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HEALTH INSURANCE MARKETPLACE

Find out if you qualify for help paying for your health insurance and buy comprehensive health insurance online at the Marketplace.

Group Benefit Partners is certified to assist Individuals, Families and Small Businesses purchase insurance through the Federal Health Insurance Marketplace, known as the on-line Marketplace Exchange.

Offering a variety of health insurance coverage, all plans on the Marketplace Exchange will contain qualifying essential benefits and range in coverage from 60/40 to 90/10.  For example, the 90/10 plan would have the least out-of-pocket expenses, but cost you the most in premium.

*Individuals must purchase their health insurance during the annual open enrollment period. Failure to do so may result in having to wait until the next open enrollment to purchase coverage. Employers are able to offer benefits year round or during their normal open enrollment as usual.

MORE ABOUT THE MARKETPLACE &

AFFORDABLE CARE ACT

For Small Businesses

You may qualify for the Small Business Health Care Tax Credit that could be worth up to 50% of the costs you pay for your employees’ health insurance.  For businesses to be eligible, you must cover at least 50 percent of the cost of employee-only (not family or dependent) health care coverage for each of your employees. You must also have fewer than 25 full-time equivalent employees (FTEs). Those employees must have average wages of less than $50,000.  CLICK HERE to see if you are eligible for the Small Business Tax Credit.

For Individuals

The Marketplace offers comprehensive health coverage which is perfect for those who may have a pre-existing health condition and plan to use a lot of health services during the year. This type of coverage is also good for those who qualify for a federal premium subsidy which allows you to have full coverage at a lower premium. Families earning up to $104,800 annually may qualify.  CLICK HERE to see if you qualify for the Premium Subsidy.

FAQs

  • No pre-existing clause. Insurance companies can no longer increase rates or deny coverage because of a pre-existing condition.
  • Dependents up to age 26 may be added to an insurance policy for both individuals and employer coverage.
  • Gender is no longer a factor in determining rates.
    Renewal rates are the same as new business rates.
  • Waiting period should not exceed 90 days.

November 1st through December 15th

Individuals must purchase their health insurance during the annual open enrollment period. Failure to do so may result in your having no coverage for the following year and having to wait until the next year’s open enrollment to sign up for coverage.

If you miss open enrollment, you may qualify for special enrollment.   You may enroll in a health insurance plan outside of the annual open enrollment dates if you have a qualifying event.

  • change in legal marital status
  • a change in the number of dependents
  • a change in place of residence and the current carrier is not available
  • significant cost or coverage change
  • a change in coverage of a spouse or dependent
  • a COBRA qualifying event
  • legal judgements, decrees and orders
  • eligible for Medicare or Medicaid

Businesses with 50+ full time equivalent employees must offer a Minimum Essential Coverage (MEC) plan, otherwise they could incur a penalty of $2,700 (in 2021) times the number of full time employees (minus the first 30 employees). A $4,060 (in 2021) penalty can also occur if an employee goes to the exchange and gets a subsidy (tax premium credit). Penalties can increase each year by the growth in insurance premiums.

 

Per the ACA, if you have fewer than 50 full-time employees you are considered a "small business" and are not required to provide group health insurance coverage to their employees.

Currently, most individuals are not subject to a tax penalty and are not required to purchase health insurance. The ACA “shared responsibility payment” and the individual mandate has been eliminated by the Trump Administration for 2019 and beyond.  While some states have established their own individual mandates, Iowa is not one of them, so you won't face a tax penalty for not being covered.

DO YOU QUALIFY FOR ASSISTANCE?

Get help paying your health insurance premiums. Use the calculators below to see if you qualify for a premium subsidy (for individuals) or a Small Business Tax Credit.

If you don’t quality for a subsidy or tax credit, you still have options!  Learn More

914 Avenue G, Fort Madison, IA 52627 Click for all locations

Phone 866-496-3102. Click to Email Us

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Group Benefit Partners | The Health Insurance Marketplace