Javascript is currently disabled. This site requires Javascript to function correctly. Please enable Javascript in your browser!

TOBY HANSEN AGENCY INC.

Temporary Health Insurance

Missed the open enrollment period, between jobs, just graduated from college and are without medical insurance?

 

Consider Short Term Medical

Short Term Medical plans are affordable because they provide insurance coverage in a different way. Short Term Medical protects you from the medical bills that can result from unexpected injuries and illnesses, without coverage for preventive or routine care.

Short Term Medical is not minimum essential coverage

 

Short Term Medical coverage from the Toby Hansen Agency can offer some of the following benefits:

Plans available up to 180 days

Coverage as soon as the day after you apply

Flexibility to choose your own doctors and hospitals, with no network restrictions

One common family deductible for length of policy

Prescription drug coverage

 

For a quote, please click here:

https://www.temporaryinsurance.com/STMConsumer/Quote/ContentPages/StartQuote.aspx

 

 

Wondering if you are eligible for insurance with the federal exchange outside of the current open enrollment period?

Look at these

Triggering events allowing

a special enrollment period

Renewal of a grandfathered or non-grandfathered

individual major medical plan in 2014

Return from active military duty

Release from incarceration

Gain of immigration status or citizenship

Permanent move to a new state

Involuntary loss of minimum essential coverage due to:

Discontinuation of a current plan that does not meet

health care reform requirements

For example, when a non-grandfathered individual major medical plan is

discontinued and replaced with a metallic major medical plan

Legal separation

Divorce

Termination of domestic partnership or civil union*

Change in full-time employment status

Loss of employer-sponsored insurance as a result of:

Voluntary or involuntary termination of employment

The employer no longer offering coverage

Death of a parent or spouse

Change in dependent status as a result of turning 26

Gaining or becoming a dependent due to:

Marriage

Domestic partnership*

Birth of child/children

Adoption of child/children

Placement for adoption of child/children

New appointment of guardianship

 

 

 

 Health Short Term Medical (STM) Q&A

 

Q. Is STM considered minimum essential coverage (MEC)?.

 

A No. STM is not considered MEC under the Affordable Care Act. This means that customers may need to pay a tax penalty depending upon their income level and the cost of the plans available.

 

Q. Is STM still considered creditable coverage?A.

A    Yes. STM is still creditable coverage as that term is used in HIPAA. People coming off STM plans and onto plans that must recognize creditable coverage will have their preexisting condition exclusion periods reduced or eliminated by the months of creditable cover­age on their STM plans. However, since major medical plans with effective dates on or after January 1, 2014, will no longer apply preexisting condition exclusion periods, creditable coverage will no longer be as pressing of an issue. It’s important to note that STM is not considered MEC as part of the Affordable Care Act.

 

Q.When exactly does an STM customer become subject to the tax penalty?

 

AThose who do not have a plan that is MEC will begin incurring the tax penalty as of January 1, 2014. If they have a plan that is MEC for part of the year and an STM plan for the remainder of that year, the penalty will be prorated based on the number of months they do not have a plan that is MEC. They can have a gap in MEC for up to three months without a penalty.

 

Q.If an STM plan ends after March 2014, does the customer have to wait until the next open enrollment period to purchase an individual major medical plan?

 

A Yes. The end of an STM plan does not constitute a qualifying life event, so the customer will have to wait for the next open en­rollment period to purchase a major medical plan. The next open enrollment period will run from October 15 – December 7, 2014; however, the first available effective date will be January 1, 2015. As long as the customer qualifies, he/she can get a subsequent STM plan in the meantime.

 

Q.Wouldn’t it be smart for all customers to buy STM until they’re sick?

 

A There are different risks with every plan. Agents can help those who qualify for STM to understand the risks and cost trade-offs. Many consumers value comprehensive major medical plans. STM might be a good choice for people who are:

Willing to pay out of pocket for ongoing health conditions because they are subject to the pre-existing condition limitation

 

Willing to pay out of pocket for preventive and other routine care

 

      1. Not opposed to paying a tax penalty or having a plan that is not MEC

      2.  

      3.  

        Q.Will STM still have underwriting, lifetime limits and exclusion of pre-existing conditions?

 

AYes. STM plans will stay the same as they are today in these areas. The Department of Health and Human Services has clarified that STM plans are not part of the individual market and are not subject to the Affordable Care Act.

      1.  

         

2

 

      1. Q.Where is our risk?

      2.  

      3. .AThe agent’s risk is the same as it is today. An agent must conduct a suitability analysis and make a recommendation with full disclosure to the applicant. It’s important to let customers know that STM plans are another major medical option; however, there are differences between STM plans and the new 2014 individual major medical plans.STM plans are not MEC. This means customers may have to pay a tax penalty depending upon their income level and the cost of the plans available.

      4. STM plans are medically underwritten (not guaranteed issue) and do not cover preexisting conditions.

      5. STM plans do not have coverage for the same benefits as a full reform plan, such as preventive care, maternity or mental health.

      6. STM plans are not renewable, so a customer will have to apply for a new STM plan once their policy ends and will be subject to medical underwriting.

      7. The end of an STM plan is not considered a qualifying life event. This means if a customer’s STM plan ends and they do not qualify for another STM plan (because their health status has changed) or they are outside of the enrollment period and can’t purchase a major medical plan, they might have a gap in coverage.

      8.  

      9.  

      10. Q.Will there be coordination of benefits (COB) if a customer has a STM in addition to another plan that is considered MEC?

      11. AThere will be COB the same way that it is done today.

      12.  

      13. Q.If a consumer loses coverage during one month and can’t get coverage until the first of the next month, will we prorate the STM rate premium? If so, will we do this only if the new individual major medical plan is ours?

 

      1. AAll of the business rules are currently staying the same, but we are evaluating new options given the current landscape.

      2.  

      3. Q.Can an employer fund a STM plan through an HRA or section 125?

 

      1. ANo.

Asset 1 Asset 2 Asset 3