Health Insurance

Open enrollment for the individual/family market is typically November 1st through December 15th of each year for a January 1st effective date..  If you do not apply for coverage during that open enrollment timeframe, you will have to wait until next year or have a Qualifying Life Event (QLE). 

Due to the many changes brought about by the Affordable Care Act (ACA), very few brokers are still selling individual/family health insurance plans.  Unfortunately, this would include Loudoun Insurance Group.  If you do not have access to an employer-sponsored health insurance plan through your or your spouse’s workplace, you will most likely have to apply directly with the carriers or through the marketplace at www.healthcare.gov.  If you qualify for government assistance, you must go through the government website to purchase the insurance. 

As of January 1, 2018, there are only two health insurance companies offering individual/family coverage in Loudoun County and most of Northern Virginia:  Kaiser Permanente and CIGNA.  Kaiser Permanente is an HMO where you are required to go to their doctors and facilities for coverage.  CIGNA has a broader network, but does not have out-of-network coverage. So as with any insurance, plan ahead and make sure you know what providers and facilities are in network for your plan before you need services.

Are you a small business owner with at least one W2 employee working 30 or more hours? 

You may be better off starting a group plan for you and your employees.  Pricing is more competitive, there are more carriers and plan options to choose from, and there is a good amount of tax savings potential for the business and your employees.  

Contact us ASAP and we will assist, but before you do, here are some of the requirements for starting these plans.  You must have at least one “common law employee” (W2, non-owner, non-spouse of owner) who is working on average 30 or more hours a week.  There is an employer contribution minimum of 50% of the employee’s premium (no requirement for contributing to spousal or dependent coverage), and there are different participation requirements that are carrier specific.