Common Questions on Health Insurance





I know I need health insurance, but where do I start?

Health insurance can be confusing! Plan benefits, premiums, and doctor networks vary from year to year. Applegate Consulting (AC) explains the benefits of each health insurance plan, so the consumer can really understand how each plan works. The first step to picking a health insurance plan is scheduling a consultation with a licensed independent agency like AC.

 

How much do you charge?

It depends on the service. Applegate Consulting (AC) charges an annual fee of $100 per individual or family for a qualified health insurance consultation to help offset the 2017 decrease in commissions paid to agents. If the client isn’t 100% satisfied with the service and provides a written complaint to AC within 60 days of the initial consultation, the client can be refunded the full amount. There are no fees for all other product lines.

 

If I go directly to the insurance company, can I receive a lower rate?

No. Qualified health insurance rates for small businesses, individuals, and families are set in stone by law. If the shopper called the insurance company directly to get a quote and enroll, the price would be the same as offered through the broker channel. For that reason Applegate Consulting (AC) can guarantee the lowest rate for any qualified health insurance plan. In addition insurance companies limit the plan choices to the ones they offer, and that’s it! AC works with all of the major insurance companies in the Colorado marketplace to give folks more options.

 

Can I change health insurance plans?

One can cancel health insurance at any time; however, one may only qualify for a new health insurance plan during Open Enrollment or through a Special Enrollment Period. Open Enrollment happens only once per year, so it’s important to make the right choice. One must have a Qualifying Life Event (QLE) such as a loss of employer coverage, child birth etc. to get coverage through a Special Enrollment Period. Different rules apply to employer coverage often referred to as group benefits. For more information and/or a full list of QLE’s, contact Applegate Consulting (AC).

 

What is Obamacare?

“Obamacare” is a term used by many to define today’s health care system in the US. President Barack Obama passed into law the Patient Protection and Affordable Care Act (PPACA) on March 23rd, 2010. The law sought to create a level playing field for consumers to compare and enroll in health insurance, while providing a tax credit to those in need. The individual mandate stated one must buy health insurance or pay a tax penalty. Private health insurance companies were ordered to design a standardized set of plans to make sure folks were receiving a plan covering the “Essential Health Benefits.” PPACA also proposed an option for states to expand Medicaid to a larger population and guaranteed individuals with health conditions acceptance by health insurance companies without a rate increase. All new applicants and health insurance plans created after March 23rd, 2010 have to meet the PPACA requirements.

All plans in place prior to March 23rd, 2010 have been called “Grandfathered” because they are not subject to the PPACA requirements.

 

What is Connect for Health Colorado?

In order to create a competitive market for health insurance, the government created a mandate that required states to open a “health insurance marketplace” or “exchange.” These exchanges were designed to create an easy system for individuals, families, and small businesses to quote, compare, and enroll in a health insurance plan. Consumers who choose to enroll through the exchange may qualify for a tax credit depending on their income level.

In 2013, the state of Colorado created Connect for Health Colorado in order to serve Coloradoans looking for health insurance plans. Applegate Consulting is certified with Connect for Health Colorado to help customers navigate the website, quote and compare, and complete the enrollment process.