On-Exchange Marketplace Health Insurance Coverage

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The Affordable Care Act (ACA), often referred to as Obamacare, provides minimum standards for health insurance policies in the USA and expands coverage to individuals who were previously unable to purchase insurance due to pre-existing conditions. You may be qualified for the government subsidy in the forms of premium tax credit and/or cost sharing benefit, if your total household annual income stays between 100% and 400% of the Federal Poverty Level.

Below are a few frequently asked questions regarding the On-Exchange Marketplace:

Insurance Companies in North Carolina that will do the On-Exchange Marketplace Enrollment for year 2020
Blue Cross Blue Shield of North Carolina (Duke and Wake Med will not be an in-network provider for BCBS NC plans in 2020)
Ambetter (Plans will be in-network with Duke and Wake Med hospitals in 2020)
Bright Health (New to North Carolina, will be available in some counties)
Why On-Exchange Marketplace Enrollment?
You may be qualified for the government subsidy in the forms of premium tax credit and/or cost sharing benefit, if your total household annual income stays between the 100% and the 400% Federal Poverty Level.
Prerequisites for Premium Tax Credit and/or Cost Sharing Benefit
1. Filing a joint tax return with your spouse
2. 'Lawfully' present in the United States of America
3. Not currently incarcerated
4. Other medical insurance options are not available, including benefits or programs offered by government bodies, such as Medicare, Medicaid, CHIP, Tricare or benefits offered through the prior or current employers.
When can I enroll for the year 2020?
1. Annual Enrollment Period: November 1, 2019 thru December 15, 2019
2. Special Enrollment Period: Any time during the year if you have a qualified life event such as relocation, married, divorce, child-birth; but you must apply within 60 days after the qualified life event.
What information do I need to provide for the enrollment?
1. Every household member's personal information including the 'lawfully present' document, such as driver's license, social security number, naturalized citizenship certificate, green card and birth certificate etc.
2. Annual household income information
3. Current medical insurance information
4. Current employment information
Do I need to pay any service fee to the broker-agent for the enrollment assistance?
What will happen if I do not enroll to any qualified medical insurance plan in year 2019?
At the moment, those who do not want to have insurance beginning in 2020 will not incur a penalty or fee (also known as the “individual shared responsibility payment”).
We’re proud that CMS has recognized us as a member of the Elite Plus Marketplace Circle of Champions for 2019. We love helping consumers with Marketplace coverage!

DISCLAIMER: Coverages may vary. Consult your agent about coverages you may need for your unique situation. Coverage descriptions above are for general information purposes only. Actual coverage is subject to all terms, conditions and exclusions provided in the individual policy.

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