The legislation increases the number of people eligible for subsidies and offers zero-dollar premiums for people with lower incomes. Temporary provisions will make coverage significantly more affordable for many who currently have purchased a plan on the marketplace, lost employer coverage, or are uninsured. The ARPA and income level If you have income over 400% of poverty level, you may be eligible for subsidies you did not qualify for before the ARPA became law. So, for example, if you are only providing health coverage for yourself and your income is around $51,500 a year, then you may be eligible for a subsidy in 2021 that you would not have qualified for prior to the ARPA. If your income is under the 400% threshold, you may qualify for additional financial assistance and see substantially reduced premium costs in some cases. Under the ARPA, premiums for healthcare plans will be capped at 8.5% for nearly every income level. Average savings will be approximately $70 per month for those who currently have a marketplace plan. People with incomes under 150% will now have zero-dollar premiums for silver plans, as well as significant reductions in out-of-pocket expenses.

Even before the passage of the ARPA, more than half of all Americans who were uninsured were eligible for financial assistance to help them get insurance coverage. Under the ARPA, the eligible number has increased, with coverage options through the marketplaces, Basic Health Programs (BHPs), or Medicaid. Uninsured individuals can also sign up during the COVID special enrollment period. This enrollment period runs through August 15, 2021 on the federal exchange and will be open year-round on Covered CA.

COBRA will also see changes under the ARPA. COBRA is a provision of the law that allows people who lose their employer coverage to keep that coverage for 18 months. Those who opt for COBRA must pay the entire premium for the plan, plus a small administrative fee. Under ARPA, the federal government will pay the entire COBRA premium through September 2021.

The ACA offers subsidies to help people with income levels between 100% and 400% of the poverty level pay for their insurance premiums. Those subsidies will increase for these individuals, so monthly premiums go even lower. The ARPA has also expanded subsidies to people with income levels above 400% of the poverty level, while people with incomes up to 150% of the federal poverty level will qualify for zero-premium plans. When will the American Rescue Plan Act go into effect? The ARPA went into effect on March 11, 2021 and many Americans have already received the stimulus checks that were also part of the plan. People with marketplace health insurance coverage can update their information on the exchange to get new details about their costs starting April 1, 2021, but changes will be retroactive to January 1, 2021. The temporary provisions are currently slated to last for two years.

If the ARPA will affect your subsidy qualifications or other details of your current plan, you can get a quote from ClearBenefits Group LLC  or contact our support team via chat or over the phone to see if your subsidy will change. You can begin this process on April 1 to get new details about your plan based on ARPA changes. Some states, including California, have announced they will adjust premiums automatically if your qualifications have changed, and you will only need to make changes if you are unhappy with your current plan.

Keep in mind that if you switch plans now, you may lose the amounts you have already paid toward your deductible, which may be a factor in whether you switch now or wait until the end of the year. If you are uninsured, you can sign up for a plan during the COVID special enrollment period that runs through August 15, 2021. States that have their own exchanges may have different special enrollment periods.

At ClearBenefits Group our licensed brokers are committed to helping individuals and families with the American Rescue Plan Act information and plans in the Durham area and every county of North Carolina. Our experts can help you with any questions you may have related to how ARPA affects your coverage. We offer a wide range of American Rescue Plan Act options to Durham, NC area residents, making it easy for you to find a health insurance plan that fits your budget and coverage needs. We also makes it easy for you to see if you qualify for a subsidy, and customer service representatives are available 8am-5pm Monday through Friday to answer your questions about American Rescue Plan Act plans in the Durham, NC area.

Check out all the individual and family health insurance plans available through the American Rescue Plan Act in the Durham area to get started today!

This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice. The above information is not intended to provide prices or coverage information for any specific insurance plan. The specific benefits covered by any insurance plan will be stated in the official documentation for the plan. Prices and rates vary by region and other factors. 

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We provide unbiased comparisons of affordable care act plans offered in your area across all carriers.

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Our licensed insurance agents are here to help you understand your available benefits, premiums, and more.

Supportive

We offer continued customer support throughout the year because make sure you have the support you need.

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We work diligently with you to help you find the best plan that not only fits your budget but also covers your health care needs.

Are you eligible for Affordable Care Act coverage?

You are most likely eligible qualify for the Affordable Care Act if you meet all of the following criteria:

~Live in the U.S.
~Are a U.S. citizen, U.S. national, or are lawfully present in the United States
~Are not incarcerated
~Are not covered by Medicare/Medicaid

You most likely qualify for ACA Coverage that is “FREE” or very low cost through an Advanced Premium Tax Credit!

~Household incomes between 100 and 400 Percent of the Federal Poverty Level generally qualify for savings
~The American Rescue Act of 2021 has substantially increased the savings available.
~More people than ever before choose or at least qualify for $0 Premium Coverage!

When can you enroll?

You can enroll in an individual health insurance plan during Open Enrollment or during a Special Enrollment Period. To qualify for a Special Enrollment Period, you must have a qualifying life event, such as loss of current coverage, low household income, or a change in marital status.

ClearBenefits Group, LLC can determine if your life event will allow you to enroll outside of Open Enrollment for Affordable Care Act plans.

 

What is the Family Glitch?

When the Affordable Care Act (ACA) was introduced, it did not allow dependents of employees who were offered an employer based health plan to enjoy the savings offered by the ACA. Now, for the first time, millions of those “employee health plan dependents” may qualify for a Subsidy which could dramatically reduce the cost of their health coverage. Because of to recent guidance by the current Administration, there is now a Fix to the Family Glitch and it allows us to help employers, employees and up to 5.1 million or more dependents this year save thousands of dollars on their dependent health coverage.

Every year we help thousands and thousands of clients pay as low as $0 for their healthcare and we would like to see if we can help you save money on your dependent coverage as well.