I’m very surprised that since the Patient Protection & Affordable Care Act has been in place since 2010, that many of you are still not aware of the basic rules and what it can do for you. Please don’t get political on me, this is simply a case study of one of our clients who definitely benefited from the law.

This client is a 42 year old female living in Houston (that’s Texas ya’ll) who has a 7 year old Daughter. Unfortunately, this nice lady went through a recent divorce which completely upended her status quo.

As far as her insurance was concerned, she was left to find suitable coverage for both her and her Daughter as her Ex-Husband was no longer able to afford to keep the Daughter on his small group health insurance policy provided by his Employer. When an employer offers a either a large group or a small group insurance policy to its employees, the cost is normally very reasonable for the employees, but spouses and children and normally very expensive to add. This is simply because the employer is not required by law to pay any portion of the spouse/child coverage, but must pick up a minimum of 50% of the employee coverage. Some employers pick up far more and do cover the entire family as part of the compensation package, but that’s somewhat rare.

When we ran the quotes, we found that she had access to only three insurance carriers in Harris County which we’re Blue Cross Blue Shield of Texas, Molina Healthcare and Community Health Choice.  Her estimated 2017 income will be about $17k, so that computes to a federal subsidy of $311/month for a household of two. Based on the income, she also qualified for a “cost sharing subsidy” as well which will reduce their deductibles and out of pocket on any Silver plan significantly.

The end result was that we managed to obtain the HMO Silver 004 plan from Community Health for a net premium of $11 per month for both her and her Daughter! The best part is that this plan has a $0 deductible and a $1,000 annual maximum out of pocket along with very low doctor and prescription co pays. Now that’s a deal!

I realize that will probably make some of you mad that your coverage is nowhere near as good and that your monthly premium is far higher than $11 per month. Remember though, her income is only $17k for this year and that’s pretty tough to make it when you’re now a single Mom. Feel bad now, don’t you?

This really worked out well for the family as a whole since the now ex-Husband was able to remove his Daughter from the small group plan at his work which saved him almost $300/month. Of course, he offered to reimburse his ex-Wife for the cost of the medical plan and she now has a far better plan than what she had before.  Truth be told, the Husband’s employer “cheaped out” and offered a crappy group health insurance policy for their coveted employees, so insurance-wise, it worked out better.

Can we do the same for you? Possibly. Just call us at 866.270.6209 or fil out our Request a Quote form. One of our agents will be in touch before you can say “I love my health insurance plan from Selected Benefits!”.