Serving all of Fresno/ Clovis  Metropolitan Areas

 

 

 

 

 

 

 

 



 

 

Quick Facts: October is the month to change or renew your existing health insurance.

 

Plans Providers 

 

You can apply for Covered 

California's carriers marketplace during open enrollment choose

GET A HEALTH PLAN QUOTE 

 

Documents to confirm eligibility

https://www.coveredca.com/documents-to-confirm-eligibility/ 

 

Exceptions to the Employer Sponsored Coverage “Affordability” Rule

Employer Health Insurance that is not “Affordable.”

If the health plan offered at work doesn’t pass the employer sponsored affordability test, then you may qualify for a subsidy through Covered California.

 

Waiting or Probationary Periods

If you have been offered employer health benefits but are required to wait the customary 30 to 90 days before benefits kick in, then you may be able to take advantage of the financial assistance through Covered California for the duration of your waiting period.

Premium Assistance

To be eligible for premium assistance, you must:

  • •Be a U.S. citizen, a U.S. national, or be lawfully present in the United States.

  • •Have an annual household income between 100 percent and 400 percent of the federal poverty level.

  • •Not have access to affordable, minimum-value health insurance through an employer.

  • •Not be eligible for other public health coverage, including full-scope Medi-Cal, premium-free Medicare Part A or military coverage.

  • •File taxes for the year that you will receive premium assistance.

  • •File taxes jointly if you are married.

https://www.coveredca.com/do-you-qualify-for-financial-help/types-of-financial-help/



For plans, comparisons click on links below 

 



To receive a personalized quote, product information or to apply online, simply click on the link below or copy and paste it into the address bar of your browser.

 

 

Kaiser Permanente, dedicated to helping you thrive


Anthem Blue Shield of California



Blue Shield of California



United Health One Hospital & Doctor Insurance, Dental, Vision, Critical Illness



National General STM supplemental plans, exclusion residents of CA

National General Accidental Medical Expense, Critical Illness, Accident, Dental, PPO Dental,Vision

 

 

National General Individual Dental Insurance

 

 

Delta Dental Insurance
 

Dental for everyone PPO plans

 

 

20 Ways to Save with Freshbenies

Offset skyrocketing healthcare costs with telehealth ($0 visit fee), doctors online, advocacy, Rx savings and more.

These non-insurance services help employers control healthcare costs while employees save time, money and frustration.

 

 

 

Open enrollment for Covered California health insurance plans happens once a year. For coverage that begins on Nov 1,  open enrollment begins on October 15, and lasts until January 31,  (Medi-Cal enrollees are not limited to this period, and do not need to renew their enrollment in Medi-Cal during this time, because Medi-Cal enrollment is year-round.)

 

 

 

Purchasing health insurance through Covered California has many advantages. Covered California is the only place where an individual can learn about and use federal financial assistance that can help reduce health care costs. Consumers can also learn if they are eligible for low-cost or no-cost Medi-Cal. This also includes the ability to make true "apples to apples" comparisons of health insurance plans.

 

Special Enrollment

 

People who experience a qualifying life event can newly enroll in a health plan through Covered California even outside the open-enrollment period. Currently, enrolled members who experience a qualifying life event can change their coverage or choose a new plan. This is called special enrollment.

 

If you enroll by the 15th day of the month, coverage will start on the first day of the next month. If you enroll after the 15th day of the month, coverage will start on the first day of the second month. For example, if you enroll on April 10, coverage will start on May 1. If you enroll on April 16, coverage will start on June 1.

 

There are a few exceptions to the regular start-date rule:

  1. For a loss of health coverage, such as losing Medi-Cal or job-based coverage, the new health plan would start on the first day of the next month following enrollment.

  2. If you get married and apply during the special-enrollment period, your new health plan would start on the first day of the next month following enrollment.

  3. If you have a child, adopt a child or place a child in adoption or foster care, and you use a special-enrollment period, you can choose to have coverage will start on the date of the birth, the adoption or the placement for adoption or foster care, or on the first day of the next month following enrollment.

 

 

Special Enrollment Acceptable document list

 

 

Avoid Obama Care Penalties"

 

Don't have health insurance? Enroll now to start coverage on January 1 on your 2018 taxes.

The fee for not having health coverage is calculated one of 2 ways. If you or your dependents don't have insurance that qualifies as the minimum essential coverage you'll pay either a percentage of your household income or a flat fee -- whichever is higher.

 

Who's at risk for a tax penalty? 


Anyone who does not have a plan that meets Minimum Essential Coverage requirements may be subject to the tax penalty. A few examples of those who may be subject to the tax penalty are:

Those that choose to be uninsured.

Anyone who buys a health insurance plan that does not qualify as Minimum Essential Coverage.

Consumers that have a gap in coverage of more than three months between health insurance plans.

Who's exempt from the tax penalty for individuals and families? 

 

Find out if the individual mandate applies to your situation 
Use our subsidy estimator to figure out how the individual mandate applies to you


To pay your premium and answer any questions pleased use this link

 

 

 

Whether or not you are exempt from the individual mandate.

 

 

If you are not exempt - the annual tax penalty you would be subject to if you don't buy or maintain a plan that meets Minimum Essential Coverage requirements.

 

 

Whether or not you're eligible for a premium subsidy and the estimated amount.

 

 

What is the tax penalty? 

The tax penalty will continue to increase from 2014 to 2016. After 2016, it will increase in relation to the cost of living. Also, the tax penalty is the greater of the specified percentage of income or the flat dollar amount.

 

Tax Penalties by Year

 

Year Tax as a % of income Minimum flat dollar amount per adult  Minimum flat dollar amount per child  Maximum flat dollar amount per family

 

2014   1.0%   $95.00    $47.50       $285.00

2015   2.0%   $325.00   $162.50    $975.00

2016   2.5%   $695.00   $347.50    $2,085.00

 

Note: The flat dollar amount (tax penalty) is the lesser of the maximum flat dollar amount per family (noted in the table above) or the sum of the minimum flat dollar amounts applicable to each individual in the family (noted in the table above).

 

2016 tax penalty examples - See how it applies to your family  

 

Example 1: A family of three

If a family of three (two adults, one child) has a household modified adjusted gross income of $100,000, and does not have major medical insurance and does not otherwise qualify for a penalty exemption, the 2016 penalty for this family would be calculated as follows:

 

  1. Figure out the total flat dollar amount:

    1. Flat dollar amount per child = $347.50

    2. Add the flat dollar amount together from above = $2085.00

  2. Flat dollar amount per adult = $695 (multiply this by 2 because there are two adults)

  3. Figure out the 2.5% of income: 2.5% multiplied by $100,000 = $2,500.00

  4. Use the greater of the two to find out what your 2016 penalty is: $2,500.00

(Disclaimer)

 

This website is owned and maintained by MKG Insurance Agency, which is solely responsible for its content. This site is not maintained or affliated with Covered California, and Covered California bears no responsibility for its content. The e-mail addresses and telephone numbers that appear throughout this site belong to MKG Insurance Agency, and cannot be used to contact Covered California.

 

 

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