Helpful Health Insurance Tips

Wesley Watkins
Wesley Watkins

The heat is definitely in full swing in Central Louisiana! Let me give you some helpful tips about health insurance so you don’t end up as hot as the outside temperature:

1. The value of health insurance isn’t necessarily related to the amount of the co-pay that you may have. The value is related to the total amount you would have to pay if/when something happened to you. Typically, this amount is called your out-of-pocket maximum. This number means you would have to pay the out-of-pocket maximum before the insurance company picks up the rest of the bills for the rest of the calendar year. If all you have is a co-pay plan with no deductible or out-of-pocket max, then you would need to calculate the frequency that you use health insurance and how.
2. Want to get an individual health insurance policy this summer? Sorry, the opportunity has passed until 2015 unless you have something special in your household like a birth, death, divorce, marriage, or move to a new area and lose coverage benefits. This is related to the Affordable Care Act.
3. Don’t have Health Insurance?  Expect to pay a tax. It’s that simple. However, you can file for hardship or an exemption to avoid the tax. The tax will increase year after year until 2016 and then can be adjusted further by the administration. In case you haven’t looked into it, the tax is far cheaper than the cost of insurance in most cases, but you still won’t have health insurance if you simply pay the tax.
4. Dental & Vision benefits for children are automatically placed on new (non-grandfathered) plans. This is a huge benefit for parents and can save a lot of money. However, the new premium of health insurance might be a lot higher than your old policy. Be sure to weigh out the differences.
5. Employer coverage–Most all employers will be moving to a shorter waiting period for new hires in 2014. An employee can’t wait longer than 90 days to get on the group health plan. Many groups are implementing a 2 month wait or shorter. This is not a choice, and most all groups should be compliant by 2015.
6. Group insurance–Health insurance sponsored by a company can be written any time of year. Unlike individual policies, we can start group coverage at any point from 2-employee companies and up.
7. Company Penalties–If the size of a company is 2 to 99 employees, then no penalties apply in 2015. Starting in 2016, companies from 50 employees and larger will either pay a penalty or offer health insurance that is affordable and essential (call me for the technical definition of what is affordable and essential). Companies with 100+ employees (full time equivalents) will start paying a penalty or offer the right kind of coverage in 2015.


To receive help in finding the cost of health care as well as finding the best health benefits, choose an insurance adviser who specializes in health insurance. If you need an insurance advisor who is an expert in health insurance—and ACA certified—please contact me at (318) 445-9359.