Tax Credit Eligibility
Do you qualify to receive a subsidy to help you pay for your health insurance?
Upcoming Open Enrollment
When is the next open enrollment period?
Qualifying Event
Do you have a life qualifying event that would enable you to shop all your options?
Tax Penalty
What are the ACA fees if you don’t have health insurance?

Do you qualify to receive a subsidy to help you pay for your health insurance?

While anyone may purchase a plan on the exchange, you may only qualify for a tax credit if:

  • Your household income is between the 138-400% of FPL (see chart below)
  • You do NOT have employer offered coverage available to you
  • If you are married, you must file jointly, not separately
  • Must be a US citizen or legal immigrant
Think you qualify? Compare Exchange
Plans
Tax Credit Eligibility Chart

When is the next open enrollment period?

Open Enrollment is currently closed – it ended January 31st.

Open enrollment typically runs November 1st-January 31st. The next open enrollment period has yet to be announced amid the uncertainty of what the current administration is planning to do regarding repealing and replacing the ACA.

However, if you have a life qualifying event, you have a 60-day window from date-of-loss to shop and obtain health coverage.

Applying Outside of Open Enrollment

Do you have a life qualifying event that would enable you to shop all your options?

Generally, with the new healthcare laws, individuals and families are only able to obtain/switch plans during a designated open enrollment period. However, if you have a life qualifying event, you have a 60-day window from date-of-loss to shop and obtain health coverage.

Life Qualifying Events include:

  • Birth, adoption or placement into foster home
  • Loss of minimal essential coverage through an employer
  • COBRA exhaustion
  • Marriage or Divorce
  • Losing coverage as a result of a move
  • Gaining membership to a federally recognized tribe
  • Gaining citizenship or lawful US presence
  • Certain income changes for those already enrolled in Marketplace coverage

If you have not experienced one of the above life qualifying events, you can still obtain coverage through a Short Term Medical plan. Short Term plans do not cover pre-existing medical conditions and does not provide certain preventative care services (immunizations, screenings, etc.).  You can choose your deductible ($500, $1000, $2500, $5000, $7500) and how much the insurance carrier pays for claims (80% or 50%) after you meet the deductible.  Nothing is covered until the deductible is satisfied first.

You can also choose the duration of your plan, 30-185 days.

Short Term Medical (STM) coverage is not a replacement for ACA mandated health insurance because this type of plan is NOT considered “minimum essential coverage” and therefore you may be subject to pay the IRS penalty for not carrying Obamacare compliant health insurance.

However, because of the shorter duration and certain exclusions, these plans are very inexpensive – often a great alternative for clients between jobs or needing a few months of coverage before the next open enrollment. Please see our individual page or contact our office for more information about Short Term Medical.

What are the ACA fees if I don’t have health insurance?

While there are exceptions, the new healthcare laws do require that the majority of US citizens and legal immigrants carry health insurance.

You are NOT required to carry health insurance if you are part of religion opposed to acceptance of benefits from a health insurance policy, an undocumented immigrant, incarcerated, a member of an Indian Tribe, your family income is below the threshold for filing a tax return or insurance is considered unaffordable. Otherwise you are required to have ACA compliant health insurance in some capacity (employer, Medicaid, Medicare, TRICARE, VA, Individual Marketplace, etc.) for 10-out-of-12 months PCY.

The IRS penalties for being without out insurance as follows:

  • 2016 and beyond - $695/adult and $347.50/child or 2.5% of family income*, whichever is greater.

* Income is defined as total modified adjusted gross income in excess of filing threshold (About $10K for Individual or $20K for family).


These plans are available until Jan 31, 2017, or if you had a qualifying event in the past 60 days.

Please fill out the below criteria to get your instant health quotes.

  
  
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With the introduction of the Affordable Care Act in 2013, there are now many ways to purchase individual health insurance. Identifying which route would be most beneficial to our clients is where the process begins.

For the majority of our clients who are not eligible for a tax credit, we often point them in the direction of the private market. It is better to enroll directly with the carrier for a variety of reasons - ease of application, easy billing and faster customer service. Return to our individual instant health quote page to get started!

For our clients who do qualify for a tax credit (find out here if you qualify), we recommend purchasing on the state exchange for overall cost-savings. We have developed a website designed specifically for our exchange clients to compare and view all their options, side-by-side. If you believe you would qualify for a tax credit, then please visit our exchange site to shop and compare those plans.

Exchange plan image

Are you between jobs?

Do you need coverage for a short period of time?

Are you in need of individual insurance outside of the ACA open enrollment?

Temporary or Short Term Medical plans can provide you with next-day coverage.

Short Term medical does not cover pre-existing medical conditions and does not provide extensive preventative care (immunizations, screenings, etc.).  You can choose your deductible ($500, $1000, $2500, $5000, $7500) and how much the insurance carrier pays for claims (80% or 50%) after you meet the deductible.  Nothing is covered until the deductible is satisfied first.

You can also choose the duration of your plan, from 30 days all the way up 185 days.

Short Term Medical (STM) coverage is not a replacement for ACA mandated health insurance because this type of plan is NOT considered “minimum essential coverage” and therefore you may be subject to pay the IRS penalty for not carrying Obamacare compliant health insurance.

Washingtonians are really only left with one prominent option for short term medical, LifeMap. They are a subsidiary of Regence and this plan is network free, allowing you to see any provider. For quotes, more information and to even apply right online, click here or the logo below:

Life map
Deductible Options 500, 1000, 2500, 5000, 7500
Policy Length 1-6 months (renewable)
Coinsurance Percentage 80/20 or 50/50
Exclusions Pre-existing conditions, most preventative care, pregnancy coverage
Coinsurance Maximum $10,000 (out-of-pocket maximum is determined by deductible and coinsurance percentage)
Network You can see ANY provider
Policy Fee $20 application fee
Policy Maximum 1 million

The most popular dental and vison plans in Washington are:

Delta Dental VSP

Click each respective logo above to review rates, plans and even complete your enrollment.


If you are a business owner looking at options for your company, please contact us for quotes.

Dental and vision bundles available as well.


If you are an individual looking for additional dental options for yourself/family please see the following:

Premera Dental Health ,Services

What Makes Us Different

Health Insurance Specialists

Our Agency was developed after years of research in finding the most competitive health insurance plans available in Washington. Unlike most insurance agencies, our office specializes only in Health Insurance and related coverages. Our reputation for saving hundreds of dollars for individuals & families and delivering industry leading customer service has made us one of the fastest growing agencies in the Northwest.

One-Stop-Shopping

The Washington Health Insurance Agency's unique position in the marketplace allows us to shop and compare from all of the major health insurance carriers available in Washington, both on and off the state exchange (Washington Healthplanfinder). We do not charge a fee for our services and because we are an appointed agent for each health insurance company, you get the same price as you would if you purchased your coverage directly from the carrier.

Obamacare Experts

Washington Health Insurance Agency has been recognized by Washington Healthplanfinder as one of their Top 5 Brokers providing ‘dedicated service and outstanding accomplishments during the open enrollment period’.

Governor Jay Inslee has also recognized the Washington Health Insurance Agency thanking us for our “outstanding contributions to the success of Washington State’s first open enrollment period under the Affordable Care Act (ACA)”. With one call to our agency, you can get expert advice on the best health insurance coverage to meet your unique needs from start-to-finish. Give us a call today to get started!