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Common misconceptions...

J2 Benefits Solutions

​IMPORTANT:  PLEASE READ THE COMMON MISCONCEPTIONS BELOW!!!

There are quite a few misconceptions about our new Healthcare that I would like to point out.  I just want everyone clear, safely covered by health and tax laws.


It IS true, you CANNOT get health insurance outside of the Government's Open Enrollment period.  Much like a corporation runs with annual open enrollments.  Now so do we all.  It is very imperative you do not delay enrolling. And understand the limitations of what is called a Special Enrollment Period (SEP).


You have to have a Qualifying Event (QE) if it is outside of Open Enrollment, which is employment change, marriage, baby, death, adoption and some other varying reasons.  And we're told starting 2016,they're going to potentially require more proof.


Cancelling current coverage does NOT count as a Qualifying Event (QE).  More and more carriers are making us agents prove loss of coverage.  Failure to pay your premium is NOT a QE either.  OR letting a policy lapse.


If you have a QE you only have 60 days to get coverage or you will have to wait until Open enrollment of next year.  Contact me, if you're in this "boat" to see if we can find a Short Term Gap policy.  Note: Short Term Gap is still subject to the tax penalty.


​You CANNOT qualify for subsidy credit towards premiums if you or your spouses Employer offers healthcare coverage and it is deemed AFFORDABLE.  A job-based health plan is considered “affordable” if the employee’s share of monthly premiums for the lowest-cost self-only coverage that meets the minimum value standard is less than 9.56% of their family’s income.


However we CAN go get a direct quote from carriers to see if it is cheaper.  We always have the option to look at Carrier rates direct as long as we're in a qualifying event period.  I do this all the time helping families compare Company benefits vs. Direct.


I am often finding that Employer coverage for Dependents and Spouses is more expensive than going Direct, so double check before you just add a spouse/dependent. The Employee generally has 50% of their premium paid by their Employer, so it's almost always good for the Employee. Most Employers do not contribute to Spouse/Dependents.


Rates are rates, no matter who you use to help you find coverage.  NO Broker or Agent can negotiate any better rate!  It's in the service you receive is what sets us apart.  Do not ever pay a fee to a Broker/Agent.  Some carriers do have Application fees, but that is never given directly to us.


Do NOT refuse your employers coverage until you've read more about the ACA rules.  Do not let that time run out!



PLEASE DO EVERYTHING IN A TIMELY MANNER IF YOU'RE AT A THREAT OF LOSING COVERAGE!​