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Understanding Open Enrollment

The last 3 months of any given year is usually a crazy one. The kids are back to school full swing and active with their various activities, the holidays are quickly approaching and everyone is scrambling to plan their budget for the upcoming new year.

During this time, in the health insurance arena we also busy planning and preparing for Open Enrollment. (For coverage starting in 2016, the Open Enrollment Period is November 1, 2015–January 31, 2016.) It is easy to forget about something like health insurance, especially if in prior years your insurance was paid through an employer or if you didn’t have insurance.

With the current law put in place by the Affordable Care Act (ACA), if you do NOT have coverage, you will have to pay a fine, which increases each year. The fine is either 2.5% of your total income or fines for each member of your household ($695 /adult, $347.50/child) with no household limit. In short, not having health insurance can be very costly.

In preparation for Open Enrollment here are some things to keep in mind:


  • Understand Metal Levels. Don’t just settle for the cheapest monthly premium choice. There are four plan levels. Bronze, Silver, Gold and Platinum. If you choose a Bronze level plan, you are paying 40% of covered medical expenses. Silver level plan you are paying 30%, Gold you pay 20% and Platinum 10%. If you are relatively healthy with little to no medical needs then maybe the Bronze or Silver is a good option for you but if you have a chronic health problem or are frequently using your insurance plan then Gold or Platinum is probably your best choice.
  • Know your carriers. Each region has regional players as well as national players. If you choose a regional carrier, make sure your doctors and hospitals participate in the plans. If you choose a national carrier, make sure their network is strong in your area.
  • Understand the lingo. Co-pay, deductible, out of pocket. What do these all mean? What are my costs? What applies to me and what doesn’t? By knowing what these terms mean, the better you will be able to understand your out of pocket costs. Check out this glossary of terms to help you throughout the process:

Of course, even with educating yourself working through the Marketplace (that’s what the ACA website for individuals is called) can still be difficult. A fast and easy way to secure health insurance is to call Kuzneski Financial Group. As your broker, here are 3 things we can do for you to make your life easier:

  1. Do the research. We will ask you your needs and price range for coverage and then provide you with a detailed comparison of all plans that fit your needs.
  2. Sign you up. We will call the Marketplace with you. Once we get on, you just need to give us permission to finish the application on your behalf and then you can jump off the call. Instead of taking an hour of your time, we only need 15 minutes!
  3. Follow up. Problems, questions or concerns about your coverage. You can call us directly and we will do all the work for you. Instead of sitting on a 1-800 line you call your client advisor directly and she takes it from there. Best of all, there is no charge to have one of our client advisors! Now you are not only saving time but money too!

Stephanie Rosenberger

Stephanie has been a client advisor at KIG for more than 5 years, specializing in employee benefits and HR solutions. She loves cats and dogs, Yuengling (see picture to left), and spending time outdoors with her husband and 3 kids. She also volunteers at the Indiana County Child & Youth Services as a foster care advocate.

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