Getting Health Insurance for You and Your Family
• Effective 1/1/2014, health plans during open enrollment are guaranteed issue. | • Rates are calculated based on the age of each family member, family size and region. | ||||||||
• 2016 Open Enrollment is from November 1, 2015 thru January 31, 2016 | • California has 19 rating regions. | ||||||||
• California has set up an exchange called “Covered California”. | • If you are eligible for coverage through your employer or your spouse’s employer you may not be eligible for tax credits. | ||||||||
• There are four standardized plan levels: Platinum, Gold, Silver and Bronze. | • If you do not qualify for tax credits through Covered CA, those same plans are also available directly through the carriers. | ||||||||
• There are three financial assistance programs available to those who qualify. | • Certified Insurance Agents and Certified Enrollment Counselors can assist you with your Covered CA enrollment. See chart on back. | ||||||||
• Premium Assistance (Tax Credits) reduces the cost of your premium. | • The price you pay for your plan is identical whether purchased directly from Covered CA or with the help of a Certified Insurance Agent. | ||||||||
• Cost Sharing Reduction reduces costs of covered services. | • In 2016 the penalty for not obtaining minimum essential coverage is $695 per adult or 2.5% of household income, whichever is greater. | ||||||||
• Medi-Cal is a program that may be at no cost to those who qualify. Thresholds were expanded in 2014. See chart on back. | • Special Enrollment Periods (outside of open enrollment) are available. See chart on back. | ||||||||
• Premium assistance and cost sharing reduction programs are only available through Covered California. | • In Los Angeles, participating carriers with Covered California are: Anthem Blue Cross, Blue Shield, Health Net, Kaiser, Oscar Health, L.A. Care Health Plan and Molina Healthcare. | ||||||||
• Premium assistance (tax credits) can be applied towards monthly premium or at tax filing for those who qualify. | • We partner with all above mentioned carriers including CIGNA and United Healthcare in the private market as well. | ||||||||
Alberta Bellisario CA License #0A02225 818.888.0880 ext. 202 alberta@pdinsure.com |
Paul Davis CA License #0669770 818.888.0880 ext. 201 paul@pdinsure.com |
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Our trusted partners: |
PAB Insurance Solutions, CA License #0178979 |
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www.pdinsure.com | |||||||||
Northridge, CA 91324 & Sherwood Forest, CA 91325 | |||||||||
Call for Appointment! | |||||||||
Services and Market Segments | Certified Insurance Agents | Certified Enrollment Counselors | |||||||
Assist in completing enrollment application | • | • | |||||||
CA Insurance License provided by CA Department of Insurance | • | ||||||||
Services offered at no cost to consumer | • | • | |||||||
SHOP Marketplace (Covered CA – Small Business Health Options Program) | • | ||||||||
Employee Applications | • | ||||||||
Private Marketplace (carrier plan options outside of Covered CA) | • | ||||||||
Individual Marketplace (Covered CA – Individual/Family plans) | • | • | |||||||
Offer consultative approach and/or recommend plans | • | ||||||||
Examples of Special Enrollment Periods | |
• Lost other health insurance including Medi-Cal | |
• Permanently moved to or within California | |
• Birth or adoption of baby/child | |
• Newly married or entered into a domestic partnership | |
• Returned from active duty military service | |
• Released from incarceration | |
• Gained citizenship; Lawful presence | |
• Income changed to Federal Poverty Guideline Level | |
• Current individual grandfathered plan will renew outside of open enrollment period | |
Program Eligibility by Federal Poverty Level (FPL) for 2015 OEP for Coverage Effective after 1/1/16
Enhanced Silver Plans 94, 87 & 73 are cost sharing reduction plans which reduce the cost of your health plan benefits.