Healthcare.gov Unplugged: Learn what's working and how to apply for a health plan at Healthcare.gov

Healthcare.gov Unplugged
REGISTER TO ATTEND A 20 MINUTE WEBINAR
At http://www.TheMedicalInsuranceExchange.com
• Webinars run daily through March 31st at following times:
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10 am, 2 pm, 7 pm.
Register for the webinar date/time that best suits your schedule.

• Call (214)764-6315 to schedule a live presentation for your
group or company.

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Here are my credentials:
Since 2003, licensed TX
insurance broker, TX License
# 1235220, National
Producer #7751382.
Certified by Health and
Human Services and Center
for Medicare Services to help
individuals qualify and apply
for the IRS health insurance
premium tax credit (subsidy),
and to help them select and
enroll in a plan.
In 2013, spoke to 76 different
business, civic, professional
and religious groups to
explain The Affordable Care
Act.
Ranked in top 1% of all
agents in TX for ACA
enrollments by the largest
health insurance carrier in
the state of Texas.

I don’t recommend it, but if you decide to enroll yourself, if you enter
my name and the information below during your Healthcare.gov
application, I will be your broker of record and will be available to
assist and support you throughout the year.

My Contact Information:

• Mike Chapman, TheMedicalInsuranceExchange.com
6505 West Park Blvd, Suite 306-312, Plano, TX 75093
(214) 764-6315 office, (214) 732-3691 cell,
mtchapman@endeavorgroup.net
• I am a subject matter expert and frequent public speaker on
healthcare and insurance matters and a frequent. I specialize in
health, life, and other personal lines of insurance and employee
benefits for businesses.
• There is no cost for my services; you pay the same rate as you would
anywhere else, but I support my clients with expert advice and
support throughout the year. And I can save you hours of time and
frustration, and prevent you from making a bad decision.
• (Note: I am paid a small commission directly from any insurance carrier that you
select that enables me that enables me to support my family and continue to
support, educate and assist the great people in the community of North Texas.)

Healthcare.gov
10/1/2013-12/7/2013

© 2013 Michael Chapman, GroupBenefitsAdvisors.com

What is a Qualified Health Plan (QHP)?

ACA is a GAME CHANGER:
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Guaranteed issue
No “Rate Ups” for Risk or Conditions



Essential Health Benefits
Ambulatory patient services
Emergency services
Hospitalization
Maternity and newborn care
Mental health and substance use disorder
services, including behavioral health treatment
• Prescription drugs
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Essential Health Benefits, contd.:
• Rehabilitative and habilitative services and devices
• Laboratory services
• Preventive and wellness services; chronic disease
management
• Pediatric services, including oral and vision care


Tons of Wellness & Preventative
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100% paid if go to an in-network provider
Adult
Women
Children
+ Obesity, smoking cessation, alcohol/substance
abuse counseling, + serious mental and emotional.

Healthcare Reform

From Now On…
• Individual QHP Health Plans are as comprehensive as
employer plans…
• Individual QHP Plans Offer wider choices than an employer
plan, but you have to choose…
• Individual QHP Health Plans are as expensive as employer
plans, unless…

What’s better than
Guaranteed Issue?

Uncle Sam May Even
Help You Pay For It!
…But if you don’t buy one,
you’ll pay a tax penalty!

Ever taken a tax deduction for…

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A House?
A New Car?
Business Expense?
Job Search Expense?
A Child or Spouse?

Have You Ever…
• Received Unemployment
Compensation?
• Taken a Student Loan?
• Federal Scholarship?

What’s The Difference?
• Between a Deduction and a
Grant?
• Between a Deduction and a Tax
Credit?
• Which is Better?

Remember This?


Now This:


What’s The Point?

EVERYONE takes deductions
and tax credits and receives
some form of govt.
assistance.

What’s The Point?
Don’t be too proud or
afraid to do something
that is legal and is in your
own and your family’s best
interest…

What’s The Point?

• …It may not be
around forever!


What is The ACA Open Enrollment Period?
• For 2014, through 3/31/2014, or…
• The Following Qualifying Events:
• Loss of employer health plan
• Loss of Income

• (Ins. Costs more than 9.5% of Employee Only
Covg.

• Death, Divorce, Remarriage, Birth, etc.

What Open Enrollment Period Means
• Means You Can Sign Up for Guaranteed Issue
Health Coverage, No Matter How Sick Or Healthy.

• BUT NO PREMIUM SUBSIDY IF EITHER SPOUSE
IS ELIGIBLE FOR A GROUP HEALTH PLAN OR IF
EITHER SPOUSE IS COBRA-ELIGIBLE


Let’s look at Obamacare Subsidies
(IRS Premium Tax Credit)…
• IRS premium Tax credit is the subsidy that,
if eligible based on household size and 2014
household adjusted income,

Reduces the cost of your health insurance.
• You can use all, some, or none of the subsidy to
reduce the cost of your health insurance premiums.
• --99% of applicants choose to use “all” of the
subsidy.

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The Subsidy (IRS Premium Tax Credit) Is Based on
What YOUR WHOLE FAMILY projects as

ADJUSTED GROSS INCOME for 2014.
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You must project for 2014-- The subsidy is NOT
based on your 2012 or 2013 adjusted gross
income.


Household Income Sources:
• W-2 Wages, 1099 income from ALL family members
• Self-employment income
• Unemployment, Workers Comp, Disability Income

• 401k, IRA, Pension Retirement Withdrawals

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The Subsidy (IRS Premium Tax Credit) Is Based on
Your 2014 ADJUSTED GROSS INCOME:


Let’s look at IRS Definition of Adjusted
Household Gross Income
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Line 37 of IRS pub. 1040 IS AFTER SCHEDULE C
itemized deductions and other adjustments.


ACA (Obamacare) Decisions
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What Do I Project My Income to be for 2014?

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What Level of Coverage do I Need, Want and can
Afford?

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How Can I Make the Best Decisions for me and My
Family?

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How and Where Can I Enroll Quickly?

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How and Where Can I Get Professional Help?

Let’s look at rates and plans…
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Click on the red icon at
http://TheMedicalInsuranceExchange.com

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Enter your Name, email, dates of birth and home
zip code to view details of all available ACA plans
in Texas.

• Don’t be fooled by focusing on price alone
….There’s Huge Differences in Doctor/Hospital
Networks between carriers and plans.

Let’s look at rates and plans…
• Don’t be fooled by focusing on price alone
….There’s Huge Differences in Doctor/Hospital
Networks between carriers and plans:
• Humana – Not in Marketplace in N. Texas
• Aetna – Has not announced which Drs., Hospitals
are in their ACA Network
• Cigna – “Skinny PPO network” (Local Plus)
• Only in Metro areas of TX, FL, CA, TN
• Fewer Drs., Hospitals

How Can I Enroll?

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Healthcare.gov – Only place to get a subsidy
Health Insurance Carrier Websites
Licensed, trained, certified TX agent who
specializes in this and services clients year
around with advice and support.


How Can I Enroll?

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Do it Yourself
Navigators, temporary call center agents
(most are not in TX)


How Can I Enroll?

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Online
In Person
By Phone
Or…


How Can I Enroll?

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By appointment on a private webinar with a


Big Webinar Advantage:

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Through screen sharing, you understand
better and faster and speed through the
subsidy application and plan enrollment.

Big Webinar Advantage:

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Maximizes your time, you never have to leave
home.
Can enroll evenings and weekends, leaving
your daytime hours free.
Average enrollment time +
questions/answers takes 1 to 1 ½ hours,
takes much less than if you did it yourself or
traveled to meet with a navigator or even an
agent.

Best “Unofficial” subsidy calculator available here:

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To View Rates and Plans for ALL ACA plans in North Texas:

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Click on the
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icon on any page at

TheMedicalInsuranceExchange.com, and enter your information.

To Download TheMedicalInsuranceExchange TroubleFree
Guide to Obamacare Enrollment:

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Click on the “Apply for Obamacare Health Insurance Here” banner at
http://TheMedicalInsuranceExchange.com and download the pdf document.

To schedule an appointment for a private webinar
consultation and enrollment in subsidy and/or health
plan:

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http://TheMedicalInsuranceExchange.com/obamacare-subsidy-calculator/
Or http://goo.gl/LbldeU

Send email to mtchapman@endeavorgroup.net, with “Obamacare
Enrollment Request” in the Subject line. Include your name and
best phone #, home zip code and date(s) of birth.
Mike Chapman, (214) 764-6315 office, (214) 732-3691 cell,
mtchapman@endeavorgroup.net

Don’t Delay!!!
Open Enrollment Deadlines:
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Apply by 2/15/14 for coverage effective 3/1/14.

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Open Enrollment Ends March 31st

Obamacare
CheatSheet:
Click on the “Apply for Obamacare Health Insurance
Here” banner at
http://TheMedicalInsuranceExchange.com and
download the pdf document.
(Download and print the paper application on same
page but use as an organizer only.)

How Can I Make an Enrollment
Appointment?
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Email mtchapman@endeavorgroup.net
Put “Obamacare Enrollment Request” in subject line.
Include family names, email, phone #, home zip and
dates of birth
Will send in emails with documents you need, along
with rates for your family, plus updates.
Will follow up with info on online enrollment and
enrollment centers when govt. technology is working.

Action Steps
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Register for the 20 minute webinar at
http://www.TheMedicalInsuranceExchange.com

•

Contact Mike Chapman at (214)764-6315 to
speak to your company or group.

•

Forward This Information to People You Know
or What Companies Do You Know That Could
Benefit.

Healthcare.gov Unplugged: Learn what's working and how to apply for a health plan at Healthcare.gov

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Healthcare.gov Unplugged: Learn what's working and how to apply for a health plan at Healthcare.gov