Individual and Family Plans

Affordable Care Act

The Affordable Care Act (ACA) of 2010Off Site Icon established the Health Insurance Marketplace, an online forum that allows individuals to purchase health insurance for themselves when it isn’t available through their employer. The Marketplace gives people access to a variety of health insurance options, and is a convenient way to shop for and compare plans.

You can choose Premier HealthOne when you shop on the Health Insurance Marketplace. Our locally-based, physician-led insurance plans include a variety of options to fit your individual needs and that of your family. Learn more about shopping on the Health Insurance Marketplace.

Why Have Health Insurance

The Affordable Care Act of 2010 established the Health Insurance Marketplace, providing accessible health insurance options to individuals who cannot be insured through their employer. Under the ACA, no one can be refused health insurance coverage due to a pre-existing condition, and those who are 26 years of age or younger may be eligible to be covered under their parents’ health insurance plans. Preventive care is provided at no cost to the individual.

The Health Insurance Marketplace is changing the way many Americans are buying health insurance. Its online forum gives individuals access to a variety of health insurance options, and is a convenient way to shop for and compare plans. Some may qualify for subsidized plans based on income levelOff Site Icon, or may be eligible for Children’s Health Insurance ProgramOff Site Icon, or for MedicareOff Site Icon or MedicaidOff Site Icon.

Most people are now required to have health insurance, and could be subject to a tax penalty if they aren’t covered. Premier HealthOne offers a wide range of affordable health plan options through the Health Insurance Marketplace during the Open Enrollment period, Nov. 1, 2015 through Jan. 31, 2016. Premier HealthOne may be right for you if:

  • You are losing coverage under your parent’s plan
  • You are not eligible for health insurance from your employer
  • You are self-employed
  • You want to explore health insurance options other than what is offered by your employer
  • You work for an employer that doesn’t offer health insurance

Premier HealthOne offers three tiers of health insurance coverage on the Marketplace to fit your or your family’s individual needs. Learn more.

Special Enrollment Period

Sometimes life events take you by surprise. Premier HealthOne is committed to offering choices when you’re faced with the unexpected. When you need to make changes to your health plan, you may qualify for a Special Enrollment Period. A Special Enrollment Period allows you to modify your plan outside the Open Enrollment period. Some reasons why one may need special enrollment include:

  • Adopting a child, or placing a child for adoption or foster care
  • Gaining citizenship or lawful residence in the U.S.
  • Getting married
  • Having a baby
  • Leaving incarceration
  • Losing other health coverage
  • Moving to a new residence

Those already enrolled in The Health Insurance Marketplace coverage may qualify for a Special Enrollment Period if they have a change in income or household status affecting eligibility for premium tax credits or cost-sharing reductions. Voluntary termination of a Marketplace plan mid-year won’t qualify you for a Special Enrollment Period.

Benefits of Having Health Insurance

Health coverage is required by law for most Americans, and individuals could be subject to a tax penalty if they don’t have health insurance.

An unexpected illness or injury can be a life-altering event, especially if you haven’t planned for it. Health insurance helps to provide a safety net for your care in case you get sick or hurt, and supports preventive care so you don’t become ill. All plans cover the following essential health benefits:

No one can be denied health insurance coverage through the Health Insurance Marketplace due to a pre-existing condition or one’s gender. The Marketplace offers cost-saving options for those who can’t afford the full cost of health insurance plans. The Marketplace savings are based on one’s income and household size:

Household Size Income Range
1 $11,670 to $46,680
2 $15,730 to $62,920
3 $19,790 to $79,160
4 $23,850 to $95,400
5 $27,910 to $111,640
6 $31,970 to $127,880
7 $36,030 to $144,120
8 $40,090 to $160,360

Do you qualify for Marketplace savings? Learn moreOff Site Icon.