Individual Health Insurance Application – FAQ
When Does Open Enrollment begin and end this year?
Open Enrollment for 2018 begins November 1, 2017 and ends December
15, 2017. This is a big change from last year, which allowed OE to continue
through the end of January. That means you have 45 days to shop this year,
not 3 months!
If I shop during this time, when will my new policy go into effect?
January 1st, 2018
What if I don’t apply for a policy during Open Enrollment?
The only people that can buy outside this time frame MUST have a
Qualifying Event in the prior 60 days of their application, and must
provide PROOF of that qualifying event. (An example of Proof would be a
COBRA letter showing you lost Employer group coverage in the last 60 days.)
What are some Qualifying Events to gain, drop or change coverage?
Examples of a Qualifying Event include losing group coverage,
getting married, having a baby, moving to another state and out of the
'servicing area' of your current plan, etc.
Not paying your premium on time and lapsing your policy is NOT a
What do I do if I just can’t do this on my own?
If you get stuck and need help, you can contact CB Health
Insurance! We are here to help you and walk you through your options and
help you find the BEST plan that meets your needs and budget! Even if you
have to pay us a consulting fee, it will provide you with peace of mind that you have looked at all options and found the one that will best meet your needs without calling every insurance carrier and doing all the research on your own.
Can I shop on my own for coverage?
Absolutely! Go to our health quotes page here: Health Insurance and
click the link to apply for either ON or OFF exchange plans. Feel free to
check both. NOTE: Some carriers have plans only on or only off the
exchange. Carriers like Blue Cross and Blue Shield of IL have plans both on
and off the exchange.
What is the difference in price ON and OFF the EXCHANGE?
There is no difference. The price is identical. However, IF you
qualify for a TAX CREDIT based on your income, the government is actually
paying a portion of your medical premium for you, thus lowering your
overall premium. NOTE: If you do not qualify for a tax credit, there is no
need to go to the government exchange (healthcare.gov) to apply.
Can I qualify for a Tax Credit?
If your income is less than 400% of the Federal Poverty Level
(FPL), you may qualify for a Tax Credit. (See document here)
Depending on how many people are in your household and the total Adjusted
Gross income for the household, you could receive a tax credit. If you are
married, you must as “married filing jointly” to receive a tax credit.
NOTE: Income below the Medicaid limit (In IL this is 138% of the FPL
qualifies you for the state Medicaid program.
Outside of the annual Open Enrollment, if I am buying a plan, what is the
latest date I should apply if I want coverage by the 1st of the
You need to apply by the 15th of the month in most cases.
Once I’ve secured coverage, is it effective tomorrow?
No. The new plans are ONLY effective on the first of the month.
What do I do to prevent a short gap of coverage?
If you need coverage for a month or two before the new plan kicks
in, purchase one-month Short Term Medical. NOTE: Short term policies are
not ACA approved; and if you have these plans longer than 3 months, you
will pay a tax penalty at the end of the year for not having adequate
coverage as defined by the law. Check for rates and plans here:
Short Term Medical.
When do I typically owe my first premium?
You’ll need to pay the first premium within a 30-day grace period
of the policy effective date or you will not have insurance.
If I’m eligible for a Tax Credit (subsidy), what portion of my premium do I
pay each month?
You don’t need to pay the full premium. You will need apply for the
Tax Credit through the government website; most companies have links from
their website to go to the 'marketplace' and get this tax credit. If you
qualify, you can receive the Tax Credit one of two ways:
- Apply towards your premium so that you pay the reduced amount. The total
premium for your coverage is $350/month, and you receive a tax credit of
$50/month, you only need to pay $300/month to the insurance company; or
- You can pay the whole amount and use the tax credit when you file your
tax return. Most people take option 1.
Do I have to pay for a Pediatric Dental Plan?
It depends. You’ll either need to either select a pediatric dental
plan for children under age 19 or verify that you have the coverage
elsewhere. The ACA states that one of the mandatory Essential Health
Benefits that must be covered now is for pediatric dental. However, many
insurance carriers chose not to embed this coverage in the medical plan,
requiring you to purchase a separate dental policy to cover this. Remember,
ACA requires you to have this coverage or pay a penalty, so be sure you