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Health Care Guide For The Self Employed

Self-Employed Professionals and Entrepreneurs: The Guide You Need to Navigate Getting Health Insurance Coverage is Finally Here!

Health Insurance Guide For The Self-Employed

Finding quality, affordable health insurance coverage when you’re self employed can be a real challenge. Divining which plan is right for you, figuring out if you qualify for Affordable Care Act (ACA) Tax Credits, and projecting your modified adjusted gross income — are all just a small part of why getting health insurance coverage can be a Herculean task. That’s why Rebecca Yates, CEO and Founder of Ark Insurance Solutions, created “The Health Insurance Guide For The Self-Employed.” It includes detailed guidance on the top 10 considerations you’ll need to address when looking for health insurance coverage, as well as a glossary to help you make sense of overly confusing insurance terms. To get this FREE guide, click here.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.
The Long-Awaited “Family Glitch Fix” and Why It Could Be Great News for Your Family

The Long-Awaited “Family Glitch Fix” and Why It Could Be Great News for Your Family

The Kaiser Family Foundation estimates that the “family glitch” currently affects more than 5.1 million Americans. Due to the narrow way that the IRS interpreted the affordability of health coverage as outlined in the Affordable Care Act (ACA), many people who haven’t been eligible to get ACA tax credits and affordable insurance through the Healthcare.gov marketplace, will now be able to get coverage. The new rule to fix the family glitch is expected to go into effect before the end of 2022.


The Long-Awaited “Family Glitch Fix” and Why It Could Be Great News for Your Family

Imagine this scenario. Tom gets great insurance through his company and his boss pays 100% of his insurance premium because he wants to be sure all his employees are covered.
Tom’s wife Amanda, and their two kids, also need coverage under Tom’s insurance. Here’s the problem. The cost to add Amanda and the kids to Tom’s plan is $1,100 per month. This is unfeasible for the couple since their combined income is around $5,500 per month.

One would think that Amanda and the kids could just go through the Healthcare.gov marketplace and get an affordable health plan. But the fact is, she and the kids have not been eligible to receive Affordable Care Act tax credits to get insurance through the marketplace since they are technically eligible to get coverage on Tom’s plan — at a mind-numbing cost of $1,100 per month.

Under the ACA’s affordability test, Amanda and the kids could have gotten affordable coverage through the healthcare marketplace, if the cost of Tom’s portion of his insurance premium exceeded 9.61% of the entire household income. But since the amount that Tom has to pay for insurance coverage each month is zero (remember his generous boss?), and $0 is definitely not more than 9.61% of $5,500, Amanda and the kids are out of luck.

Now you might be asking, “wouldn’t the high cost to add Amanda and the kids to Tom’s plan be used for the affordability test? $1,100 is definitely more than 9.61% of their monthly household income.”

Well that’s the “family glitch.” When the act was written, it didn’t take into account the affordability of health insurance for dependents, only the employee’s cost of health insurance — measured against the entire family’s income. Very glitchy.

So here’s what’s changing. With the Biden Administration’s final rule on the “Family Glitch Fix”, families will get a break. When the new rule takes effect, the affordability of insurance premiums will be based on the cost of premiums to get all dependents covered, not just the employee’s cost for his/her/their own coverage.

This means that many more people will be able to get ACA Tax Credits and get insurance through the Healthcare.gov marketplace. The “Family Glitch Fix” will take effect on January 1, 2023 which means that individuals and families can sign up for more affordable plans during the upcoming Health Insurance Open Enrollment which runs between Nov. 1, 2022 and Jan. 15, 2023.

To find out what the Family Glitch Fix might mean for you and your family, make an appointment with an Ark Insurance agent today. Get an appointment on our calendar to avoid the rush.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.
What are the Silicon Slopes Health Plans?

What are Silicon Slopes Health Plans and What Do They Mean For Your Utah Business?

They could mean great rates on group health insurance, and if the medical loss ratio is low for your company, you might actually get a rebate check from your plan administrator.
What are the Silicon Slopes Health Plans?

If you own a small business, you understand the challenge of finding affordable, quality health insurance coverage for your employees. The Kaiser Family Foundation estimates that businesses with five employees could pay $100,000 in the first year for coverage — not including copays and coinsurance.

Last week, Silicon Slopes, a 501(c)(3) nonprofit organization empowering Utah’s startup and tech community, introduced Silicon Slopes Health Plans. Developed in partnership with University of Utah Health and EMI Health Plans, these plans are partially self-funded, and look to move beyond the transactional approach, where it’s all about paying premiums and claims, to put more focus on the ultimate goal of keeping employees healthy.

So how exactly do these plans work, and how can you know if they’re right for your company?

First, let’s look at a typical “fully insured” health plan. This is the model we’re all familiar with where the employer pays a fixed monthly premium to the health insurance carrier, and in return, the carrier pays all eligible member claims. If the premium collected is greater than the amount of the claims, the carrier gets to keep the excess as profit.

With a partially self-funded health plan, the employer contracts for the assistance of a health insurance carrier or third-party administrator (TPA) to administer all aspects of the health plan. The employer funds the claims payments. Something called “stop loss” insurance pays any catastrophic claims for conditions such as cancer or premature birth. While claims will vary from month to month, the employer reaps the rewards when few claims need to be paid. Any surplus funds can be reserved for future claims.

There are several attractive features of a partially self-funded plan (like the Silicon Slopes plans), including a statistical likelihood that it will cost less.

Other benefits of a Silicon Slopes Health Plan include:

  • As the employer, you can choose whether providers are in IHC network or non-IHC network
  • The plans are administered by University of Utah Health or EMI Health
  • These are “medically-underwritten” plans which means if your staff is very healthy, your company can actually see the benefits through lower rates
  • You’ll be pooled with other like-minded employers
  • You need not be a tech company or a start-up to benefit from this plan
  • You can qualify to participate with as few as two (2) full-time (W2) employees
  • You can sign up your company to participate at any time, with the starting date at the first of the next month

There are some important considerations to take into account when looking at these plans. Ark Insurance Solutions can help. Reach to us today for a no-cost consultation to determine if a Silicon Slopes Health Plan is right for your business.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.