Health insurance is a contract between a beneficiary and a payer. Payers have contracts with service providers that have agreed to a fixed price. Further, the funds collected by the payer are gathered into a risk pool to cover extraordinary expenses so no one person has to may more than a certain amount. If you don't use the insurance the funds are paid to providers to cover the expenses of others. The rates charged are based on how much was paid for health care services and administrative costs. Part of those administrative costs include paying brokers a commission on business they help place with a company. Health insurers are required to perform a review every year to see if they paid 80% of the premium revenues received out in claims to the beneficiary. If the insurer paid less than 80% of premium revenues in claims then they must rebate the consumers. It is important that you understand how your insurance works when seeking services. Many companies have contractual requirements to request help from the company to control the costs before accessing services or claims could be denied. This should be viewed as a win-win situation. If you have problems getting approval for medical problems or you feel you are paying too much for services please contact me at the number above.
Here is a 5:24 minute video from the Kaiser Family Foundation to help explain health insurance:
Call (800) 547-1567 to talk to a certified Washington Healthplanfinder® Agent.
Get help with your Healthplanfinder account. You might be surprised how much money an agent can help you save. Having problems with your WAHBE account? Call, I can help!
Here is another YouTube playlist that explains basic concepts about health insurance
Understanding Health Insurance
On April 12, 2016, the Internal Revenue Service (IRS) issued Revenue Procedure 2017-24 to index the contribution percentages in 2017 for the purposes of determining the affordability of an employer's plan under the Affordable Care Act (ACA).
For plan years beginning in 2017, employer-sponsored coverage will be considered affordable if the employee's required contribution for self-only coverage does not exceed:
Call (360) 834-0200 or (800) 547-1567 if you need help including other states as well.
I HIGHLY RECOMMEND CHECKING YOUR INCOME ON THE
ADJUSTED GROWTH INCOME CALCULATOR
BEFORE STARTING AN APPLICATION ON AN EXCHANGE.
In Washington and other states the widest selection of choices and the best place to search, once your application is finished (whew!), is through Washington Healthplanfinder (Washington only) or healthcare.gov. The links below are another, much easier way to enroll if you don't qualify for an Advanced Premium Tax Credit (APTC) which are only available through the exchanges. By using these links a licensed agent will be assigned to help with setting up and helping you with your account. Coverage is only available in states insurers have been allowed to file rates. Not all companies provide direct links.
Washington Healthplanfinder only
*Best choice for people that want to work on their own.
>HealthSherpa Healthcare.gov helper. Use this for states that don't have their own exchange like Washington.
+Please provide the following when prompted.Thomas Gibson NPN 6261584.
**To get my help with your account on the "Washington Healthplanfinder" select "Find a Broker", fill in my last name "gibson" and press enter. My name is Thomas Gibson. I can possibly help you get health insurance even if the state office said no. I get paid by the companies I represent and they all pay about the same. There is never any charge to you for my service. Please call and leave a message that you entered a request for help to speed up response time. We are not automatically notified when you request help.
For help with any health insurance related questions please call (360) 834-3377 or (800) 547-1567 anytime for assistance. Other contact information is available below.