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Two Important Health Insurance Changes for Individuals in 2021

Note: These changes are a result of the American Rescue Plan Act that was signed into law by President Biden on March 11, 2021.

1. There are new income guidelines to qualify for the Health Insurance Marketplace.

The new law changed the eligibility guidelines to enroll in coverage through the Health Insurance Marketplace by eliminating the upper income limits. Previously, a single person making more than $51,000 or a couple with income greater than $69,000 did not qualify because their income exceeded 400% of the Federal Poverty Level. Now the general guideline is that you should not have to pay more than 8.5% of your income for health insurance premiums for a silver benefit level.  A bronze plan will be less expensive.

ExamplesSingle, aged 35Married, aged 50 & 48
2021 Estimated Adjusted Gross Income$60,000$150,000
Premium Tax Credit eligibility$232$777
Premium for Bronze HSA$145 – $275$275 – $650
Premium for Silver CoPay Plan$275 – $440$650 – $1100

The people who can benefit the most from this are self-employed and those with no access to employer provided health insurance.  Realtors, farmers & ranchers, self-employed trades people, early retirees and small business owners should find out how much savings are available to them.

2. The amount of Premium Tax Credit has been increased.

Anyone that is already enrolled through the Health Insurance Marketplace is eligible for a larger amount of Premium Tax Credit (PTC) in 2021 than the amount that was calculated when you enrolled.  If you are paying a premium, it would be smart to update your account so that the higher amount of PTC can be applied to your account.  If you already have a $0 premium, you will be able to collect the additional PTC when you file your 2021 income tax return.  The average amount of additional PTC is $50 per month per person.  There is also an option to use the additional PTC to upgrade to a new policy with a higher level of benefits.  However, be careful, as this may cause any year-to-date medical expenses that you have paid to be reset to $0 on a new policy.

A Special Enrollment Period continues until August 15th.

Anyone that is eligible but has not enrolled in the Health Insurance Marketplace can take advantage of this Special Enrollment Period.  You do not have to prove that you have lost other insurance coverage or just had a “qualifying event”.  Your health insurance will begin on the 1st of the month after you complete your enrollment. We can provide you with a quote for health insurance and answer all your questions.  Please call 402.488.5100 or email chrismcpike@comproins.com.

By Chris McPike, Location Manager/Agent, ComPro

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