Get the Health Insurance Coverage You Deserve

FAQs

My COBRA coverage from my former employer terminates later this year. Should I wait until then to get replacement coverage or is there a reason why it would make sense for me to switch to an individual policy now?

This is an excellent question. The good news is you have the option of continuing with COBRA until it expires or switching to an individual policy now. It would make sense to explore your options now - for example you might qualify for premium subsidies that could make individual coverage less expensive that your COBRA premium. If it did not make sense to make a change now, at least you would know what to expect should you find yourself in need of replacement coverage later this year when COBRA expires.

Is the coverage available to individuals comparable to what I was used to under my employer’s group benefits plan?

Employer-sponsored coverage could be with a fully insured health plan or a self-insured plan. Under a fully insured plan, the policy would cover all ten of the Essential Health Benefits, the same as individual policies, in accordance with the Affordable Care Act. Self-funded plans can be customized by the employer, so it all depends on the plan you were used to.

It’s important to note that even if the group plan was underwritten by the same insurance carrier as the individual coverage you are considering, that does not mean all of the providers that were in-network under the group plan will be in-network under the individual plan. Most carriers maintain several different provider networks that apply to specific plans.

One of the services we provide to you is researching whether your preferred providers are in-network for the individual coverage you are considering.

How can I qualify for premium subsidies and how do they work?

Premium subsidies went into effect with the Affordable Care Act (Obamacare) as a way to get more people insured by subsidizing the cost of insurance premiums for those under certain income thresholds. The income thresholds vary by number of dependents to be covered and the income levels of all members of a household.

Premium subsidies are determined on the basis of the income you expect to receive. When you file your taxes next year, the subsidies you received are reconciled with your actual income. This means you may receive a higher tax refund if your income estimate on which the subsidies were based were too low. But if you ended up making more money than you estimated, some or all of the subsidies you received will be clawed back.

Why should I work through Cotinuum? Isn’t it cheaper to buy coverage direct from the insurance company?

There is no difference in price for the same insurance plan sold through an insurance broker or directly from the insurance company. This is because by law there can only be one price for a plan. Insurance companies must file their policies and pricing with the state’s department of insurance each year, ensuring consistency.

Working with an insurance broker like Cotinuum gives you the opportunity to work with experienced professionals who know how to navigate the ins and outs of insurance policies, coverage levels, networks, and the application process. We are also a trusted source after your policy has gone into effect for any questions or issues that may arise.

There are many moving parts to the world of insurance coverage - insurance brokers like Cotinuum help you make sense of everything so that you can make confident decisions for you and your family.