GOOD THING THERE S PARAMOUNT.

Transcription

1 HEALTH INSURANCE MARKETPLACE BAD THINGS HAPPEN. { GOOD THING THERE S. PIC-HIX-BROCHURE2015

2 THE AFFORDABLE CARE ACT AND. By now, you re probably familiar with the Affordable Care Act, which requires most Americans to have health insurance. Well, at Paramount, we have some exciting news to share with you as you re preparing to enroll. Not only have we doubled our number of plan choices for 2015, we ve also reduced our monthly premiums on all our plans. And you ll still have access to some of the most popular physicians in the area, including ProMedica Physicians and hospitals. This year, enrollment ends February 15, Every month you go without coverage, you can be penalized by the IRS. THE GREATER OF Adult... $325 Child...$ Family Max... $975 OR 2% of income PENALTY TIMELINE { THE GREATER OF Adult... $695 Child... $ Family Max... $2,085 OR 2.5% of income

3 { Budget-friendly options HEALTH INSURANCE MARKETPLACE PLANS COME WITH SOME PRETTY GREAT PERKS. Many northwest Ohio residents have already enrolled and are not only avoiding tax penalties, but they are also enjoying the following benefits that come along with a Paramount Marketplace plan. An affiliation with ProMedica, so you will always have access to its facilities and physicians Convenient location in the Toledo area, allowing us to answer your questions in person Availability of a Personal Call Center representative, which means you can talk to the same person every time you call us 24/7 nurse line Instant message us with Live Chat Access to our asthma, depression, diabetes, heart disease, and pregnancy medical management programs Preventive visits have copay Prescription drug coverage 4

4 GOLD 1 Deductible SILVER 3 SILVER 2 $3,500 Single/ $7,000 Family $2,500 Single/ $5,000 Family $5,000 Single/ $10,000 Family $5,500 Single/ $11,000 Family $30 $25 BENEFITS OOP Max Preventive Visit PCP Visit Specialist Visit Urgent Care ER Drug Coverage *After deductible has been met. GOLD 2 $75 $60 $75 $60 SILVER 1 $1,000 Single/ $2,000 Family $6,600 Single/ $13,200 Family $15 $30 $45 2 $1,500 Single/ $3,000 Family $5,000 Single/ $10,000 Family $10 $ BRONZE 1 $6,000 Single/ $12,000 Family $6,250 Single/ $12,500 Family $25 BRONZE 2 $5,000 Single/ $10,000 Family $6,500 Single/ $13,000 Family $ CATASTROPHIC $6,600 Single/ $13,200 Family $6,600 Single/ $13,200 Family $35 copay (First 3 visits) 2015 PLANS $250 $300 $1,900 Single/ $3,800 Family $6,600 Single/ $13,200 Family $35 $70 $90 Full plan benefits can be found { at GetParamount.com. 4 6

5 IF YOU LIVE HERE, Williams Fulton Lucas Ottawa Defiance Henry Wood Sandusky Erie YOU CAN ENJOY. Putnam Hancock Wyandot Seneca Crawford Huron Richland Ashland Marion Morrow We also cover parts of Allen, Delaware, Hardin, Knox, Lorain, and Paulding counties. To find out if we service your ZIP code, visit GetParamount.com. 8

6 LET S SEE IF YOU RE ELIGIBLE. To be eligible for health coverage through the Health Insurance Marketplace, you: WANT TO KNOW HOW YOU CAN BUY HEALTH INSURANCE MARKETPLACE PLANS? It s easy. Enroll online at GetParamount.com or healthcare.gov. If you have questions, simply call us at Enrollment is also available through healthcare navigators. A list of navigator locations can be found at localhelp.healthcare.gov. Must live in the U.S. Must be a U.S. citizen or national (or be lawfully present) Must not currently be incarcerated Eligible dependents must be under age 26, or age 28 upon written request If you have insurance through your employer, you can still buy insurance through the Health Insurance Marketplace if your premiums contributions are more than 9.5% of your household income or if your current insurance pays less than 60% of the cost of covered benefits. 10

7 { SO, HOW MUCH IS THIS GOING TO COST ME? Well, that depends on the plan you choose, how old you are, where you live, and your tobacco use. That said, you ll know how much you ll be paying and what your benefits are before you choose a plan. You can even get a free quote at GetParamount.com with no commitment to enroll. DO I QUALIFY FOR ANY SAVINGS? Possibly. It all depends on your family income and family size. Reference the chart below. And if you still aren t sure, visit healthcare.gov to determine what assistance you may be eligible to receive. $ 2015 MARKETPLACE INCOME ELIGIBILITY* FAMILY SIZE 64 & UNDER TOTAL ANNUAL PRE-TAX HOUSEHOLD INCOME 65 & OLDER 1 Up to $16,105 $16,106-$29,175 $29,176-$46,680 $46,681+ NEFITS 2 Up to $21,707 $21,708-$39,325 $39,326-$62,920 $62, Up to $27,310 $27,311-$49,475 $49,476-$79,160 $79, Up to $32,913 $32,914-$59,625 $59,626-$95,400 $95, Up to $38,516 $38,517-$69,775 $69,776-$111,640 $111, Up to $44,119 $44,120-$79,925 $79,926-$127,880 $127,881+ Below 138%** Below 25* Below 40* Above 40* Medicaid*** Marketplace plans with costshare reductions and/or premium tax credits Marketplace plans with premium tax credits Marketplace plans Paramount Elite Medicare *Based on healthcare.gov income levels as of 11/2014. **Percentage is related to the federal poverty levels produced by the federal government. ***Paramount Advantage doesn t determine eligibility. Please contact your local county Department of Job and Family Services. 12

8 { WHEN EXACTLY CAN I ENROLL? SIGN ME UP! WHAT SHOULD I DO TO ENROLL? All you need are a few simple things for each family member seeking health insurance. They are: Open Enrollment runs November 15, 2014 through February 15, 2015 You must enroll by the 15th of the month to receive coverage starting on the 1st of the following month You may also qualify for Special Enrollment Periods outside of Open Enrollment if you experience certain qualifying life events. If you don t enroll, you will pay a tax penalty to the IRS. Social Security number or document number for legal immigrants Employer and income information, such as pay stubs or W-2 forms If currently covered by health insurance, the policy number If eligible for employer health insurance coverage (even if the coverage is through another person s job; for example, a spouse s or a parent s), information about the employer s health insurance plan (visit healthcare.gov for a full list of required information) 14

9 WANT TO KNOW MORE ABOUT HEALTH INSURANCE MARKETPLACE PLANS? All you have to do is visit GetParamount.com or call us at Paramount Insurance Company is a Qualified Health Plan issuer in the Health Insurance Marketplace and does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation or health status in the administration of the plan, including enrollment and benefit determinations.