If self enrolling, please reference your agent's FFM ID and National Producer Number (NPN) - Click Here to locate AIA Agent FFM ID & NPN Numbers
Beginning January 1st, 2014, all individual and family health plans must meet new Affordable Care Act (ACA) requirements.
There is not a requirement to use Marketplace (HealthCare.gov) however, application for advance tax credits towards your insurance premium is only available by applying for coverage through Marketplace (HealthCare.gov).
This information applies to people who are on their own to buy individual (non-group) health insurance including: self-employed, between jobs or coverage not offered from an employer for other reasons.
All people will qualify for health insurance regardless of health or pre-existing conditions and starting January 1st, 2014, most people must have basic (minimum essential) coverage or pay a penalty. There are certain exceptions/exemptions to this rule.
Rates are based upon age, geographic location, tobacco use, and the benefit plan you choose. The rates will be the same if accessed directly via the Insurance Carrier or through Marketplace.
When comparing the available health plans, your Local Certified Marketplace Affiliated Agent - Abel Insurance will be your resource to navigate you to the most beneficial plan for your needs. There is NO additional cost for utilizing the assistance of your Local Certified Marketplace Affiliated Agent - Abel Insurance.
If you can afford Health Insurance but choose NOT to buy it, you will pay the penalty, which is known as the “Individual Responsibility Payment.”
Beginning in 2014, the Federal Affordable Care Act (ACA) requires that all health care plans, sold either through the market place exchange (ie: Cover Oregon) or directly with insurance company provide a basic package of core benefits called “Essential Health Benefits.”
Plan labels will help you understand the level of coverage you are buying. Insurers can sell more than one plan in each of the categories. Standard Plans will have the same essential health benefits, which make it easier to compare between different companies based on price, doctor/hospital networks, customer service, and other factors.
Advance Payment of Premium Tax Credits (APTC) help offset the monthly costs of health insurance premiums. The amount you will receive is based on household income and family size. APTC can be refundable and/or advanceable. A refundable APTC is available to an individual even if you do not owe any taxes. An APTC allows an individual to receive help at the time of purchase rather than paying their premium out of pocket and waiting to be reimbursed when filing their annual tax returns.
Advance Tax Credits may not be used to help cover the cost of an employer-sponsored coverage or coverage bought outside of Marketplace.
The Oregon Health Plan (OHP) provides health coverage to low‐income Oregonians through programs administered by the Division of Medical Assistance Programs (DMAP).
Healthy Kids (Oregon’s Medicaid/CHIP coverage) provides no-cost health coverage options for uninsured children and teens up to 19 years of age.
This comprehensive coverage includes provider visits, prescriptions, behavioral care, dental services and preventative care. A family’s income determines whether a child is eligible to participate.