O'Brien Benefits & Financial Services, Inc.

Individuals

HEALTH PLANS

Affordable Health Insurance Options for Individuals and Families

What type of health coverage do you need?  The answer may depend on if you qualify for a subsidy, or you live in a state that still mandates insurance.  If you have a pre-existing condition and/or expect to use a lot of health services, you may want to consider a comprehensive health plan directly from one of our top carriers below.

Visit our partner, HealthSherpa (see button below) who can help you decide which Marketplace are best for you and help you make the best use of your marketplace health insurance plan.

Affordable Health Insurance Options for Individuals and Families

What type of health coverage do you need?  The answer may depend on if you qualify for a subsidy, or you live in a state that still mandates insurance.  If you have a pre-existing condition and/or expect to use a lot of health services, you may want to consider a comprehensive health plan directly from one of our top carriers below.

Visit our partner, HealthSherpa (see button below) who can help you decide which Marketplace are best for you and help you make the best use of your marketplace health insurance plan.

INDIVIDUAL & FAMILY

Dental Plans

Choose between a wide variety of carriers and plans and receive services In-network with more than 150,000 providers nationwide.
Delta Dental Plans

FOR INDIVIDUALS & FAMILIES

Choose between a wide variety of carriers and plans and receive services In-network. Delta Dental has the largest network of dentists nationwide.

SELECT YOUR PREFERRED CARRIER(S) BELOW TO QUOTE, COMPARE AND BUY DENTAL PLANS

Supplemental

HEALTH PLANS

Quote & Purchase

As an individual, you are mostly likely no longer required to have comprehensive health insurance from the Marketplace.  However, how comfortable are you without coverage?  Studies show that an unforeseen illness or accident could wipe you out financially, but without a subsidy, you may not be able to afford a plan on the Marketplace.  Our non-ACA solutions are designed to protect you and your family’s physical health and financial wellness, without breaking the bank.

Short Term Health

Enroll any time of year
Enroll today, get covered tomorrow
Covers sudden illness or injury
36 month policy in some states

Vision Plans

Enroll any time of year
Coverage for every stage of life
100% of preventative services covered
Low premiums

Dental Savings Plans

Purchase anytime of the year
100,000 Dentists Nationwide
Pay one low annual fee
No annual caps

Disability Insurance

Purchase any time of the year
Protects your most valuable asset – your ability to earn a living.
Customize to meet your lifestyle
Customized to meet your budget

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Disability Insurance

Disability Insurance protects your ability to earn a living during your working years. In other words, it protects one of your most valuable assets. And, this is pretty important considering that statistics show our chances are greater of becoming disabled than dying between the ages of 25 & 45. During the time you are unable to work due to a qualifying disability (illness or injury), the replacement of your regular income through a monthly benefit provided by disability insurance helps to maintain your pre-disability lifestyle.

Employers often provide standard short-term disability (STD) and long-term disability (LTD) insurance to meet federal guidelines. Individual disability income insurance can be customized to meet your needs and considers your occupation, age, income and other factors in determining your cost and monthly benefit payment amount.

What type of coverage is available?

A standard Short Term Disability (STD) policy allows for income payments to begin after a two-week waiting period. Payments will continue to the insured until he/she recovers or maxes out the benefits. Thus, total benefits for a STD could last for anywhere from one month to two years, depending on the policy.

A Long Term Disability (LTD) policy allows for income payments to begin after a ninety-day waiting period, although it could be much longer depending on the policy. Once payments begin, they will continue far longer than STD. Thus, the total benefits for a LTD could last for a few years, up to age 65, or even for life.

Discount Dental Plans

With a dental savings plan you pay an annual fee and get access to significantly reduced rates. And dental savings plans offer many benefits over traditional dental insurance. Things like no annual caps or limits and absolutely no paperwork.

Our plans cover more than 100,000 dentists nationwide. These quality providers have agreed to charge reduced fees on the dental services you need. So you’ll get the quality care you deserve at a bigger savings than you ever imagined possible.

Individual Vision Plans

Take care of your eyes with an individual vision plan that can be purchased separately or combined with your major medical insurance. Individual vision plans are similar to individual dental policies, as they are inexpensive and save you money on routine eye care, such as exams, eyeglass frames and lenses, contacts, and even offer big discounts on procedures like LASIK. Additionally, monitoring your eye health with regular exams helps to prevent serious eye diseases like glaucoma and cataracts, and also helps to detect early stages of diabetes, high blood pressure, and high cholesterol.

Select your preferred carrier

 

Short Term Insurance

If you have missed the open enrollment period per the Affordable Care Act (ACA), and do not qualify for special enrollment, or are in between jobs, or maybe you need a more affordable alternative to the ACA, you can purchase Short Term Health Insurance any time of the year.  Per the new health insurance regulations as set by the Trump Administration, there is no longer a tax penalty or individual mandate, so you do not have to worry about non compliance of the essential health benefits.

A short term health plan is a non-ACA option that is much less expensive than a comprehensive health plan, because it does not cover pre-existing conditions nor does it contain all of the essential benefits required by the ACA. The great thing about a short term policy is that it will help you avoid financial disaster in case of unexpected illnesses and accidents. And, per new federal guidelines, carriers allow for plans up to one year, and are renewable for up to three years in some states.

What is the Marketplace?

The public health insurance Marketplace (also referred to as an “Exchange”) is where you can purchase health insurance (also known as Obama Care) for you and your family.  A plan from the marketplace is considered a comprehensive major medical plan and also contains the essential health benefits as established under the ACA law.  When you purchase your health insurance through the marketplace, you are guaranteed issue regardless of any pre-existing condition and you may be eligible for a subsidy (premium tax credit) to help off-set high premiums.  When you visit our partner’s website, HealthSherpa, they will be able to help you determine if you are eligible for a subsidy.

The essential health benefits are as follows:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Prescription Drugs
  • Mental health and Substance Abuse disorder services
  • Rehabilitative and habilitative services and devices
  • Pediatric services, including oral and vision care
  • Preventive and wellness services, and chronic disease management

Are you required to buy health insurance?

Currently, most people are not required to purchase health insurance. The ACA “shared responsibility payment” and the individual mandate has been eliminated by the Trump Administration for 2019 and beyond. However, some states have established their own individual mandates, so you still may may be subject to your specific state tax penalty, if any.

When can you enroll?

It’s important to know that you can only purchase your health insurance during the annual open enrollment which is November 1 to December 15th of each year, or unless you qualify for the special enrollment period.

What if you miss the deadline?

You can still sign up for health insurance after the deadline if you meet any of the following qualifying events:

  • change in legal marital status
  • a change in the number of dependents
  • a change in place of residence and the current carrier is not available
  • significant cost or coverage change
  • a change in coverage of a spouse or dependant
  • a COBRA qualifying event
  • legal judgements, decrees and orders
  • entitlement to Medicare or Medicaid

 

 

Types of Major Medical Coverage

 Health Maintenance Organization Or HMO
An HMO offers lower premiums and a significant savings on routine and preventative healthcare. However, this type of health plan requires you to appoint a primary care physician and to use doctors and facilities that are affiliated with the HMO. Thus, if you use healthcare service providers outside of the HMO, there is a good chance those charges won’t be covered by your policy. But, the great thing about an HMO is that the only charges you incur, outside of your premiums, are co-pays for doctor’s visits and other services such as procedures and prescriptions.

Preferred Provider Organization Or PPO
A PPO will save you money on services if you use the preferred providers within the network. Keep in mind that deductibles must be met on this plan before some services will be covered. The good thing about a PPO is they generally will allow a certain amount of services annually outside of the deductible with a small co-pay, and most often the PPO has a large network with quality care providers and excellent prescription drug coverage.

Health Savings Account (HSA)
An HSA is a tax-advantaged bank account tied to certain high-deductible health plans. It allows you to use tax free dollars to pay for allowable health expenses, such as copays, prescription drug costs and more.