Baron & Associates, Inc. FAQ

Baron & Associates, Inc may show you other plans that your current broker may not show you. We could also market another type of insurance. We offer medical, dental, vision, life, short-term disability (STD), long-term disability (LTD), voluntary plans, etc.

Baron & Associates Inc offers a more personal touch and 24/7 response to any problem or question that comes up....even on weekends when other larger companies would not be available to help you.

All prices that Baron & Assoicates, Inc receives will be the same quotes that you would receive from that larger company. It is based on your company information, not ours. The quotes may even be less because there is no mark-up from Baron & Associates, Inc that you may get with larger companies.

Health insurance is a contract with an insurance company, which agrees to pay some or all of your medical bills based on your "coverage," or the terms of your policy. In exchange, the insurer is paid a premium by the insured. Most Americans have private health insurance, either through their employer's group plan or by their own individual policy. Others are covered under public programs such as Medicare and Medicaid.

It's no secret that health care is expensive today. Regularly paying a set premium for health coverage assures that money will be available to defray the cost of everything from routine checkups to catastrophic medical bills.

All three are medical charges you must pay out of your own pocket, even if you have insurance. Your deductible is the initial amount you must pay each year for covered health services before your insurer will begin to pay. Plans may have separate individual and family deductibles and/or deductibles for separate services such as hospitalization. A copayment is a fixed amount you pay toward each medical service, such as $25 for a checkup. Coinsurance is a fixed percentage, rather than a flat amount, that you pay toward each service.

The Patient Protection and Affordable Care Act (PPACA), commonly known as Obamacare, was signed into law by President Barack Obama on March 23, 2010. It includes reforms designed to make health insurance better and more affordable, rein in health costs and expand coverage among Americans. The act requires most Americans to have health insurance or face a penalty. It also makes it illegal for insurers to set dollar limits on coverage, drop you if you get sick or charge more or deny coverage because of a pre-existing condition.

The Affordable Care Act's "individual mandate" requires all Americans, with a few exceptions, to have health insurance that typically offers "minimum essential coverage." Going without insurance could bring a tax penalty. The fee for not having coverage in 2015 will be 2% of your yearly household income Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) or $325 per person for the year ($162.50 per child under 18). The maximum penalty per family using this method is $975. The penalty for 2016 would be the greater of 2.5 percent of income or $695 per person. After 2016, the penalty rate is adjusted for inflation. The penalty will show up as an additional tax or a reduction in your federal tax refund.

The law excuses certain individuals from the penalty, including members of religious sects that have religious objections to health insurance, participants in health care sharing ministries, and those who are uninsured for less than three months of the year. You also could be exempt if your income is too low to require a federal tax return, you can't reasonably afford coverage, or you would have qualified for Medicaid had your state elected to expand the program as provided for under the Affordable Care Act.

Depending on your income, you may be eligible for lower-cost, subsidized coverage purchased through the health insurance exchange. Or, you may qualify for free or low-cost coverage through Medicaid or the Children's Health Insurance Program, aka CHIP.

Some provisions of the Affordable Care Act do not apply to so-called grandfathered plans written before the law took effect. These include the freedom to choose your own doctor, preventive services at no additional cost, and the right to appeal if your insurer denies a claim. However, as with new policies, grandfathered plans are required to cover children up to age 26, provide a simple summary of coverage and costs, and cease any lifetime limits on benefits.

You're OK if you are currently insured through: an individual or group plan (grandfathered or not); a veterans health care program, including Tricare; Medicare; Medicaid; the Children's Health Insurance Program, or CHIP; Peace Corps volunteer plans; or COBRA continuation coverage for the unemployed.

Yes. For employer-based insurance, it means: preventive services at no additional cost (unless you have an older, grandfathered plan); an end to lifetime/annual dollar limits and cancellation of coverage if you get sick; guaranteed coverage for your adult children until age 26; guaranteed coverage if you have a pre-existing condition; and the right to appeal a denied claim. If your employer's plan costs more than 9.5 percent of your income or doesn't meet the law's minimum coverage requirements, you might qualify for subsidized coverage on your state health marketplace, or exchange.

All private health insurance plans offered through the state marketplaces must offer the same set of "essential health benefits" as defined under the Affordable Care Act. These include: hospitalization; emergency care; rehabilitative services; lab tests; prescription drugs; preventive care; maternity, newborn and pediatric care; and treatment for mental health disorders and substance abuse.

Marketplace plans will be grouped into four "metal" categories, from less expensive bronze and silver coverage to the more expensive gold and platinum plans. If you are younger than 30, have a very low income or lost your insurance because your previous policy was canceled for not meeting Obamacare's new standards, the marketplaces also will offer high-deductible, lower-premium catastrophic coverage.

The new state marketplaces are designed to be secure and password-protected. All health insurance policies offered through them have been approved by your state's department of insurance and certified by the marketplace. You'll need to fill out an online application; the site will determine if you qualify for premium discounts, reduced out-of-pocket costs, or coverage under Medicaid based on your income and family size.

In many ways, no; Medicare officials have been stressing to seniors that their benefits are not fundamentally changing and that they will not need to use an online marketplace. But thanks to the Affordable Care Act, Medicare recipients now receive free preventive services, including a wide range of health screenings and an annual wellness visit.