Health Insurance Marketplace & OPEN ENROLLMENT
Under the Affordable Care Act you must enroll in a qualified health for 2015 or you may have to pay a penalty on your federal taxes. Most people can only enroll in a new health plan during Open Enrollment so now is the time to shop, compare, and enroll.
Open Enrollment season is coming!
- C.A.R. Group Health Plans – Next Open Enrollment November 1st to December 15th, 2015.
- Individual health plans and Covered California Open Enrollment November 1st to January 31st 2016.
As the exclusive broker for the California Association of REALTORS’®, we offer members access to three different markets to find a plan to meet their needs. Only RealCare can offer the C.A.R. group plans which feature a variety of HMO and PPO options including access to a large statewide PPO network, and Kaiser group plans. In addition, we can help you compare options with Individual and Family plans, or Covered California. Finding the right fit has never been more important because the choice you make now may be locked in for an entire year! Trust RealCare to help you find the right plan for you and your family.
2016 HEALTH INSURANCE OPTIONS
Most of our web page visitors are affiliated with the California Association of REALTORS®. As a C.A.R. member, you have several options available to you for health insurance. Each is outlined below. If you are not a C.A.R. member, you will not be able to enroll in the C.A.R. group health plan, but will qualify for other options.
OPTION 1: C.A.R. Group Health Plans
If you are a member of the California Association of REALTORS® you are eligible for coverage under the C.A.R. group health plans. C.A.R. offers group medical, dental, vision, life, and AD&D coverage for members, their families, and their full time W2 employees. The C.A.R. group medical plans are offered through Kaiser and Anthem Blue Cross. Here are some key features of the medical plans:
- All guaranteed issue plans with no pre-existing condition limitations.
- Kaiser group medical rates are often lower than individual and Covered California plans
- C.A.R.’s Kaiser portfolio includes additional plan options and plans with lower deductibles
- C.A.R. Anthem plans use the statewide Prudent Buyer PPO network giving you access to more doctors and hospitals than you can get with individual plans.
- C.A.R.’s Anthem portfolio includes several plans to choose from, including an HMO
- C.A.R. group plans are billed through RealCare, eliminating hassles with the carrier’s payment systems; and features consolidated billing for medical, dental, vision and life.
C.A.R. Open Enrollment happens twice a year – April 1st to May 15th and November 1st to December 15th. These are official Open Enrollment periods for C.A.R. members and their full time W-2 employees. Medical rates for Kaiser and Anthem Blue Cross CHANGE on June 1st each year. Medical rates are based on the group’s renewal date of June 1st. Dental, Vision and Life rates change January 1st each year.
In addition to Open Enrollment certain C.A.R. members have special enrollment dates:
- If you are a NEW C.A.R. member, you have a 60 day window to enroll for coverage. The new member enrollment period begins on the day you join C.A.R. and ends on the 60th day of membership.
- If you have been a C.A.R. member for longer than 60 days, but have experienced a qualifying event, you can join the C.A.R. group plan within 60 days of your qualifying event.
Here are links to the C.A.R. Health Plan pages, where you will find rates, benefits and enrollment forms:
OPTION 2: Individual and Family Plans
As mentioned above, the Open Enrollment for Individual and Family Plans (IFP) happens in the Fall. You can’t purchase an IFP plan outside of their Open Enrollment period unless you experience a Qualifying Event such as a loss of other coverage, birth, adoption, marriage, or divorce.
All IFP plans are guaranteed issue – no one can be turned down due to medical conditions or history, and there is no waiting period for pre-existing conditions.
We offer IFP plans from a variety of insurers including Kaiser, Anthem Blue Cross, Blue Shield of California, Cigna, Health Net, Sharp Health Plan, Western Health Advantage, and others. Individual plans may or may not offer lower rates than group health plans. The rates depend on many factors including network access, plan design, zip code and age. We encourage everyone to compare their IFP and group options – whether through C.A.R. or another group. Often you will find that although IFP plans are less expensive, but provider access is significantly restricted to small provider lists.
“It is extremely important that consumers do their homework to research provider access, availability of medication, and overall out of pocket costs before making a change. We do our best to provide the tools consumers need to select the right plan for them.”
-Pat O’Brien, Vice President
To compare the costs and benefits for individual plans, visit our Individual and Family Plans Quoting Page to enter your data and see the plans and rates available in your area.
OPTION 3: Covered California
The Open Enrollment period for Covered California coincides with that for IFP plans and generally starts in the Fall.
Some consumers will qualify for assistance with health insurance costs under the Affordable Care Act. Those who meet certain income and family size guidelines may qualify for the Advance Premium Tax Credit (APTC) and/or Cost Sharing Reduction (CSR). The only way to get the Advance Premium Tax Credit or Cost Sharing Reduction is to apply for coverage through Covered California. The tax credit can reduce your premiums significantly. In addition, the Cost Sharing Reduction can lower your out of pocket expenses. We encourage every consumer to check their eligibility for the tax credit or cost sharing reduction. If you do qualify, then you must apply through Covered California to get assistance. If you won’t qualify, then there is no reason to apply through this new system.
All the plans available in Covered California are also available through the Individual and Family plans directly. The only difference in these plans is whether you can get a tax credit or cost sharing assistance or not.
To find out if you may qualify for the tax credit or cost sharing assistance, view the 2015 Covered California Income Guidelines chart.
- Determine your best estimate of what your household Adjusted Gross Income will be for 2015.
- Look up the number of people in your family (the number you claim on your tax return) and find the income closest to your estimate. If your income falls within the chart, you may qualify for a tax credit and potentially cost sharing reduction.
OPTION 4: Alternative Coverage
If you find yourself without any coverage options, you may want to consider one of the following. None of these options will meet the federal guidelines for minimum essential coverage. However, they can help you pay for your medical expenses, or get immediate access to a provider.
- Short Term Health Insurance – This is not guaranteed issue, and does not meet the federal guidelines for minimum essential coverage, but it can protect you against financial loss in the event of a catastrophic illness or accident. CLICK HERE to get a quote and apply.
- Accident Insurance – A stand alone accident policy could help with small costs, but won’t meet the federal guidelines for minimum essential coverage. Nevertheless, an Accident plan can help pay some expenses, even if you have insurance with a large deductible. Call (800) 826-2005 for information.