us_health_advisors

Group Health Insurance for Arizona Companies With 30-100 Employees

Sat, 11 Apr 2026 16:03:42 GMT

Arizona businesses with 30 to 100 employees have some unique considerations for group health insurance plans. While these groups are large enough to potentially gain underwriting advantages, they’re also small enough where premium increases can be more impactful, compared to those businesses with bigger groups.

Also, in addition to traditional group health insurance plans like fully insured or level funded plans that offer comprehensive coverage, alternative strategies like individual coverage health reimbursement accounts (ICHRAs) may make more sense for these sized businesses. Small-to-midsize businesses in Arizona will also want to weigh the benefits of using a professional employer organization (PEO) versus potentially saving money and getting better service with a group health insurance broker.

Here, we break down what Arizona midsize group health insurance options are available, what to consider when choosing insurance, group health insurance trends to be aware of in 2026, and common mistakes to avoid when choosing midsize business health insurance.

Arizona employers in Phoenix, Scottsdale, Mesa and Tucson often evaluate group health insurance differently depending on workforce demographics, provider network access and cost considerations.

The most important factor for Arizona employers choosing group health insurance is not just premium cost. It’s balancing long-term risk, employee satisfaction and provider access.

Key Takeaways

Arizona employers with 30 to 100 employees have a variety of group health insurance plans to choose from, including fully insured and level funded plans. Alternative strategies, such as offering an individual coverage health reimbursement account (ICHRA), may also be a good option for midsize Arizona businesses. Factors like underwriting and premiums should be taken into account.
When midsize Arizona employers are selecting a health insurance plan, some key things to consider include employee demographics, claims risk, budget tolerance, provider/network needs, prescription exposure and growth plans, including hiring and retention.
In 2026, rising group health insurance premiums are contributing to a shift toward more level funded plans, especially for Arizona employers with 30 to 100 employees. Some employers are also increasing employee cost-sharing to offset rising premium costs.

How Arizona Employers With 30–100 Employees Typically Choose a Health Plan

Most Arizona employers in the 30–100 employee range evaluate their options based on five key factors:

Workforce health profile: Healthy groups often benefit from level-funded plans, while higher-risk groups may prefer fully insured stability
Budget predictability: Fixed monthly costs vs potential savings with some risk
Provider access: Ensuring key hospitals and doctors are in-network
Prescription exposure: High-cost medications can significantly impact plan selection
Growth trajectory: Plans should scale as your workforce expands

Reviewing these factors side-by-side leads to better plan decisions and fewer surprises at renewal.

Common Group Health Insurance Plans for AZ Midsize Companies

What works for a large 1,000+-employee enterprise may not be the best fit for a midsize employer in Arizona. Due to their smaller size, AZ employers with 30 to 100 employees can also look at alternative health plans, like ICHRAs , to provide employees with healthcare coverage while being mindful of budgets.

For Arizona employers with between 30 to 100 employees, the following are some of the most popular plans to choose from.

Group Health Plan Types (Quick Comparison)

Before diving into each option, here’s a quick comparison of the most common group health plan types available to Arizona employers:

Quick Tip: Don’t Just Compare Premiums

Two plans with similar monthly costs can have very different long-term outcomes depending on claims risk, prescription exposure and network fit. Always evaluate the total cost and employee experience — not just the premium.

Fully Insured

Fully insured plans involve a fixed premium for the employer for consistent healthcare for employees. For companies with 2 to 50 employees, premiums are based only by county and age. For companies with 51 or more employees, underlying risk determines premiums. This means, if a midsize Arizona employer has a workforce with a lot of healthcare needs, a fully insured plan may be more expensive, because risk is higher due to a smaller pool size.

Level Funded

With level funded plans , employers pay a fixed premium cost, as well as stop-loss insurance for claims that exceed the amount paid for. Level funded plans also require health plan administration. These types of plans can be cost-effective for midsize employers with lower risk, since premium costs can stay lower compared to fully insured plans. We’re seeing them increase in popularity, especially for midsize businesses that are feeling the pressures of rising premiums and want to save.

Real Example: Arizona Employer Savings

A 98-life Arizona employer we worked with moved from a UnitedHealthcare level-funded plan to an Aetna AFA level-funded option in late 2025, resulting in approximately $156,000 in annual savings — while maintaining comparable provider access for employees.

Results like this depend on group size, claims history and plan structure, but they highlight how the right strategy can significantly reduce costs over time.

�� 2026 CASE STUDY: The Cost of Overpaying

Why this worked: Instead of accepting a standard renewal increase, this group moved to a plan that rewarded their specific health profile. At AZ Health Insurance Brokers , we specialize in finding these "hidden" savings for midsize companies in Phoenix and Scottsdale.

Individual Coverage Health Reimbursement Arrangement (ICHRA)

With an ICHRA, the employer determines a fixed amount per month that they offer to employees tax-free to use for individual health insurance and medical expenses. ICHRAs provide employers with the advantage of predictable healthcare costs, while also offering an in-demand workplace benefit to employees. Another benefit is that employees can choose the exact healthcare coverage they need, without being restricted to an employer offering.

Professional Employer Organization (PEO)

For some midsize businesses, using a PEO may make financial sense. PEOs offer outsourced human resources support, helping with tasks such as benefits administration, tax compliance, payroll administration and safety programs. For midsize businesses that want to outsource HR, it may make sense to use a PEO to administer healthcare, as well.

However, it’s important to be aware that PEOs come with high fees that could also include medical rate increases as a company grows. It’s common to see annual increases of up to 35% or more, depending on risk pool. When a midsize company is incurring too many costs with a PEO due to growth , making the switch to a health insurance broker may make more sense.

The PEO-to-Broker Transition Guide: Why 50+ Employees is the Turning Point

As an Arizona company grows toward the 50 to 100 employee mark, the financial math of a Professional Employer Organization (PEO) often stops making sense. While PEOs provide administrative simplicity, they often trap midsize businesses in expensive "risk pools" where you pay for the health claims of other companies.

The "Underwriting Advantage"

Once you hit the 50-employee threshold, your business gains significant underwriting advantages. Moving from a PEO to a licensed broker allows you to leverage your own group’s specific health profile .

By switching to a Level-Funded or Fully Insured model, you can often secure lower rates because you are no longer subsidizing the high-risk claims of a PEO’s larger, anonymous pool.

PRO-TIP: Check for the "35% Cliff" It is common for PEOs to hit growing Arizona businesses with annual medical rate increases of 35% or more. If your renewal looks like this, it’s a clear signal that you have outgrown the PEO model and are ready for a customized group health strategy.

How Arizona Employers With 30-100 Employees Choose the Right Plan

With lots of group health insurance plans and services to choose from, there are different factors that will influence a midsize company’s selection for a health insurance plan. They include the following.

Employee demographics

Everything from how many employees you have, to the age range of your employees, will impact the healthcare costs you can expect to pay. At Arizona Health Insurance Brokers, we look at employee demographics to assess risk and find the most budget-friendly plans that meet employee healthcare needs.

Claims risk (healthy vs. high utilization)

For employees that have a high utilization of prescriptions and medical provider services, that impacts claims risk compared to a young, healthy workforce with more minimal healthcare needs. Claims risk will determine where you can find the most savings, in a fully insured plan versus level funded plan, for example.

Budget tolerance

Your business budget and financial projections are also going to play a major role in determining which plans you’re able to afford both now and in the future, taking claims risk into account. Healthcare costs can greatly impact your business growth, both positively in terms of recruitment and retention, but also negatively, if you select a higher-cost plan than what was necessary. An Arizona insurance broker will look at your business budget to see what makes the most sense for your unique business.

Provider/network needs

Your workforce may have preferred providers and/or healthcare networks, which may only be covered under certain group health insurance brands. You can find out preferences using employee surveys and choose the group health insurance solution that offers the most coverage for the majority of your employees’ preferences.

Prescription preferences

Similarly, prescription prices can vary widely based on group health insurance providers. Prior to selecting a midsize business health insurance provider, employee surveys can reveal which prescriptions employees need coverage for, so you can match up the health insurer to that prescription coverage.

Growth plans (hiring/retention)

Additionally, your business should take its growth plans into account to ensure you choose a health insurance solution that can scale with your business, as well as provide enough value to help attract talent and retain employees. Your budget and growth projection will influence what makes sense. At Arizona Health Insurance Brokers, we work as an extension of your business to ensure the health insurance option you choose matches your growth plans for the time period you’re covered.

2026 Trends for Midsize Arizona Employers

If your business is approaching a deadline for renewing or choosing a new health insurance provider, there are some important trends in Arizona group health insurance for midsize businesses to be aware of. If your business has recently grown into the 30-100 employee category, you’ll also likely encounter some changes in how you approach group health insurance. Here’s what to be aware of.

Rising premiums

Arizona health insurance premiums for the most popular health plans rose 29% in 2026, which was the 12th-largest increase in the country, according to AZ Big Media . As a result, midsize businesses must either allocate more budget toward healthcare coverage for employees, look at different healthcare coverage models (such as level funded insurance), and/or increase employee cost-sharing.

Shift toward level funded group health insurance

As mentioned, level funded group health insurance plans can be a good option for midsize businesses, especially those with healthy workforces. Because level funded health plans can offer significant savings compared to traditional fully insured plans, more Arizona midsize businesses are talking with AZ Health Insurance Brokers to determine what a level funded plan might offer their business in terms of cost savings.

Increased employee cost-sharing

In 2026, more than half of employers planned to increase workers’ share of healthcare costs to accommodate for increased premiums, according to Mercer’s Survey on Health and Benefit Strategies . Arizona midsize businesses have sought strategies such as increasing annual out-of-pocket maximums and instating higher deductibles for workers. When you talk with AZ Health Insurance Brokers, we can share what we’re seeing with competitors in your space, so you can ensure you make decisions that help you retain your recruitment numbers and don’t risk dissatisfying your current employees.

Rx costs impacting renewals

Prescription drug costs are a major factor in group health insurance decisions for AZ midsize businesses. As two-thirds of U.S. workers have at least one prescription medication , AZ midsize companies are looking at prescription drug costs in relation to various plans to find the best one for their workers. We help simplify the process of choosing a group health plan by guiding Arizona employers, especially those in the Phoenix metro and Maricopa County. Through their options based on workforce needs, provider access and long-term cost strategy. We can help you survey your team on what prescriptions they’re using, to find the most cost-effective plans that offer coverage for those drugs.

Common Mistakes Employers Make

Whether you’re considering whether to renew your existing plan or not, or you need a new group health insurance plan altogether for your midsize AZ business, we advise avoiding the following mistakes when choosing a group health insurance plan.

Only shopping 1 carrier

Group health insurance is an important decision for your business. With so many Arizona group health insurance brands to choose from, and a variety of plans offered by most brands, you can save significantly when you shop and compare brands. We help you compare multiple carriers and plan options based on your workforce and budget.

Not exploring level funded plans

Level funded health insurance plans may seem like a new concept to some AZ midsize business owners and organizations, but they could provide substantial healthcare coverage at a fraction of the cost you may expect or be used to. Level funded healthcare plans can make financial sense, especially for AZ midsize businesses with healthy workforces. Talk with an AZ Health Insurance Broker to see if this type of plan might be a fit for your business.

Ignoring network fit

Beyond budget, network coverage matters to your employees. It dictates which doctors and hospitals employees can see for affordable rates, which matters especially for life events like pregnancy. An employee survey can clue AZ midsize businesses in to whether or not employees have preferred providers. That way, you can find the best fit for the majority of employees in terms of network coverage that fits your budget.

Focusing only on premium

Related, focusing only on costs can dissatisfy employees. For workers with expensive prescriptions or who are working with a preferred provider for chronic illness, pregnancy or another significant medical issue, not having adequate coverage could result in employee turnover. Health insurance continues to be the top workplace benefit, as KFF reports , and plan details influence employee satisfaction.

Renewing without strategy

If you’re an AZ midsize business currently with a health insurance plan, you’ll have about 60 to 90 days to review upcoming renewal rates and shop around for potentially new plans. Simply renewing your existing plan could leave cost savings on the table, not to mention dissatisfy employees. A strategy that takes factors like your business budget, growth plans and evolving employee demographics into account can help you optimize your 2026 group health insurance plan .

Need Help Evaluating Your Group Health Plan?

If your company has 30–100 employees, choosing the right health plan can significantly impact both your budget and employee retention.

At AZ Health Insurance Brokers, we help you:

Compare fully insured vs level-funded vs ICHRA strategies
Evaluate claims risk and cost-saving opportunities
Match plans to your preferred provider networks
Prepare for renewals and avoid unnecessary premium increases

Every business is different, and the right strategy depends on your workforce, budget and long-term goals.

Arizona Midsize Business Health Insurance FAQs

Written by: Nicki Escudero

Nicki is a specialized healthcare content creator focused on navigating the evolving Arizona insurance landscape. She works closely with licensed brokers to translate complex 2026 ACA and private market trends—such as the 29% premium spike and the rise of level-funded strategies—into actionable guides for families and business owners . Her work ensures that Arizona employers understand how to optimize their benefits while protecting their bottom line.

Reviewed by: Ethan J. Pickner, Licensed Arizona Health Insurance Broker

Ethan is the founder of AZ Health Insurance Brokers and has been a licensed health insurance expert for nearly 12 years . He specializes in helping self-employed individuals and business owners navigate the complexities of the Arizona market to find high-value, cost-effective coverage. Since 2014, Ethan has helped thousands of Arizona residents and companies seamlessly navigate major plan transitions, ensuring they maintain access to top-tier provider networks while securing the best possible rates in Maricopa County and throughout the state.

Reviewed by: Ryan Calloway, Group Benefits Specialist

Ryan is a Group Benefits Specialist at AZ Health Insurance Brokers, specializing in tailored solutions for Arizona companies with 30 to 100+ employees. He is an expert in identifying the "PEO Trap" and guiding midsize businesses through the transition to more cost-effective level-funded and fully insured models . Ryan leverages his deep knowledge of the Phoenix and Scottsdale markets to help employers implement data-driven strategies—like network fit surveys and pharmacy spend audits—to combat rising 2026 premiums and improve employee retention.

Which Arizona Hospitals Accept Which Insurance?

Thu, 09 Apr 2026 16:40:14 GMT

Hospital health services are among the most expensive treatments. Unless you need to go to a hospital for a timely emergency, it’s helpful to check if an Arizona hospital accepts your insurance plan before you go. Otherwise, out-of-pocket hospital costs could be as high as $7,500 for a broken leg or around $30,000 for a 3-day hospital stay.

This guide outlines which Affordable Care Act (ACA) Marketplace and private health insurance plans are accepted by Arizona’s top hospitals in 2026 — including Mayo Clinic, Phoenix Children’s, HonorHealth and more.

Who This Guide Is For

This guide is designed for:

Arizona families choosing a health insurance plan
Individuals who want to keep a specific doctor or hospital in-network
Self-employed individuals comparing ACA Marketplace vs private PPO options
Anyone buying their own health insurance and trying to understand which plans work with different hospital systems

If you don’t have access to employer-sponsored coverage, choosing the right individual or family plan — especially one that works with your preferred hospital — becomes even more important.

It’s important to note: as of 2026, Banner|Aetna and BCBS Statewide PPO plans are no longer offered by the ACA Marketplace. If you need to transition to a new provider, see our Transition Guide in this blog.

We’ll also break down the difference between ACA Marketplace plans and private PPO plans, so you can make the best choice for your family.

Key Takeaways

The most important factor when choosing health insurance in Arizona is not just the monthly premium — it’s whether your plan gives you access to the doctors and hospitals you actually want to use.

ACA Marketplace plans are health insurance plans offered by the federal government . There are specific open enrollment dates , from November 1 through January 15, as well as special enrollment opportunities for qualifying life events. These plans are often the best fit for individuals with pre-existing conditions or those who qualify for income-based subsidies, which can significantly reduce monthly premiums and out-of-pocket costs.
Private individual health insurance or family health insurance plans are typically accessed through a health insurance broker and offer more flexibility with provider networks and plan design. These plans may involve medical underwriting and are generally a better fit for individuals who are relatively healthy and looking for broader doctor access or more customizable coverage.

The right option often comes down to your income, health history and which doctors or hospitals you want access to — which is why comparing plans side-by-side is so important.

How to Choose the Right Plan for Your Hospital (Quick Guide)

If you’re trying to match your insurance with a specific hospital, here’s a simple way to narrow it down:

Want access to Mayo Clinic? → You’ll need a private PPO plan
Need Phoenix Children’s coverage? → ACA and private plans are both options
Using HonorHealth doctors? → Check PCP vs specialist participation carefully
On a budget and qualify for subsidies? → ACA Marketplace plans are typically best
Want maximum flexibility and doctor choice? → Private PPO plans offer broader access

If you have further questions, you can contact the Arizona health insurance experts at AZ Health Insurance Brokers for up-to-date information when you need it, at no cost to you. Call 602.617.4107 or email info@azhealthinsurancebrokers.com .

What Are the Best Hospitals in Arizona?

In Arizona, different hospitals have different specialties. Some Arizona hospitals are nationally ranked in terms of their expertise and service, such as Mayo Clinic and Banner University Medical Center – Phoenix.

If quality of care is important in your health insurance plan decision, these hospitals are consistently ranked among the best hospitals in Arizona by U.S. News & World Report :

Mayo Clinic: Not only is Mayo Clinic ranked number one out of Arizona hospitals , it’s also nationally ranked as one of the top hospitals in the country in specialties including cancer, diabetes, cardiology and lung surgery.
Banner University Medical Center – Phoenix: Ranked number two by U.S. News & World Report for Arizona hospitals , Banner University Medical – Phoenix is a leader in specialties such as ear, nose, throat, geriatrics and neurology.
HonorHealth Scottsdale Shea Medical Center: HonorHealth Scottsdale Shea Medical Center is ranked three by U.S. News & World Report among Arizona hospitals. It’s a general medical and surgical facility that specializes in areas such as colon cancer surgery and pulmonology.
Phoenix Children’s Hospital: Phoenix Children’s Hospital is the number one ranked children’s hospital in Arizona and offers top pediatric care in the U.S., with nationally ranked pediatric cancer care, cardiology and other specialties.
St. Joseph’s Hospital and Medical Center: Home to Barrow Neurological Institute , ranked as the top neurosurgery residency program in the U.S. by the Doximity Residency Navigator, St. Joseph’s Hospital and Medical Center, part of Dignity Health Medical Group Arizona, is also rated in areas including rehabilitation and urology.

Keep in mind that not all top hospitals accept every insurance plan, especially ACA Marketplace plans. Use this guide to match your health insurance with the hospital(s) you want access to.

Arizona residents often choose hospitals based on a combination of specialty care, location and whether their preferred insurance plan is accepted — which is why comparing hospital systems and insurance networks together is one of the most important steps when choosing a health plan.

2026 Arizona Hospital-to-Plan "Cheat Sheet"

If you want access to these Top Arizona Facilities, here is the most direct path to the right insurance:

Mayo Clinic (Phoenix/Scottsdale): You must choose a Private PPO plan (like UHC Choice Plus or Aetna Open Choice). ACA Marketplace plans are not accepted here in 2026.
Phoenix Children’s Hospital: Both ACA Marketplace (Imperial, Antidote) and Private PPO plans are accepted.
HonorHealth (Scottsdale/North Phoenix): Accepted by Ambetter, Cigna, and Oscar on the Marketplace. Critical Note: Specialists are in-network, but HonorHealth Primary Care Physicians (PCPs) are generally not participating in Marketplace plans this year .
Banner Health (Statewide): Broadest acceptance including Ambetter, BCBSAZ, and UnitedHealthcare . Note that Banner|Aetna Marketplace plans ended for 2026.
Dignity Health / Barrow Neurological: Accepts Cigna on the Marketplace. Coverage at Barrow can vary by individual doctor, so always verify the specific physician .
Tucson Medical Center (TMC): The primary choice for Southern Arizona, accepting Ambetter, BCBSAZ, and Imperial .

Best Arizona Hospitals by Specialty (Quick Guide)

While rankings are helpful, most Arizona residents choose hospitals based on their specific healthcare needs and location. Here’s a simple way to think about which hospitals are best depending on your situation:

Best for complex or specialized care: Mayo Clinic
Best for pediatric care: Phoenix Children’s Hospital
Best for Scottsdale and North Phoenix residents: HonorHealth
Best for Tucson residents: Tucson Medical Center
Best for broad statewide access: Banner Health

Choosing the right hospital is often the first step — the next step is making sure your health insurance plan gives you access to that facility.

Quick Tip: Start With Your Hospital First

If you have a specific hospital in mind (like Mayo Clinic or Phoenix Children’s), start by confirming which insurance plans they accept. This can quickly narrow down your options and help you avoid costly out-of-network bills.

What Arizona Hospital Contracts Changed in 2026?

In addition to Banner|Aetna exiting the ACA Marketplace, there’s also some contract news regarding various AZ hospitals and the insurance plans they accept. For example, with HonorHealth and Blue Cross Blue Shield , a new contract means patients with Blue Cross Blue Shield can continue to attend HonorHealth facilities for appointments and procedures.

Another major change to be aware of is that BCBSAZ Statewide PPO is no longer offered on the ACA Marketplace. If you have questions about your health insurance being accepted at HonorHealth or any other Arizona hospital, contact the AZ Health Insurance experts .

��Abrazo Health

Abrazo Health is one of the largest healthcare systems in Arizona. The network specializes in stroke and neurosciences, cardiovascular health, maternity services, minimally invasive surgery and complex spine and orthopedic procedures. The following are ACA Marketplace and private health insurance plans accepted by Abrazo Health.

ACA Marketplace Plans

Private Insurance Plans

BCBS of NE
UHC Choice Plus PPO
Cigna or Aetna’s PPO network
Private Healthcare Systems (PHCS) and MultiPlan PPO network

Common plans used for Abrazo:

ACA Marketplace plans like Ambetter,BCBS and UHC, along with private PPO options depending on provider preferences.

��Barrow Neurological Institute

The Barrow Neurological Institute is attached to St. Joseph’s Hospital and Medical Center. It specializes in areas including neuro psychology, neurological disorders and neurological rehabilitation.

While Barrow Neurological Institute is contracted with Cigna through the ACA Marketplace, each department within Barrow Neurological Institute has different doctors, and those doctors each have different insurance contracts. It’s important to filter coverage by individual doctors at Barrow Neurological Institute.

ACA Marketplace Plans

Varies by doctor
Cigna Connect

Private Insurance Plans

BCBS of NE
UHC Choice Plus PPO
Cigna or Aetna’s PPO network
Private Healthcare Systems (PHCS) and MultiPlan PPO network

Common plans used for Barrow:

ACA Marketplace plans through Cigna, along with private PPO options depending on provider preferences.

�� Banner – University Medical Center Phoenix (Part of Banner Health)

This flagship Banner Health facility is recognized for its academic medical center excellence and is affiliated with the University of Arizona College of Medicine . It’s ranked among the top hospitals in Arizona for specialties like cardiology and cancer care. The following are ACA Marketplace and private health insurance plans accepted by Banner – University Medical Center Phoenix.

ACA Marketplace Plans

Ambetter
BCBSAZ ACA Health Choice
BCBSAZ Maricopa Focus
BCBSAZ Neighborhood
UHC

Private Insurance Plans

BCBS of NE
UHC Choice Plus PPO
Cigna or Aetna’s PPO network
Private Healthcare Systems (PHCS) and MultiPlan PPO network

Common plans used for Banner:

ACA Marketplace plans like Ambetter, Oscar and UHC, along with private PPO options depending on provider preferences.

�� Banner Children’s (Part of Banner Health)

Banner Children’s is a leading pediatric hospital system in Arizona, specializing in care for infants, children and adolescents. Known for its pediatric emergency services, neonatal intensive care (NICU) and specialty programs in areas like pediatric cardiology and orthopedics, Banner Children’s is a trusted option for families across the Phoenix metro area. Because pediatric care often requires ongoing specialist visits, it’s especially important to verify that your child’s doctors and facilities are in-network when choosing a plan. The following are ACA Marketplace and private health insurance plans accepted by Banner Children’s.

ACA Marketplace Plans

Ambetter
BCBSAZ ACA Health Choice
BCBSAZ Maricopa Focus
Imperial
Oscar
UHC

Private Insurance Plans

BCBS of NE
UHC Choice Plus PPO
Cigna or Aetna’s PPO network
Private Healthcare Systems (PHCS) and MultiPlan PPO network

Common plans used for Banner Children’s:

ACA Marketplace plans like Ambetter, Imperial and Oscar, along with private PPO options depending on provider preferences.

��Carondelet Health Network

The Carondelet Health Network is located in southern Arizona and provides high-quality 24/7 emergency care. The Carondelet Health Network accepts the following ACA Marketplace and private health insurance plans.

ACA Marketplace Plans

Ambetter
Antidote
BCBSAZ ACA Health Choice
BCBSAZ Pima Focus
Imperial
Oscar
UHC

Private Insurance Plans

BCBS of NE
UHC Choice Plus PPO
Cigna or Aetna’s PPO network
Private Healthcare Systems (PHCS) and MultiPlan PPO network

Common plans used for Carondelet:

ACA Marketplace plans like Ambetter and BCBS, along with private PPO options depending on provider preferences.

��Dignity Health Medical Group Arizona

Dignity Health Medical Group Arizona specializes in areas including bariatrics, orthopedics and cardiology. Dignity Health Medical Group Arizona accepts the following ACA Marketplace and private health insurance plans.

ACA Marketplace Plans

Cigna

Private Insurance Plans

BCBS of NE
UHC Choice Plus PPO
Cigna or Aetna’s PPO network
Private Healthcare Systems (PHCS) and MultiPlan PPO network

Common plans used for HonorHealth:

ACA Marketplace plans through Cigna, along with private PPO options depending on provider preferences.

��HonorHealth

HonorHealth is a top-rated health system in the Scottsdale and North Phoenix region, frequently recognized for its excellence in orthopedic surgery, cancer treatment and cardiovascular care. With 6 hospitals and more than 2,000 doctors, it's a popular choice for local families. HonorHealth accepts the following marketplace and private health insurance plans.

ACA Marketplace Plans

Ambetter
Cigna Connect Individual and Family plans
All HonorHealth hospitals, facilities urgent care locations and HonorHealth Medical Group specialists participate
HonorHealth primary care physicians (PCPs) don’t participate
Oscar

Private Plans

BCBS of NE
UHC Choice Plus PPO Network
Cigna or Aetna’s PPO network
Private Healthcare Systems (PHCS) and MultiPlan PPO network

Common plans used for HonorHealth:

ACA Marketplace plans like Ambetter and Oscar, along with private PPO options depending on provider preferences.

�� Mayo Clinic Arizona

Mayo Clinic in Phoenix is consistently ranked as the #1 hospital in Arizona and among the top in the nation by U.S. News & World Report . Known for handling complex cases, it offers cutting-edge treatments backed by research.

Mayo Clinic does not accept any ACA Marketplace plans. The key to getting admitted into Mayo Clinic to see a specialist is to have a private healthcare plan, such as UHC Choice Plus or Aetna Open Choice. While these plans may be more expensive compared to an ACA plan, they can help you see the most highly regarded doctors in Arizona when you need to. If you’re relatively healthy, you can save more on private plans.

It’s important to review plan details carefully, as access to Mayo Clinic can vary depending on the specific PPO network. Mayo Clinic is very selective with the plans it accepts, so it’s important to verify eligibility before enrolling in a private PPO.

BCBS of NE
Cigna or Aetna’s PPO network
UHC Choice Plus PPO Network

Common plans used for Mayo Clinic access:

Private PPO plans such as UHC Choice Plus, Aetna Open Choice, and select BCBS PPO options.

��Northern Arizona Healthcare

Northern Arizona Healthcare providers include Flagstaff Medical Center (FMC), Verde Valley Medical Center (VVMC), Northern Arizona Healthcare Orthopedic Surgery Center (NAHOSC) and Northern Arizona Healthcare Medical Group (NAHMG). Northern Arizona Healthcare accepts the following ACA Marketplace and private health insurance plans.

ACA Marketplace Plans

Ambetter
BCBSAZ

Private Plans

BCBS of NE
Cigna or Aetna’s PPO network
UHC Choice Plus PPO Network
Private Healthcare Systems (PHCS) and MultiPlan PPO network

�� Phoenix Children’s Hospital

Phoenix Children’s Hospital is consistently ranked as one of the best pediatric hospitals in the nation, offering specialized care in fields like pediatric cardiology, oncology and neurology. It’s a top-tier choice for families across Arizona. Phoenix Children’s Hospital accepts the following ACA Marketplace and private healthcare plans.

ACA Marketplace Plans

Antidote
Imperial

Private Insurance Plans

BCBS of NE
UHC Choice Plus PPO
Cigna or Aetna’s PPO network
Private Healthcare Systems (PHCS) and MultiPlan PPO network

Common plans used for Phoenix Children’s:

ACA Marketplace plans like Imperial and Antidote, along with private PPO options depending on provider preferences.

��Summit Healthcare

Summit Healthcare is located in Show Low, Arizona, and has an expert Bone & Joint Center featuring top orthopedic and podiatry specialists. Summit Healthcare accepts the following ACA Marketplace and private health insurance plans.

ACA Marketplace Plans

BCBSAZ Neighborhood Network

Private Insurance Plans

BCBS of NE
UHC Choice Plus PPO
Private Healthcare Systems (PHCS) and MultiPlan PPO network

Common plans used for Summit:

ACA Marketplace plans through BCBS, along with private PPO options depending on provider preferences.

��Tucson Medical Center

Tucson Medical Center is one of the largest and most respected healthcare providers in southern Arizona, serving the Tucson community with a wide range of services including emergency care, cardiology, orthopedics and maternity services. TMC is known for its patient-centered approach and strong regional network of physicians and specialists. For individuals and families in Tucson and surrounding areas, choosing a plan that includes TMC can be an important factor when comparing ACA Marketplace and private health insurance options. The following are ACA Marketplace and private health insurance plans accepted by Tucson Medical Center.

ACA Marketplace Plans

Ambetter
Antidote
BCBSAZ ACA Health Choice
BCBSAZ Pima Focus
Imperial

Private Insurance Plans

BCBS of NE
UHC Choice Plus PPO
Cigna or Aetna’s PPO network
Private Healthcare Systems (PHCS) and MultiPlan PPO network

Common plans used for TMC:

ACA Marketplace plans like Ambetter, BCBS and Oscar, along with private PPO options depending on provider preferences.

��Valleywise Health

Valleywise Health is Phoenix’s public teaching health system, with one of the country’s top burn and trauma centers. Valleywise Health accepts the following marketplace and private health insurance plans.

Ambetter
Antidote
BCBSAZ ACA Health Choice
BCBSAZ Maricopa Focus
UHC

Private Insurance Plans

BCBS of NE
UHC Choice Plus PPO
Cigna or Aetna’s PPO network
Private Healthcare Systems (PHCS) and MultiPlan PPO network

Common plans used for Valleywise:

ACA Marketplace plans like Ambetter, BCBS and UHC, along with private PPO options depending on provider preferences.

Quick Tip: Always Double-Check Your Doctor

Even if a hospital accepts your insurance, not every doctor or specialist within that hospital may be in-network. Always confirm both the facility and the specific provider when choosing a plan — this is one of the most common reasons people end up with unexpected out-of-network costs.

Transition Guide for Switching ACA Marketplace Insurance

Whether you’ve lost ACA Marketplace coverage due to the Banner|Aetna or BCBS Statewide PPO ACA exit, or you’re not satisfied with your current coverage on an ACA plan, here are some things to keep in mind for switching ACA coverage.

Open enrollment is between November 1 through January 15. ACA open enrollment allows you to switch plans, regardless of your health or life situation. Anyone can sign up for a new plan or switch ACA plans during this time.
What if you miss open enrollment? If you missed open enrollment and no longer have ACA health insurance because of the Banner|Aetna or BCBS Statewide PPO exit, you still have options. You can talk with a private insurance broker to get health insurance at any time of year, so you have coverage before the next open enrollment period.
You may qualify for a special enrollment period. Life changes such as moving, divorce, marriage and losing health insurance through work could qualify you to enroll in ACA Marketplace health insurance outside of open enrollment. Talk with an ACA insurance expert to see if you qualify.

The cost of not having health insurance at all is high, because without it, you may have to pay tens of thousands of dollars or more for emergency coverage or a condition such as cancer. Secure insurance right away so you’re protected for whatever may come.

Need Help Choosing an Arizona Health Insurance Plan That Covers Your Hospital?

If you already have a hospital in mind, we can help you quickly identify which plans give you access — and which ones to avoid.

At AZ Health Insurance Brokers, we help you:

Match your insurance plan to your preferred hospital and doctors
Compare ACA Marketplace and private PPO options side-by-side
Understand your true total costs (not just monthly premiums)
Check eligibility for subsidies or cost-saving options

Whether you’re looking for individual coverage, family coverage or group health insurance for your Arizona business, we’ll guide you to the best fit.

�� Call us at 602.617.4107, email quotes@azhealthinsurancebrokers.com , or contact us online . We’re here to help you get the coverage you need, with access to the hospitals you trust.

Arizona Hospitals & Insurance Coverage FAQs

Written by: Nicki Escudero

Nicki is a specialized healthcare content creator focused on navigating the evolving Arizona insurance landscape. She works closely with licensed brokers to translate complex 2026 ACA and private market trends. Her work ensures that Arizona residents understand how to keep their preferred hospital systems, like Mayo Clinic and HonorHealth, in-network.

Reviewed by: Ethan J. Pickner, Licensed Arizona Health Insurance Broker

Ethan is the founder of AZ Health Insurance Brokers and has been a licensed health insurance expert for nearly 12 years. He specializes in helping self-employed individuals and business owners navigate the complexities of the Arizona market to find high-value, cost-effective coverage. Since 2014, Ethan has helped thousands of Arizona residents seamlessly navigate major plan transitions and life events, ensuring they maintain access to top-tier facilities like Mayo Clinic and Phoenix Children’s Hospital while securing the best possible rates in Maricopa County and throughout the state.

Turning 26 and Losing Health Insurance in Arizona? Here’s What to Do (2026 Guide)

Wed, 25 Mar 2026 20:27:12 GMT

Turning 26 in Arizona creates a 60-day Special Enrollment Period to secure new health insurance. Whether you qualify for ACA subsidies or need a private PPO plan to keep your preferred doctors, this 2026 guide explains your best options in Arizona.

Adulthood presents many milestones. You get to vote, you’re able to legally drink alcohol, and you can start building your credit score. Unfortunately, as we reach our mid-20s, that also means you’re no longer able to stay on your parents’ family health insurance plan.

Current federal law only allows for young adults to remain on their parents’ health insurance policy until the age of 26. The good news is, even if you experience major life events like getting married or having a child, you can still remain on the plan until you turn 26.

Once you turn 26 years old, you’ll need to purchase your own individual health insurance or look into other options, like getting group health insurance through work.

Don’t stress if you’re nearing that milestone age. This guide for how to get health insurance in Arizona explains what you need to know.

Key Takeaways

Generally, you’re able to stay on your parent’s or parents’ health insurance plan until the end of the month in which you turn age 26. You’ll then have a special enrollment period that qualifies as a life event that provides up to 60 days for enrolling in an employer plan or a private individual health insurance plan or an individual plan through the Affordable Care Act Marketplace.
If you qualify for discounts based on income, an ACA Marketplace plan may make the most financial sense for an individual plan. If you don’t qualify for discounts based on income, and your employer doesn’t offer health insurance, or employer health insurance doesn’t provide coverage for your preferred providers, you may want to choose a private individual health insurance plan.
Shopping for health insurance for the first time can be confusing. Make sure you’re making the right choice. AZ Health Insurance Brokers provides free guidance to present you with all your options, based on your budget and your health insurance needs.

1. Understand Why You Need Health Insurance as an Adult

If you’re losing healthcare coverage under your parents’ plan, you may be wondering what the point in getting a new health insurance plan would be. Maybe you’re rarely sick. You may have never experienced a major illness or accident that required a hospital stay.

There’s no penalty for not getting health insurance in the U.S. But if you lose coverage and don’t secure it, you could run into bigger issues in the future.

Why does health insurance matter if you’re healthy?

Health Insurance Helps You Avoid Debt

Many people don’t realize the true cost of healthcare without health insurance in the U.S. For example, Healthcare.gov reports the average cost of a 3-day hospital stay is around $30,000. Comprehensive cancer care can reach up to hundreds of thousands of dollars. According to KFF , those without health insurance pay at least 40% of healthcare out-of-pocket, and hospitals charge higher rates for uninsured patients.

High medical bills can lead to debt quickly. In 2025, Debt.org reported medical bills were the top reason people declared bankruptcy. If you don’t get health insurance coverage , you could be putting yourself at risk for serious future financial challenges.

Health Insurance Helps You Maintain Optimal Health

Unfortunately, people who don’t have health insurance aren’t as likely to get medical care when they should. According to KFF , uninsured adults are far more likely than those with health insurance to postpone healthcare or to not get it altogether because of cost concerns. Minor health issues that seem minimal could turn into bigger issues if they go undetected and aren’t addressed quickly.

Health insurance gives you the ability to get preventive care, routine health screenings and treatment when you’re sick. In the event you get seriously ill, how quickly you seek medical care can significantly impact the outcome. Health insurance gives you peace of mind you can maintain optimal health and get valuable treatment whenever you need it.

2. Determine When You Lose Health Insurance Coverage as an Adult

AZ Health Insurance Brokers can help you with all your health insurance needs, but first, it’s important to understand what’s required of you, when and why.

If you’re still 25 years old, the first step is to find out exactly when you lose coverage. On some plans, your coverage automatically stops on your 26th birthday. Other plans will extend coverage until the end of your birthday month. Other health insurance plans may even let you stay on your parents’ plan until the end of the tax year. Find out when your health insurance coverage ends.

PRO-TIP: Check your specific policy today—some employer plans cut off exactly on your 26th birthday, leaving you uninsured for the rest of the month if you don't plan ahead. While many plans extend to the end of your birth month, others stop immediately on your 26th birthday. Don't risk a gap in coverage; verify your date now so you can have your new plan ready to start the very next day.

It's best to begin researching your health insurance options before you turn 26 so you can seamlessly continue health insurance coverage. Understand when your coverage ends, then learn about your health insurance options once it does end.

3. Find Options for Health Insurance When You Turn 26 Years Old

You have a few options for securing healthcare coverage when you need it as an adult. These include:

Get Individual Health Insurance

If your employer doesn’t offer healthcare coverage, you can get health insurance through:

An insurance broker or agent
The federal health insurance marketplace, also known as the Affordable Care Act (ACA) exchange

Health Insurance Options After Age 26 (Quick Comparison)

Here’s a simple breakdown of the main options available once you turn 26:

Each option has pros and cons, so the best choice depends on your income, health, and provider preferences. Once you understand your options, the next step is understanding what those plans typically cost.

How Much Does Health Insurance Cost After Age 26 in Arizona?

Health insurance costs can vary depending on income, plan type, and health history. Below are typical monthly cost ranges based on Maricopa County rates (costs may vary slightly in other Arizona counties):

The biggest factor in cost is whether you qualify for ACA subsidies, which are based on income. Many Arizona residents in Phoenix, Scottsdale, Mesa and Tucson compare ACA marketplace plans with private options based on their income, health, and preferred doctors.

Real Examples: What Health Insurance Might Look Like at Age 26

The right plan depends heavily on your income, health, and goals. Here are a few real-world scenarios to illustrate how options can vary:

Example 1: Lower income with subsidy eligibility
A 26-year-old in Arizona earning around $25,000 per year may qualify for a significant ACA subsidy — sometimes reducing their monthly premium by around $250–$300. In many cases, this makes a marketplace plan the most affordable option.

Example 2: Higher income, healthy individual

A healthy 26-year-old earning around $100,000 per year typically won’t qualify for ACA subsidies. In this situation, private PPO plans often provide better value, with lower monthly premiums and more flexibility when choosing doctors.

Example 3: Ongoing medical condition (e.g., diabetes)
A 26-year-old with a condition like diabetes will often find that ACA marketplace plans are the best fit, since they cover pre-existing conditions and essential medications without medical underwriting.

How to Choose the Right Health Insurance When You Turn 26

When comparing your options, most Arizona residents evaluate a few key factors:

Do you qualify for ACA subsidies?
If your income falls within the eligible range, marketplace plans may be the most affordable option.
Are you healthy or do you have ongoing medical needs?
Marketplace plans are ideal for pre-existing conditions, while private plans can be more cost-effective for healthy individuals.
Do you want to keep your current doctor?
Check provider networks carefully — especially with ACA HMO plans.
Do you take any expensive prescriptions?
Formulary coverage varies significantly between plans.
Do you want the lowest monthly premium or predictable costs?
Lower premiums often mean higher deductibles and out-of-pocket costs.

If you’re turning 26 and unsure which option makes the most sense, we can help you compare plans side-by-side at no cost.

Buying individual health insurance through a broker or agent

A reputable health insurance broker can guide you through the entire process of getting affordable health insurance that meets your healthcare needs. It doesn’t cost anything to work with a broker. They’re paid commissions from health insurance companies, so they don’t charge clients for their services. This means, you can have a health insurance expert manage most of the comparison shopping for you, at no extra cost to you.

Buying individual health insurance through the ACA marketplace

The Health Insurance Marketplace , also known as the “exchange”, is a service that helps people shop for and enroll in health insurance. Some states run their own marketplaces, but Arizona health insurance uses the federal marketplace.

You can use the exchange to compare plans and prices on individual health insurance plans. You’ll also provide income and household information that may qualify you for tax credits and other savings that make insurance more affordable.

If you buy health insurance through the ACA exchange , you typically have a 60-day window before and after losing coverage to enroll in a new plan, so it’s important to start reviewing your options early.

Private Health Insurance vs. the ACA marketplace: Which Is Better?

Both private health insurance brokers and the ACA marketplace may provide good health insurance plans for a variety of budgets.

Consider using a qualified Arizona health insurance agent or broker if you:

Want personal attention and guidance: An individual health insurance agent or broker will do most of the work of signing up for insurance for you. They make it easy to compare your options. Once you’ve selected a plan, they can help you get coverage right away.
Don’t qualify for a government subsidy: If you don’t qualify for discounts for federal insurance, you could find better and more affordable plans through an insurance agency.
Want to keep your doctor, but they’re not covered by an ACA health insurance plan: An individual health insurance agent can help you find a plan you can afford that’s accepted by your doctor of choice.

Consider using the ACA marketplace if you:

Qualify for a government subsidy: If you make between 100% and 400% of the federal poverty level income, health insurance could be cheaper for you if you go through the federal exchange.
Don’t care which doctor you see: Many ACA plans come with a narrow in-network list of doctors. If that’s fine with you, a plan through the ACA exchange may work for you.

Enroll in Your Employer’s Group Health Insurance Plan

Typically, you can only enroll in an employer’s group health insurance plan during what’s known as “ open enrollment ”, which is a special time period where you can sign up for a new healthcare plan or change your current health insurance plan . Losing health insurance coverage when you turn 26 years old is a qualifying event that gives you access to a special enrollment period, meaning you can sign up for health insurance during this time, even if it’s outside of open enrollment . Employment-based plans must provide you with a special enrollment period of at least 30 days after you lose coverage because you turned 26 years old.

If your employer offers health insurance, talk to your human resources representative about their offerings. They can give you the information you need to research their plans and costs, and help you sign up. If you don’t enroll in a plan during the special enrollment period, you’ll have to wait until the next open enrollment period begins.

Important to note: Some employers cover their employees generously when it comes to employer health insurance , and some put more of the financial responsibility on you. Just because your employer offers health insurance, doesn’t mean you have to sign up for it. You may get a better deal by buying your own private plan. Compare your out-of-pocket costs with insurance from an employer to buying your own private insurance. See which has better coverage and costs for your comfort.

Get Help From AZ Health Insurance Brokers

Health insurance is an essential part of a healthy lifestyle, but figuring out the details can be stressful. If you’re about to lose health insurance because you’re turning 26, or you already have lost your health insurance coverage, contact AZ Health Insurance Brokers. We can answer any questions you have, explain your health insurance coverage options and provide you with a free quote.

Call us at 602.617.4107, contact us online or email quotes@azhealthinsurancebrokers.com for information.

Health Insurance After Age 26: FAQs

Written by: Nicki Escudero

Reviewed by: Ethan J Pickner, Licensed Arizona Health Insurance Broker

Ethan is the founder of AZ Health Insurance Brokers and has been a licensed health insurance expert for nearly 12 years. He specializes in helping self-employed individuals and business owners navigate the complexities of the Arizona market to find high-value, cost-effective coverage. Since 2014, Ethan has helped hundreds of young professionals seamlessly navigate the "Age 26" transition, ensuring they avoid costly gaps in coverage while securing the best possible rates in Maricopa County and throughout Arizona.

2026 Arizona Employer Health Insurance Trends

Tue, 24 Mar 2026 19:57:09 GMT

In 2026, many Arizona employers are seeing double-digit premium increases, shifting plan structures, and more pressure to balance cost control with employee satisfaction. Understanding these trends early can help businesses avoid costly renewal mistakes and make smarter long-term decisions.

For business owners in Arizona, it’s helpful to monitor trends regarding health insurance every year, so you can make relevant changes and know what matters most to your employees. Since health insurance continues to be a top tool for recruitment and retention for employees in 2026, it’s important to offer an attractive plan that also fits your budget.

In Arizona, we’re seeing developments in everything from premium amounts, to the types of plans many large employers are choosing. Read on for this guide to Arizona business health insurance for business owners.

Key Takeaways

In 2026, employers (and employees, if applicable) are experiencing premium increases compared to 2025. Some employers are passing on those costs to employees, while others are increasing health insurance budgets to accommodate rising costs without sacrificing health insurance coverage for workers.
Fully insured plans remain strong among business health insurance plan choices for Arizona employers. Level funded insurance plans are also increasingly popular, while self-funded plans tend to be less popular for large employers.
Employers can work with a health insurance broker to avoid common pitfalls when choosing health plans in 2026 and beyond. The biggest mistakes Arizona employers make with health insurance plan selection include renewing without reevaluating, choosing the cheapest premium, and ignoring employee usage patterns.

Top Trends for Arizona Business Health Insurance in 2026

This year has seen some significant changes in health insurance costs, plans and employer deployment in Arizona. Arizona employers in Phoenix, Scottsdale, Mesa, Chandler and Tucson are all experiencing similar trends in rising costs and shifting plan structures. Here’s what to be aware of.

Business Cost Trends for Health Insurance in 2026

In 2026, the state of Arizona’s health insurance premiums increased an average of 29%, which is the 12th-largest rate increase in the country, according to AZ Big Media . As premiums are increasing, employers have to decide whether to take on the extra costs and factor those into business budgeting, or pass on higher premium costs to employees and keep employer contributions the same.

Blue Cross Blue Shield of Arizona (BCBS of AZ) continues to have a dominant presence in the state’s employer health insurance plans. The brand has around a 58% commercial health insurance market share in the state.

To help employers with rising costs, AZ Blue plans to remove 10% in administrative costs and provide comprehensive healthcare coverage that helps prevent higher costs, like emergency room visits, specialist visits and hospital admissions.

Aetna is currently making a major push to gain market share in Arizona, particularly for groups sized 20 to 250 employees. While BCBS of AZ remains highly competitive in the 51+ fully insured market, our internal data shows that Aetna is often more competitive in the 20–250 space, frequently offering lower rates than the legacy carriers.

For businesses in this mid-size range, simply renewing with a dominant carrier without checking Aetna's current aggressive pricing could result in overpaying for coverage.

To lower premium costs overall, many Arizona employers are raising deductible costs for employees. This puts more of the financial responsibility on employees over time, while keeping immediate premium costs low, so employers can both manage budgets and retain coverage options.

How to Combat the 29% Arizona Premium Increase in 2026

With Arizona facing the 12th-largest rate increase in the country, business owners must be proactive to protect their bottom line. Here are the three most effective strategies to offset these rising costs:

Request a Level-Funded Quote: If your workforce is relatively healthy, level-funded plans can offer significant savings compared to traditional fully insured plans.

Audit Your Pharmacy Spend: High-cost prescriptions are a major driver of the 29% increase. Identifying plans with more efficient formularies can lower total group costs without reducing coverage.

Start the Comparison Process at Day 90: Waiting until 30 days before renewal limits your leverage. Since rates are typically released 60 to 90 days out, starting early allows you to shop the entire Arizona market, including carriers like Aetna, BCBSAZ, UnitedHealthcare, and Cigna.

Business Health Insurance Plan Type Trends in AZ in 2026

In 2026, we continue to see fully insured plans be the most popular choice, especially for large employers. However, as employers learn more about level funded plans , many small to mid-size businesses are choosing these options with guidance from a health insurance broker to keep health insurance costs low for businesses, while offering employees coverage they need.

As health insurance costs rise, level funded plans can provide potential savings for businesses with relatively healthy workforces. Employers pay a fixed cost for healthcare coverage every month, as well as pay into an stop-loss insurance account to protect against claims that exceed the amount paid for. Level funded plans can help businesses save money, as they continue to offer healthcare coverage.

Fully self-funded plans can work for certain large employers, but they come with higher financial risk and administrative complexity. Many Arizona businesses instead explore level-funded options as a more balanced approach. With fully self-funded plans, employers pay all claims and, thus, have higher risk with unlimited liability. Level funded plans are a type of partially self-funded plan, with the added benefit of stop-loss insurance to cover catastrophic and high-cost claims.

2026 Arizona Employer Health Insurance Trends (Quick Summary)

The trends above can feel overwhelming, so here’s a simple breakdown of what Arizona employers are seeing and what it means when evaluating your options.

Understanding these trends is important, but how you respond to them matters even more. Below are the most common mistakes Arizona employers make when choosing a health plan.

Biggest Employer Health Insurance Mistakes in 2026

To avoid high costs and to keep employees satisfied, it’s helpful to keep business health insurance best practices in mind. At AZ Health Insurance Brokers , we help businesses navigate pitfalls like the following.

1. Renewing group health insurance without re-evaluating

Your business health insurance needs may change every year, due to a variety of factors. These include the size of your workforce, your revenue and health insurance budget, changing health insurance market factors, and the health of your workforce. You will usually get 2 to 3 months of notice of the rates to expect before your health insurance renewal. Keep your renewal date in mind, so you can do due diligence on changes in your workforce and in the health insurance market to compare your best options.

2. Choosing the cheapest group health insurance premium

It may seem like choosing the least expensive health insurance premium makes sense, especially if you want to keep costs at their lowest while still offering some type of health insurance. But keep in mind how important good health insurance is to today’s employees. The risks of putting the brunt of healthcare costs on your workers could backfire and result in retention issues and recruiting challenges for your business.

The key is to find the most cost-effective option that provides the best value. A slightly higher premium, especially from a different carrier than you previously considered, may provide vastly improved benefits. Again, an Arizona group health insurance broker can walk you through all your options.

3. Ignoring employee usage patterns

An important factor to evaluate come renewal time is how employees are using the health insurance coverage you’ve offered in the past year. You may discover that your workforce is healthier than you realized and experiences lower usage. A level funded plan may help you save money, for example.

If you’re on a self-funded or level funded plan and see that employee usage is costing you more than what you could save on a fully insured plan, it may also be time to switch. An experienced group health insurance broker can help you evaluate employee usage patterns and how they relate to the type of health insurance you should select.

4. Not evaluating pharmacy costs

Pharmacy costs are a big factor in overall healthcare costs for employees. Looking at employee usage patterns, employers can see pharmacy trends and line those up with expenses on various plans. This is another area where it’s helpful to have a broker’s guidance, to ensure workers can get the medications they need at an affordable price, as well as to ensure an employer isn’t overpaying for a plan based on pharmacy costs and usage.

5. Not comparing level funded options

For employers that have never considered level funded options, now’s the time to add these plans into a group of choices to compare. As we’ve mentioned, employee usage patterns may indicate that level funded options could save a business money, especially with healthy workforces.

Within level funded options, there’s also a lot to compare. A group health insurance broker will do the research for you to show you the best plans to consider.

6. Not planning for workforce growth

If your business is likely to grow at all in the next year, that could drastically impact your group health insurance costs on the wrong plan. A broker will take your overall business forecasting into account, to ensure you have a plan that scales with your business over the next year, for whatever growth you anticipate.

How Employers Should Evaluate Their 2026 Health Plan

When we help employers choose a business health plan, the following are the factors we evaluate. You’ll notice that not all are health insurance-related. We take a holistic look at your business operations, to find a plan that meets your budget and your goals.

Real Example: Arizona Employer Savings

A 98-life Arizona employer we worked with moved from a UnitedHealthcare level-funded plan to an Aetna AFA level-funded option in late 2025, resulting in approximately $156,000 in total annual savings — while maintaining comparable provider access for employees.

The following are the key factors we evaluate:

1. Workforce size and demographics

The size of your workforce, and demographics like age and lifestyle, will influence the best health insurance plan at the best price. This includes if you plan to expand your business over the next year.

2. Budget tolerance

Your healthcare budget will dictate the limits of what plans to include for comparison. While fully insured plans will offer predictable costs, budget tolerance for self-funded plans becomes more complicated. We discuss what your capabilities are now and how they may change based on anticipated business growth, to align plan choices that fit your budget.

3. Provider needs

Surveying employees on which providers and hospital networks they prefer can also help provide important insights regarding provider needs to find appropriate group health insurance coverage. It can be frustrating to have a plan that doesn’t cover your preferred doctors, so knowing this type of information is helpful for assisting employers in selecting the best plan.

4. Prescription usage

Similarly, prescription coverage matters for employees who use medication. That’s another vital factor we evaluate to find plans that may work for a business.

5. Recruitment goals

Finally, for employers that want to grow their workforces over the next year, we help businesses understand how various health insurance plans will impact those recruitment goals. We use data from working with businesses throughout Arizona to help each new client understand the best plans for recruitment and how others may impact those objectives.

When to Start Planning 2026 Employer Coverage

As mentioned, renewal rates for group health insurance are typically released 60 to 90 days before renewal. As soon as these are released, you should contact an Arizona health insurance broker to start shopping and comparing plans. Because you have a limited amount of time to evaluate your options, it’s important to get started right away. If your group health insurance renewal is approaching, now is the time to compare your options. We help Arizona employers evaluate fully insured, level-funded and alternative strategies side-by-side, so you can reduce expenses while improving employee coverage and long-term cost predictability.

How AZ Health Insurance Brokers Helps Employers Reduce Costs

AZ Health Insurance Brokers provides free assistance to employers who are looking to renew a health insurance plan or choose a new one. Because we get paid by the health insurance company the employer chooses, you don’t have to worry about paying additional fees to find the right group health insurance.

Additionally, a major benefit of working with Arizona Health Insurance Brokers for group health insurance is that you get a personalized experience with an expert agent. We’re here to answer any questions you have, any time. The customer service is far and beyond what you might experience with a third party or health insurance carrier customer service option.

As experts in Arizona group health insurance, we draw on a wealth of knowledge and expertise to help each unique client. We can provide the best options based on your budget, workforce and business goals. We can help you enhance your offering among similar businesses in your industry in Arizona.

If your renewal time for group health insurance is approaching, contact AZ Health Insurance Brokers today. We’ll quickly help you research the best options for your evolving workforce, to save you money and keep your employees satisfied. Contact us online , email info@azhealthinsurancebrokers.com , or call 602.617.4107 to speak with our friendly team.

Arizona 2026 Group Health Insurance FAQs

Written by: Nicki Escudero

Reviewed by: Ethan J Pickner, Licensed Arizona Health Insurance Broker

Also reviewed by: Ryan Calloway, Group Health Insurance Specialist

Ryan brings 8 years of specialized licensing experience to the team, focusing exclusively on group health insurance. He has managed benefits portfolios for Arizona businesses ranging from 15 to 1,000 employees, helping them implement level-funded and fully insured strategies that balance cost-control with employee retention.

Best Family Health Insurance Plans in Arizona (2026 Guide for Families & Maternity Coverage)

Wed, 18 Mar 2026 16:15:56 GMT

This guide is based on real client scenarios and plan comparisons from Arizona families we’ve helped across Phoenix, Scottsdale, Mesa and surrounding areas.

Arizona families in 2026 can choose between ACA Marketplace plans with subsidies or private PPO options for broader doctor access. Whether you are planning for maternity or looking for the best network for Phoenix Children's Hospital, this guide simplifies your 2026 Arizona health insurance options.

For people with families or for those who want to start their own, healthcare is often a top priority. Pregnancy and childbirth require additional healthcare considerations, so both mother and newborn get the care they need before and after birth.

If you’re wondering what the best family and maternity health insurance is in Arizona, this guide explains what to consider to get family health insurance that protects your family.

Family Health Insurance in Arizona

Arizona families have several health insurance options depending on their income, employment situation and healthcare needs. Many families in Phoenix, Scottsdale, Mesa, Chandler and Tucson compare Affordable Care Act Marketplace plans with private PPO health insurance options to find the right balance between monthly premiums, provider access and out-of-pocket costs.

Key Takeaways

There’s a wide variety of Arizona family health insurance plans available, including for families with pregnancy needs. Some of the top Arizona maternity and family health insurers include Ambetter, Blue Cross Blue Shield, Imperial Health, Cigna, Oscar and UnitedHealthcare.
When you’re getting a family health insurance plan, some of the top considerations include: how much you’re able to pay each month toward a premium, how much you’re willing to pay out of pocket toward a deductible and out-of-pocket maximum, who your preferred providers are, whether or not your family members have specific prescriptions they need covered, and what type of healthcare needs your family members have.
If you or your spouse becomes pregnant, maternity care and newborn care may also factor into your family health insurance needs. Contact an Arizona health insurance broker to navigate your options and secure the right coverage.

Best Family Health Insurance Options in Arizona

There are several ways to secure a health insurance plan for your family. Even if you’re not offered one through your or your spouse’s employer, you have other options to get coverage now and for future family additions.

Affordable Care Act (ACA) health insurance: The Affordable Care Act (ACA) Marketplace is the federal government’s offering of health insurance to individuals and families. Individuals and families can only typically sign up for an ACA plan during open enrollment, which is typically November 1 through January 15 every year. However, there are special qualifying events, including having a baby, that enable you to enroll in an ACA plan during a special enrollment period. A benefit of ACA plans is that you can shop the ACA Marketplace to find the exact plan you want, rather than being restricted to a single plan your employer offers. However, the most affordable ACA plans tend to be health maintenance organizations (HMOs), which will limit what healthcare providers you can see under the plan and which generally require referrals from a primary care physician (PCP) in order to see a specialist. If you prefer a preferred provider organization (PPO) plan with broader provider access, many families explore private health insurance options outside the ACA Marketplace.
Private health insurance: Private family health insurance offers lots of benefits for families who want to customize their health insurance plans. You can work with a health insurance broker for free, who will present plan options based on exactly what you’re looking for and your budget. You can sign up at any time of year and match your plan to your preferred providers, prescriptions and other healthcare needs.
Employer health insurance: Your and/or your spouse’s employer might offer group health insurance coverage . Some employers cover the full health insurance premium, while others will share expenses with employees. Employer health insurance can be a convenient option, but there are also some considerations. You’ll want to make sure your preferred providers are covered under an employer plan, or else you’ll have to pay out-of-pocket for those expenses. In some cases, you may be able to get more value for less money by opting for a government health insurance plan or a private health insurance plan.

The good news is, you always have an option to get health insurance whenever you need it, even outside of open enrollment dates for plans like ACA Marketplace offerings. If you need family health insurance outside of ACA open enrollment, and you don’t get health insurance through work, contact AZ Health Insurance Brokers for other family health insurance options.

Key Features to Look for in Family Health Insurance

Your family’s health is important, so it’s helpful to try to compare health insurance options considering the following factors.

Network adequacy: You may have preferred pediatricians, family practitioners and specialists you like to see or want your family to be able to see under your insurance plan. Look at potential networks for what doctors are covered. Generally, a PPO provides more flexibility for provider choice than an HMO.
Prescription drug coverage: If members of your family currently have prescriptions, that should be another consideration. You’ll especially want insurance coverage for expensive medications, so check that an insurer covers the prescriptions you need.
Preventive care benefits: Do you want health insurance coverage for well-child visits, immunizations and screenings? If you do, as you compare insurers, look for providers that cover these services.
Maternity and newborn care: Some health insurers offer comprehensive benefits for soon-to-be and new moms, such as medical device coverage for breast pumps. If you’re seeking family healthcare coverage specifically for pregnancy coverage and growing a family, learn about this type of coverage as you compare plans.
Emergency services and hospitalization: Generally, health insurance plans with lower deductible and out-of-pocket maximums will absorb costs for emergency services and hospitalization better than plans with higher deductibles and out-of-pocket maximums. Keep in mind, if you’d rather pay less each month in premiums, you may pay more for emergency services.
Mental health services: According to the CDC , mental health is closely related to physical health. For example, depression increases risk of conditions including stroke, heart disease and diabetes. Some health insurance plans will offer coverage for services like counseling. Look for mental health coverage if you’re interested in it.
Dental and vision coverage options: Like mental health, dental health is also linked to overall health. Low-cost dental health plans typically cover routine annual cleanings and services. You may also be interested in vision coverage if anyone in your family needs glasses/and or prescription lenses, or you want the option to get annual eye exams for your family members covered by insurance.

Insuring a family means you’ll want to evaluate the health needs of those in your family, from a pregnant mom to a growing child. Your healthcare needs could change periodically depending on the developing health needs of your family members, so keep these factors in mind for what to look for in family and maternity health insurance.

Cost Considerations for Family Health Insurance

Adding new members to your family can also mean changes to your health insurance costs. Ideally, you want to keep costs low while also getting the exact healthcare coverage you need. The following are some family health insurance cost factors to consider.

Premium costs versus estimated out-of-pocket expenses: Health insurance plans typically require a monthly payment, also called a health insurance premium. How much you pay in a premium will impact your out-of-pocket expenses. Generally, the higher you pay in a premium, the less you’ll pay in out-of-pocket expenses when you actually get treatment. If you pay a lower monthly premium, that can save you money if your family stays relatively healthy, but you may pay more out-of-pocket when you seek treatment.
Deductible structures for family coverage: A deductible in health insurance is the amount of money that’s paid before healthcare coinsurance activates, meaning the insurance company covers most or all of the costs of treatment. With family health insurance plans, typically the entire family shares one deductible. That means, for every family member that receives treatment, however much is paid for that treatment goes toward the one deductible. In some cases, such as in some HMO plans, a family plan may have separate deductibles for each family member, or no deductible whatsoever. The deductible structure can be a factor worth comparing when you’re considering plans.
Family out-of-pocket maximums: An out-of-pocket maximum is the limit you’ll have to pay for covered services before a family health insurance plan covers all of the covered service expenses. Similar to deductible structures, some plans will apply out-of-pocket maximum terms once a total out-of-pocket maximum has been reached via contributions from various individual family member health expenses. For other plans, all members may be covered once a certain number of family members (two family members, for example) reach their individual maximum out-of-pocket. Ask providers you’re considering for these details to compare.
Cost-sharing subsidies and tax credits for families: Families who enroll in health insurance through the ACA Marketplace may be eligible for cost-sharing subsidies and tax credits. The premium tax credit lowers monthly payments for insurance coverage for families who qualify. There are also cost-sharing reductions (CSR) , which lower deductibles and other out-of-pocket costs. If your family is eligible for these, you can lower your overall health insurance costs.
HSA-compatible or not: Families can also choose to manage their healthcare by opening a high deductible health plan (HDHP) in conjunction with a health savings account (HSA) , on their own or through an employer health insurance plan. HSA plans are like a savings account, where families can save money on a pre-tax basis for payments toward qualified medical expenses. Under tax law, HSA-compatible plans must have a minimum deductible and a maximum out-of-pocket cost set for both individuals and families.

To navigate all these maternity and family plan options, it’s helpful to talk with a family health insurance broker who will use your budget and your ideal healthcare coverage to present you with a selection of relevant health insurance plans.

How AZ Health Insurance Brokers Helps Families Choose the Right Health Plan

When helping Arizona families compare health insurance plans, we typically narrow down the best options using a step-by-step process. Each factor helps determine whether Marketplace coverage or private health insurance may be the better fit.

1. Estimated Household Income

Estimated income helps determine whether Affordable Care Act (ACA) Marketplace plans may be the best option. Families who qualify for premium tax credits or cost-sharing reductions may significantly lower their monthly premiums and out-of-pocket costs through Marketplace coverage.

2. Health History and Pre-Existing Conditions

Health status can influence which types of plans are available. Families with pre-existing conditions or expensive ongoing medical needs typically benefit from ACA Marketplace plans, which guarantee coverage regardless of health history. Healthier families may have the flexibility to compare both Marketplace plans and private health insurance options.

3. Preferred Doctors and Hospital Networks

Many families want to keep their existing pediatricians, specialists or hospitals. Comparing provider networks helps determine which insurance plans include those providers in-network. In Arizona, families often check whether plans include hospitals such as Banner Health, HonorHealth or Phoenix Children’s Hospital.

4. Expected Healthcare Usage

Upcoming medical needs can significantly influence which plan makes the most sense. For example, families expecting a baby or planning a surgery may choose plans with lower deductibles or out-of-pocket maximums, while healthier families who rarely visit doctors may prioritize lower monthly premiums.

5. Prescription Drug Coverage

If anyone in the household takes ongoing medications, it’s important to verify that those prescriptions are covered under the plan’s formulary and that the copay or coinsurance amounts are affordable.

6. Total Annual Cost Comparison

Finally, families often compare the total potential annual cost of different plans. This includes both the yearly cost of premiums and the maximum out-of-pocket exposure. Looking at the full financial picture helps families understand their potential liability if significant healthcare expenses arise during the year.

After families review the factors above, it becomes easier to narrow the options down to the plans that best match their needs. The table below summarizes the key factors we typically review when helping Arizona families compare health insurance plans.

Once these factors are evaluated, families can narrow the choices down to the health insurance carriers that provide the best balance of cost, provider access and coverage.

Top Health Insurance Providers for Arizona Families: Pros & Trade-Offs

In Arizona, those seeking maternity and family health coverage have lots of provider options. The following are some of the top family and maternity health insurance carriers Arizona families commonly compare.

Ambetter: In terms of popularity for ACA Marketplace plans, Ambetter is the number one Marketplace insurer, with the most people enrolled. One major benefit to Ambetter is that this provider offers state-to-state reciprocity, which means if you need healthcare in a different state, you’ll be covered by doctors who are contracted with Ambetter in that state. While these benefits may be attractive, it’s important to compare costs of plans, as Ambetter plans may be more expensive compared to other carriers.
Imperial Health: Imperial Health is the top ACA Marketplace plan connected to Phoenix Children’s Hospital. This health insurance carrier offers a pregnancy program for expectant mothers, a 24-hour nurse advice line, personal care management and dedicated customer support. It’s important for families to be aware that Imperial health plans are limited to health maintenance organization options, with coverage limited to Arizona, Nevada, Utah and Texas.
UnitedHealthcare (UHC): For private family health insurance plans, UnitedHealthcare (UHC) is the most popular preferred provider organization offered, with their UHC Choice Plus PPO network being accepted at most Arizona facilities. UHC also offers individual dental and vision products for Arizona families.
Blue Cross Blue Shield (BCBS): Blue Cross Blue Shield (BCBS) is another popular health insurance option for Arizona families. It’s the only health insurer in Arizona that provides plans for all 15 counties.
Cigna: Cigna is also popular with Arizona families, with an extensive lab network and contracts with several Arizona healthcare providers. Because Cigna ACA Marketplace plan costs tend to be pricier compared to other carriers, it can be the ideal family insurance choice if you have preferred doctors or prescriptions that are covered by Cigna.
Oscar: Oscar is a popular, cost-effective ACA Marketplace carrier that uses a technology-forward approach. Most of the same doctors covered under Cigna insurance plans are also covered under Oscar, which is contracted with Arizona healthcare providers including HonorHealth, Banner Health and Abrazo Health. Those with Oscar health insurance don’t need a referral from a primary care physician to see a specialist, so that means these plans offer more healthcare provider choice. However, members are limited to in-network providers for covered care, as Oscar is an exclusive provider organization.

We recommend looking at both the financial and healthcare value of a plan, as well as customer satisfaction ratings for family coverage. Each network has its own unique strengths, so it’s important to compare how they’ll benefit your family.

If you have doctors you’re particularly interested in seeing, that’s an important consideration, because you’ll want those providers covered to keep costs lower. Think about how frequently you anticipate doctors’ visits when factoring in expenses.

Need a Family Health Insurance Plan in Arizona? Contact Us

AZ Health Insurance Brokers specializes in maternity and family health insurance plans in Arizona. We help people who are growing their families or who are planning on becoming pregnant to choose the right maternity healthcare coverage so they’re secure on this incredible journey. As your spouse and/or children’s healthcare needs change, we can help you find the right plan that fits your healthcare budget and your desired coverage.

The first step to finding the right family health insurance plan is comparing your options with a licensed Arizona health insurance broker who understands the local market. You can call us at 602.617.4107, email info@azhealthinsurancebrokers.com or contact us online . We’ll be in touch to answer any questions you have.

Family Health Insurance & Maternity Health Insurance FAQs

Turning 65 in Arizona: 2026 Medicare Enrollment Guide (Parts A–D, Medigap & Advantage Explained)

Thu, 19 Feb 2026 03:21:31 GMT

A common question we get at AZ Health Insurance Brokers is:

How do I enroll in Medicare in Arizona when I turn 65?

The Medicare program has a 7-month Initial Enrollment Period (IEP), which starts 3 months prior to when you turn 65 and lasts for 3 months after the month you turn 65 years old. To avoid a penalty, you should plan on enrolling in the Medicare IEP, unless you qualify for automatic enrollment due to a special situation, such as you’re already getting disability benefits from Social Security.

If you’re turning 65 within the next 6–12 months, this is the time to review Medicare options — not after retirement paperwork starts.

In this guide, learn more about the Medicare timeline, how Medicare Parts A-D work in Arizona, Medigap vs. Medicare Advantage comparisons in AZ, and how working with an AZ health insurance broker can help you sign up for Medicare with ease, for free.

Who This Guide Is For

Arizona residents turning 65 soon
Adults retiring or leaving employer coverage
People comparing Medicare Advantage vs Medigap
Spouses helping parents transition to Medicare

Key Takeaways

If you’re nearing the age of 65 years old, it’s time to start thinking about Medicare in AZ. The Medicare Initial Enrollment Period (IEP) lasts for 7 months, typically spanning 3 months prior to when you turn 65 years old to 3 months after the month you turn 65 years old.
If you miss the Medicare IEP, you may have to pay a lifetime monthly late enrollment penalty, which can increase the longer you wait.
You have different Medicare options in AZ. These include Parts A, B, C and D, plus Medigap policies to add on to Original Medicare.

How to Choose Medicare at 65 in Arizona

Turning 65 and enrolling in Medicare isn’t one-size-fits-all. The right path depends on your work status, doctors, prescriptions, and how you prefer to manage healthcare costs.

Most Arizona residents compare Medicare plans based on four factors: provider access, prescription costs, monthly premium comfort, and long-term out-of-pocket predictability. Reviewing these side-by-side before enrolling leads to better plan fit and fewer coverage surprises.

Medicare decisions can vary by city and provider network in Arizona

Phoenix residents turning 65 should compare Medicare Advantage networks that include Banner Health, HonorHealth, and Mayo Clinic providers.
Scottsdale and Mesa Medicare beneficiaries often compare Medigap plans for broader physician access and fewer network restrictions.
Arizona retirees relocating from California or Texas should re-evaluate Medicare plan networks, drug formularies, and provider availability when establishing residency.

Moving to Arizona at retirement?

“If you’re relocating to Arizona after turning 65, your previous Medicare Advantage plan may not transfer. Many retirees switch to a new Arizona-based Medicare Advantage or Medigap plan to maintain provider access and prescription coverage.”

Start with these key questions Arizona residents should walk through before enrolling:

Step 1: Are you still working for a company with 20+ employees?

If yes, you may be able to delay Parts B and D without penalties and stay on your employer coverage.
If no, your Initial Enrollment Period is critical to avoid lifetime penalties.

Step 2: Do you want nationwide provider access?

If keeping access to doctors across the country is important, Original Medicare with a Medigap plan may be the better fit.

If you're comfortable using local provider networks in Arizona, Medicare Advantage plans may offer lower premiums.

Step 3: Do you take expensive prescriptions?

Prescription needs can significantly affect which plan is best.

Comparing Medicare Part D and Medicare Advantage drug formularies is essential before enrolling.

Step 4: Do you prefer lower monthly premiums or predictable total costs?

Lower premiums → Medicare Advantage
Predictable out-of-pocket costs → Medigap + Original Medicare

Step 5: Do your doctors and hospitals accept the plan you're considering?

Provider access varies widely across Arizona.
Always confirm:

Primary doctor
Specialists
Preferred hospitals (Banner, HonorHealth, Mayo, Dignity, etc.)

Step 6: How often do you expect to use healthcare?

Frequent care, chronic conditions → Medigap often provides more stability
Occasional care, budget-focused → Advantage may be more cost-effective

Step 7: Are you planning to travel or split time between states?

Snowbirds and frequent travelers often prefer Original Medicare + Medigap for nationwide coverage flexibility.

“Medicare plan availability, provider networks, and drug formularies vary by county across Arizona, so comparing options locally in Maricopa, Pima, and surrounding counties is important before enrolling.”

Step 8: Do you want extra benefits like dental, vision, and hearing?

Medicare Advantage often bundles these benefits.
Original Medicare requires standalone plans.
Cost vs coverage tradeoffs should be reviewed before enrolling.

7 Medicare Mistakes Arizona Residents Make at 65

Turning 65 is a major transition, and many Arizona residents make avoidable Medicare decisions that can impact coverage, provider access, and long-term costs.

Here are the most common mistakes we see.

1. Missing your Initial Enrollment Period (IEP)

Your first Medicare enrollment window is limited. Missing it can lead to late enrollment penalties and delayed coverage. You may not be able to sign up until the General Enrollment Period (GEP) from January- March 31st.

2. Assuming employer coverage automatically works with Medicare

If you're still working, Medicare coordination depends on employer size and plan design. Many people assume coverage continues seamlessly — but that’s not always the case.

3. Choosing a plan without checking your doctors and hospitals

Provider networks vary widely across Arizona. Always confirm your physicians, specialists, and hospitals are included before enrolling. That way, you can find a plan that includes coverage for your Arizona doctors. Typically, Medicare Advantage plans and/or Medigap plans paired with Original Medicare offer the most provider choice to ensure you’re covered.

4. Ignoring prescription drug coverage

Even if you don’t take medications now, delaying Part D coverage can lead to permanent penalties and higher costs later.

5. Not comparing Medicare Advantage vs. Medigap

Each option works differently:

Advantage: lower premiums, network-based care
Medigap: higher premiums, broader access and predictable costs

Choosing without understanding the trade-offs can lead to frustration later.

6. Waiting until after retirement to review options

Many people assume they’ll “figure it out later.” Planning before retirement gives you more flexibility and avoids rushed decisions.

7. Not working with a local Medicare advisor

Medicare options vary by county, provider networks, and drug formularies. A local broker can help compare plans based on Arizona-specific availability and provider access.

“Most Medicare mistakes aren’t intentional — they happen because the process is confusing. Having a plan review before your 65th birthday can prevent costly coverage gaps and ensure your doctors, medications, and hospitals are covered.”

Call to talk with an Arizona health insurance broker early on to learn about your options and sign up for the right plan, on time. Call 602.617.4017 to talk with an Arizona Medicare broker for free now.

What Is the AZ Medicare Timeline?

The Arizona “Medicare timeline” for signing up for Medicare to avoid penalties is typically between ages 64 and 65 years old. You’ll want to sign up for Medicare during this period to avoid lifetime late penalties.

Penalty costs for not signing up for Medicare in AZ on time are expensive. Most penalties are lifetime penalties (an increase of 10%+), so signing up for Medicare during the IEP is crucial. Keep this timeline in mind.

Potential automatic enrollment: If you’re already getting disability or retirement benefits from Social Security or the Railroad Retirement Board when you turn 65 years old, you’re automatically enrolled in Medicare Part A (Hospital Insurance) and Part B (Medical Insurance).
3 (or 4) months before you turn 65 years old: If you’re still working and need to get benefits, the Medicare IEP begins 3 months before you turn 65 years old. If your birthday is on the 1st of the month, your enrollment period starts 4 months before you turn 65 years old.
The month you turn 65 years old: This is generally the middle month of when your Medicare IEP is.
3 (or 2) months after the month you turn 65 years old: During this time, your window for signing up for Medicare and avoiding penalties is closing. If your birthday was on the 1st of the month, you only have 2 months after the month of your 65th birthday to sign up for Medicare and avoid penalties.

What happens with Arizona Medicare enrollment if you’re still working at 65 years old or older? It’s important to be aware that only employees working at large group employers, which are those with at least 20 employees, can delay Medicare enrollment without a penalty. If you’re working with a small group employer of fewer than 20 employees, you’d need to activate Medicare within the IEP to avoid penalties. If you’re still working for a large employer, you have the option to drop your employer coverage for Medicare, or you could have both Medicare and employer coverage.

If you want to delay Medicare enrollment because you’re still working, you may be eligible for creditable coverage for prescription drugs in Arizona. This type of coverage enables you to avoid having to pay a Medicare Part D late enrollment penalty, as long as you’re enrolled in prescription drug coverage from your employer that pays, on average, at least as much as Medicare prescription drug coverage. If you don’t have creditable coverage and go 63 days or more in a row without Part D Medicare coverage, you may have to pay a lifetime Part D late enrollment penalty.

What Are Medicare Parts A, B, C and D in Arizona?

Medicare is a federal health insurance program for people age 65+ and certain younger individuals with disabilities. Medicare Parts A and B are “Original Medicare,” which include hospital and medical insurance. Medicare Part D provides prescription drug coverage. Medicare Part C, also known as Medicare Advantage, offers an alternative to Original Medicare, with more insurance coverage and low to no cost premiums.

These are the four types of Medicare to consider during the IEP. It’s helpful to compare and shop AZ Medicare options early, so you can be ready to enroll and avoid a penalty. An Arizona health insurance broker can help you compare pricing and coverage in plans such as Part C (Medicare Advantage) versus others with higher premium costs.

Medicare Part A & B: Medicare Part A (Hospital Insurance) offers coverage for inpatient hospital treatment, skilled nursing facility treatment, some at-home healthcare services and hospice care. The costs for Medicare Part A are $0 for most people, which is why it’s also known as “premium-free Part A”. If you miss the IEP, your monthly premium may increase up to 10%. Medicare Part B (Medical Insurance) offers coverage for outpatient care, preventive services, medical supplies and specific doctors’ services. In 2026, the Standard Part B Premium is $202.90 per month. This price may be higher, depending on your income, and the amount can change each year. If you miss the IEP, you’ll pay an extra 10% lifetime penalty for every year you could have signed up for Part B but failed to do so.
Part C (Medicare Advantage): Medicare Part C , also known as a Medicare Advantage Plan, is similar to a private healthcare insurance plan, that’s approved by Medicare. These plans typically include everything that’s included in Part A and Part B, as well as may offer Part D prescription drug coverage and extra coverage for programs like dental, vision, wellness and hearing programs. Arizona has 90+ plan options in 2026, and 100% of AZ residents have access to plans with low or no cost premiums, which can help you save, compared to getting a plan through the government.
Part D: Medicare Part D offers prescription drug coverage. In 2026, Medicare Part D out-of-pocket prescription drug costs cannot exceed $2,100 for the year, due to the Inflation Reduction Act. After someone pays that amount for prescription drugs, Medicare Part D beneficiaries won’t have to pay anything for covered Part D drugs for the rest of the year.

Remember that failing to sign up for Part A, B, C and/or D during the IEP could result in a penalty, should you choose to sign up later. Talk with an AZ health insurance broker early on, months before you turn 65 years old, so you understand your eligibility and how to avoid penalties.

What Is Medigap vs. Medicare Advantage in AZ?

An Arizona Medigap policy pairs with an Original Medicare plan, as long as the policyholder has both Part A and Part B of Original Medicare. A Medigap policy helps cover out-of-pocket medical costs, such as deductibles, coinsurance and copayments. Medicare Advantage replaces Original Medicare and may offer additional benefits, such as vision, dental and hearing.

You can purchase a Medigap plan through a private insurance carrier. Since Medigap and Medicare Advantage plans offer similar benefits, the comparison table below shows key differences.

In Arizona, you have a 6-month “guaranteed issue” window for Medigap when you first turn 65 years old. This means, you can get a Medigap policy in AZ without being denied due to factors like gender, health status or age.

Talk with an Arizona health insurance broker to compare Medigap options versus Medicare Advantage policies in Arizona.

Why Are Brokers Good for Medicare in AZ?

AZ Health Insurance Brokers has helped hundreds of Arizona residents enroll in Medicare and compare Advantage and Medigap options across carriers like UnitedHealthcare, Humana, BCBS, and Aetna. Our guidance is tailored to local provider networks, prescriptions, and long-term cost planning.

Local health insurance brokers based in Arizona, like the ones at AZ Health Insurance Brokers, have a deeper knowledge of local Arizona medical provider networks. There’s no cost to work with an Arizona health insurance broker to get Medicare, because health insurance brokers are paid by the carriers, not by you. That means, it’s completely free to consult with an AZ health insurance broker to compare your Medicare options and select the best plan for you.

With expertise on Arizona networks like Banner Health, HonorHealth, Mayo Clinic and many more, we can help you select a Medicare plan in AZ that providers coverage for the Arizona physicians and networks you’re interested in.

If you’re approaching the age of 65, or you’re already there and need Medicare coverage now, contact AZ Health Insurance Brokers for free Medicare insurance services in AZ. Fill out our form online, email info@azhealthinsurancebrokers.com or call 602.617.4107. We’ll be in touch shortly.

Arizona Medicare FAQs

The Complete 2026 Guide to Buying Group Health Insurance in Arizona

Fri, 06 Feb 2026 21:58:02 GMT

Group health insurance in Arizona is employer-sponsored medical coverage purchased under a single policy that covers eligible employees and, in many cases, their dependents. AZ Health Insurance Brokers works with Arizona construction firms, engineering groups, medical practices, and startups to design compliant group health strategies, manage renewals, and reduce premium volatility.

Year after year, paid health insurance continues to be a top benefit workers want from employers. A report by Forbes found the top benefit employees want from employers is employer-covered healthcare. Employer-covered healthcare is also the top benefit employers say they provide, so it’s likely your top competitors are offering it to stand out to talent.

According to a 2025 report by the United States Census Bureau , around 89% of U.S. employees had health insurance . From our experience at AZ Health Insurance Brokers, that number aligns with what we’re seeing in Arizona. Nearly every mid-size employer we talk to already offers health insurance.

In addition to meeting employee demand, there are many other benefits to providing health insurance for workers , including:

Tax advantages: Companies can deduct their contribution toward their employees’ health insurance premiums as a business expense. This also lowers employee’s taxable income.
Reduced operating costs: A 2025 survey found half of American Millennials and Gen Z (and a fifth of Baby Boomers) would take a pay cut if their employer prioritized their well-being.
Better work outcomes: According to the American Mental Wellness Association , happy employees are 12% to 20% more productive than unhappy employees, which can increase profitability at your company.

Simply offering group health insurance isn’t always simple, though. In 2026, Arizona business health insurance renewal premiums have seen an average increase of 11% to 19%. While solutions like level funded insurance plans make the most sense for “healthy” business groups to escape these increases, it’s important to compare all your options to choose the best group health insurance plan for your business and your employees.

If you’re an Arizona business owner or startup founder interested in keeping employees happy and healthy, this guide explains how to buy commercial health insurance in Arizona . New Paragraph

Key Takeaways

Group health insurance is the most in-demand employee benefit for Arizona businesses in 2026.
Arizona group health insurance premiums are increasing an estimated 11%–19% , largely driven by GLP-1 drug utilization.
Employers have several ways to buy group health insurance in Arizona, including fully insured, level funding, self-funding and partial funding, as well as professional employer organization (PEO) services. With 2026 premium increases averaging up to 19% in Arizona, level funded health plans for businesses can save companies money when employees are relatively healthy.
Working with a licensed Arizona group health insurance broker does not increase employer cost and improves plan design and compliance.

Who Group Health Insurance in Arizona Is Best For (and When to Consider Alternatives)

Best for companies with 2+ W-2 employees
Best for employers wanting predictable benefits
May not be ideal for very small or highly distributed teams
Alternatives include ICHRAs or individual-market strategies

1. What Is Group Health Insurance?

Nearly 58% of non-elderly Americans get their health insurance through their employer , according to the KFF . Most large and midsize companies offer group health insurance to their employees, as do many smaller businesses that are looking to attract and retain top talent.

Group healthcare coverage refers to a single health insurance policy issued to a business that covers all eligible employees and, many times, their partners and dependents. Individual health insurance, contrastingly, is one policy issued to one person or family for health insurance.

One of the most significant differences between the two types of health insurance is how the insurance company calculates risk.

With individual health insurance plans or family health insurance plans , the premium costs are primarily based on the age and medical history of the person or family seeking coverage, although location and tobacco use also play a role.
With group health insurance , the risk is spread over the entire group, using information such as age, gender and prescription history of the employees. The goal of an insurance company is economy to scale, meaning the more the company can spread risk among a larger group of people, the better the rates will be.

Employers can choose to cover the full cost of the group health insurance premium for their employees, or they may require their employers to pay a portion. When you’re trying to determine how much of the premium you’ll cover for your workers, keep in mind the Affordable Care Act (ACA) offers tax credits to eligible small businesses to help offset the cost of health insurance.

2. How to Enroll in Group Health Insurance in Arizona (Step-by-Step)

There are four ways to buy group health insurance in Arizona. They are through:

Fully insured health plans
Level funded health plans
Self-funding and partial funding
Professional employer organizations (PEO)

Note: The first two options on the above list are ideal for 95% of companies (with fewer than 250 full time employees) that want to buy group health insurance, according to commercial health insurance broker Ryan Calloway. Let’s expand on the basics of each option.

#1. What Is Fully Insured Group Health Insurance?

In the fully insured market, insurance carriers don’t price the policy based on the health/pre-existing conditions of your employees. Instead, rates are based on two things: age and county.

Naturally, this makes the premium slightly higher, because anyone who meets the criteria to deploy a group health insurance plan can gain acceptance into the fully insured platform.

“The good thing here is that employers can’t be discriminated against due to the health of employees,” says Calloway. “The rates are what they are, and they’re only based on age and county.”

Who fully insured group health insurance plans are good for: Small groups (2 to 50 eligible employees) and those with pre-existing conditions may benefit from fully insured group health insurance plans .

You should also know: If your group is more than 50 people, you can go the fully insured route, but then you’ll need to get your policy underwritten. That changes the landscape a bit and should involve a more detailed discussion with your business health insurance broker .

#2: What Is Level Funding in Group Health Insurance?

Level funded insurance is an excellent option if you have a generally healthy group of employees you wish to provide coverage for. In level funding insurance, the insurance carrier underwrites the policy based on your employees’ current and past health. The more people you have in your group, the greater potential for savings, because the carrier can spread the risk out over the group.

Who level funded group health insurance plans are good for: Companies with employees that number from 6 to 1,000 – the healthier your group, the more discounted your premium will be. That’s why level funded plans are such a good option to consider amid premium rate hikes in Arizona in 2026.

You should also know: You can get money back at the end of the year if the total amount of claims is lower than what was projected at the outset.

#3: What Is Self-Funding and Partial Funding in Group Health Insurance?

Self-funded insurance plans are a great option for large employers that have 1,000+ employees. Self-funding works like this: you approach the carrier and essentially “rent” their network. As the employer, you pay for claims as they’re incurred, and, as such, you absorb the risk. You reimburse the carrier for the difference between the amount the employee is paying and the contracted amount between the facility and the insurance carrier.

Partial funding is the same idea, only in partial funding, you purchase reinsurance (also known as stop-loss insurance) to cap your risk. This can apply on an individual employee basis or for the group as a whole, known as the aggregate.

Individual employee basis: If any one employee incurs a major expense, you only pay whatever amount you set as your maximum employer liability. The stop-loss insurance then kicks in and covers anything above your maximum liability.
Aggregate: The same principle applies, only it looks at the whole group. You set your maximum employer liability for the aggregate, and once you hit that, stop-loss insurance kicks in and covers anything above the cap.

Who self-funded and partial funded group health insurance plans are good for: Self-funded and partial funded group health insurance plans may work for large employers with 1,000+ employees.

You should also know: You can tailor the self-funded or partial funded group health insurance plan however you like, setting things such as office visit and prescription copays, which could help offset GLP-1 costs. You may choose to work with a third-party administrator (TPA), who can provide a flexible plan design for your business.

#4: What Is a Professional Employer Organization (PEO)?

A professional employer organization (PEO) exists to spread risk for smaller groups (15 employees or fewer). Instead of the benefits being under the employer’s tax ID number, you actually deploy benefits under the PEO’s tax ID number. Your group of employees joins a much larger group of people, thereby spreading the risk among the bigger group and, thus, reducing your rates.

A PEO typically manages not just your company’s health insurance, but also your 401(k) and your payroll. PEOs provide human resources (HR) support, as well.

Who PEO group health insurance plans are good for: Employers with small groups (15 employees or fewer) who want to offer rich benefits may benefit from PEO group plans.

You should also know: You’ll pay fairly steep administration fees for a PEO platform, typically $60 to $100 per employee on the payroll per month. This administration fee is typically the most significant reason why a PEO for group health insurance plan may not be a cost-effective solution for most groups. However, it’s still worth exploring to compare your options.

3. How Can You Buy Group Health Insurance in AZ?

To enroll your company in a health insurance plan, you’ll need to work with an agent or broker, fill out an employee census form, get quotes and select and enroll in a health insurance plan.

Now that you understand the four options for buying group health insurance, let’s look at the five steps to actually getting your company enrolled in a plan.

#1: Contact a Reputable Health Insurance Agent or Broker

There are many scenarios in which it won’t cost you extra to use a broker to buy group health insurance in Arizona. At AZ Health Insurance Brokers , we would love to set up a call to gain a complete understanding of your needs. Getting in touch with us is easy.

Call us at 602.617.4107, or
Click the appropriate “Get a Quote” button on our website, and fill out the form.

In our first phone call, we’ll ask several questions to get a clear view of your group health insurance needs, including the size of your company. To be eligible for small business health insurance, a company must have two or more non-common law employees. Depending on the size, requirements for quoting will vary.

This determination is important, because the ACA limits what can affect the rates for small groups. Age of enrollees, tobacco use and location can influence small group rates, but medical claims history, health of enrollees and the business type cannot affect small group rates.

We’ll also discuss the types of employees you have, whether they work full- or part-time, and which of the four types of coverage would be the best fit.

Another benefit of working with us is that we’ll help ensure you meet compliance requirements for using health insurance pre-tax deductions. Businesses need to set up a section 125 cafeteria plan in order to receive certain benefits on a pre-tax basis, per the Internal Revenue Service (IRS). A premium-only plan (POP) document is also required for groups that offer a pre-tax plan to employees. We’ll help you file all necessary paperwork to ensure you’re meeting legal requirements.

#2: Fill Out an Employee Census Form

Your next step is to fill out what’s called an “employee census” form. Insurance companies use these to gather information about your employees, so they can estimate the healthcare costs for your group. This is how they come up with a rate quote.

The census form will ask for the following information for each of your employees, their spouses and their dependents:

Name
Date of birth
ZIP code
Gender
Whether the employee plans to waive coverage

** We also need a copy of their existing insurance renewal (if plan is currently in place) and some superficial company data (address, TIN, etc.)

#3: Get Quotes

Next, it’s time for your broker to get quotes from the insurance carriers they’ve identified would be the best fits for the type of group health insurance you need. An experienced broker knows the requirements set forth by the IRS, the ACA and the insurance carriers themselves, all of which affect the types of plans you can offer.

“We take the data you give us and bid to every carrier,” Calloway says. “This way, we can deploy the best tailored solution to meet your needs. Medical, dental insurance , vision, disability – we shop it all for you, to get you exactly what you’re looking for at the best possible rates.”

Remember that different carriers have different value-adds. Do you want a robust wellness program? Are you simply looking for the least expensive rates? Brokers listen to what’s important to you and your company culture, and then take the weight of finding it off your shoulders.

#4: Choose Group Health Insurance

This is a critical step. You and your broker should examine the plan details, including things such as:

The waiting period for new hires: You get to set this.
Eligibility restrictions: Arizona is a right-to-work state, and employers get to define eligibility restrictions. For example, you may offer health insurance to employees who work any number of hours. You’re not bound by the minimum 30 hours of work a week that many states require.
Open enrollment: You get to decide how long you want the window to be for employees to make their selections.

Your broker can help you understand the details and quotes. Then, it just comes down to enrollment, which brings us to the final step.

#5: Enroll in Group Health Insurance

Once you decide on a group health insurance type, it’s time to enroll. Make sure to choose a broker who does this process electronically, as that makes the process faster and simpler.

“Conducting the enrollment process online is not only easier for everyone, but it gets better engagement with employees,” Calloway says.

4. What Are the Arizona Group Health Insurance Brands You Should Consider?

There are several companies that offer group health insurance plans in Arizona. At Arizona Health Insurance Brokers, we’ll help you find the one that makes the most sense for your business. Your options include the following Arizona business health insurers.

Aetna

Aetna offers both preferred provider organization (PPO) plans and health maintenance organization (HMO) plans for businesses. The provider offers comprehensive coverage options that include health, pharmacy, dental and vision benefits. Learn more about Aetna group health insurance .

Blue Cross Blue Shield (BCBS) of Arizona & Prosano Health

Blue Cross Blue Shield (BCBS) of Arizona is one of the most popular insurers in Arizona, especially for businesses with 51 or more employees that are looking for fully insured plans. Nearly all Arizona healthcare providers (98% of hospitals and 96% of physicians) are included in the BCBS of Arizona statewide provider network.

In 2026, Prosano Health® plans by AZ Blue are also increasing in popularity. These plans are exclusively for BCBS of Arizona members and offer a guaranteed 5% premium discount compared to similar AZ Blue plans, which can help offset overall health insurance premium increases. They’re available for small to large groups and offer exclusive access to Prosano Health Care Centers.

Learn more about BCBS of Arizona group health insurance .

Cigna

Cigna’s comprehensive wellness programs that focus on preventive care make it a standout for group health insurance choices. Cigna plans feature rewards for healthy behaviors and chronic condition management that could lead to a healthier workforce. Learn more about Cigna group health insurance .

UnitedHealthcare

UnitedHealthcare is one of the largest work healthcare providers in the country. The organization offers employee wellness programs, including weight loss and smoking cessation support, as well as digital tools for employees to easily manage their plans. Learn more about UnitedHealthcare group health insurance .

UnitedHealthcare Surest

UnitedHealthcare’s Surest insurance requires no deductibles or co-insurance from members, just copays to get services from providers on the UHC Choice Plus (PPO) network. Employers can offer it on a fully insured and self-funded basis.

Surest provides an excellent modern strategy for controlling healthcare costs without raising deductibles. It’s a technology-forward solution that we predict will have major implications on the group health insurance industry overall. We’re already seeing its impact in adoption levels and satisfaction rates. Learn more about UnitedHealthcare Surest .

Why Use AZ Health Insurance Brokers for Group Health Insurance? Get Boutique Customer Service & Robust Resources

AZ Health Insurance Brokers acts as an extension of our clients’ HR departments. We offer an overall strategy for payroll, benefits, compliance, acquisitions and more. When you work with AZ Health Insurance Brokers, you receive the following tools.

Employee Navigator

We offer this robust benefits administration platform to our clients at no cost. Employee Navigator facilitates benefits onboarding for new hires and open enrollment.

It integrates with many payroll systems and Consolidated Omnibus Budget Reconciliation Act (COBRA) vendors, thereby providing a single solution for payroll, benefits, onboarding and paid time off (PTO) management. Everything is coordinated digitally through this one platform, creating an exceptional experience for everyone involved.

Boutique Customer Services + Dynamic Strategy

“We provide white glove, concierge service,” Calloway says. “Our relationship doesn’t end once you sign on the dotted line, as it does with many brokers. We offer a true, one-point-of-contact support system for all our clients. We appreciate our clients, and that reflects on the services we offer.”

AZ Health Insurance Brokers focuses on creative strategies that maximize our clients’ budgets. “We make sure employees understand their benefits, by talking with new hires, building open enrollment guides, and hosting virtual and on-site company meetings,” Calloway says. “Our setup procedures help mitigate price increases, known as a claims redirection strategy. Everything we do is informed by your needs and priorities. We aim to build, expand and improve upon the process for all parties involved.”

COBRA/State Continuation

We have many solutions for COBRA administration. State continuation is a relatively new state law that’s very similar to COBRA but that requires all employers with 2 or more employees to offer state continuation, which is essentially COBRA.

Arizona’s “Mini COBRA” law, A.R.S. § 20-233 , applies to employers with 19 or fewer workers, to ensure workers who lost their job with a smaller employer or Arizona startup can still continue healthcare coverage. Arizona’s Mini-COBRA offers continuation coverage for up to 18 months.

We have solutions for both COBRA and state continuation. They vary from client to client. We can help you navigate what you’re liable for.

>>Learn more: What Is COBRA? An Employee’s Guide to COBRA Insurance

Even More Group Health Insurance Services in AZ

AZ Health Insurance Brokers has helped countless Arizona businesses set up their group health insurance plans and helped employees get desired coverage. A few examples include:

In the past few years of working with a 125-employee engineering services group, year-over-year, we’ve helped the organization secure a 10% reduction in medical insurance premiums.
We helped solve major compliance issues for a 150-employee stucco contractor. The client was facing large ACA fines, which we were able to eliminate. At the same time, we were able to fix all completion issues and assist in benefits changes that improved company culture.

When you work with us, in addition to setting up your group insurance offerings, we also help with:

Compliance: A cafeteria plan, also known as a section 125 plan, offers tax advantages for both you and your employees, but several documents are required to make sure your cafeteria plan complies with laws and regulations.
Premium-only plan (POP) document: This form is required for all groups offering a pre-tax plan to employees.
WRAP document: This form is required for all groups offering more than one plan and/or a variety of benefits.
1095/1094 reporting: This end-of-the-year tax document is required for level funded and self-funded groups.
PCORI fees: This annual fee is associated with level funded and self-funded groups.

Don’t let documents like these overwhelm your business. Our decades of experience in the AZ group health insurance space can help provide your business with financial advantages and benefits that improve employee satisfaction.

Talk With an AZ Business Insurance Professional to Find the Best Commercial Insurance

When you need to buy group health insurance in Arizona, first talk to an experienced broker who can further explain the above options and help you choose the best one for you and your employees.

“Insurance is a commodity,” Calloway says. “You can shop for it at 10 different places, and you’ll basically get the same rates. A broker adds value, acting as an overall fiduciary for your company and ensuring you spend your money in the best possible way.

“It costs nothing extra to consult with us to figure out what makes the most sense,” Calloway adds. “We will guide you through a somewhat confusing industry and offer expert advice on what’s appropriate for your needs.”

Not only can a broker advise you on which type of commercial health insurance is right for your business, but they can help you manage risk, generate price quotes, cross-reference policy packages, provide tech support with paperwork, and help with compliance issues.

Talk with an Arizona group health insurance strategist about your 2026 renewal.

Our mission is to gain a complete understanding of your insurance needs, serve as your strategic advisor, and exceed your expectations. We’re happy to answer your questions, explain your options, and get you a free quote. Call us at 602.617.4107, email info@azhealthinsurancebrokers.com or send us a message today .

This article was written by Nicki Escudero and reviewed by Ethan Pickner, Licensed Arizona Health Insurance Broker and founder of AZ Health Insurance Brokers.

Group Health Insurance in AZ FAQs

What Is an ICHRA? How Individual Coverage HRAs Work for Small Businesses in 2026 (Arizona Guide)

Sun, 01 Feb 2026 15:52:43 GMT

As an employer, you’re probably aware of the advantages of offering healthcare coverage for employees . Healthcare coverage is consistently ranked as one of the top benefits professionals want from employers today. The U.S. Bureau of Labor Statistics reported in September 2025, 72% of private industry workers had access to healthcare benefits .

You have lots of options for the type of healthcare benefits you offer your staff . ICHRAs provide your employees with more freedom in the healthcare providers they choose to work with. They can also help your business save money compared to other small business group health insurance plans.

This guide explains what an ICHRA is, what the potential benefits of offering one are, and how to make one available for your business.

Quick Summary:

An Individual Coverage Health Reimbursement Arrangement (ICHRA) lets employers reimburse employees tax-free for individual health insurance and medical expenses. Unlike group plans, employees choose their own coverage while employers control costs with fixed monthly allowances.

For example, an employer can offer $400 per month per employee to reimburse individual health insurance premiums.

What Is an ICHRA? (Simple Definition)

An ICHRA is a type of employer-funded benefit that reimburses employees for individual health insurance premiums and qualified medical expenses.

ICHRA stands for Individual Coverage Health Reimbursement Arrangement.

ICHRA allows employers to offer tax-free health benefits while controlling costs with a fixed monthly allowance.

ICHRA differs from QSEHRA because there are no employer size limits and no IRS contribution caps.

How Does an ICHRA Work?

An ICHRA is a type of health reimbursement arrangement (HRA) that enables employees to purchase individual-market insurance and get reimbursed for their coverage through an employer-funded account.

Businesses of any size can adopt an ICHRA for their employee healthcare coverage option. How an ICHRA works is simple.

Employers set a monthly allowance limit for healthcare reimbursement for their employees, including for health insurance premiums and/or qualified medical expenses.
Employees select their own health insurance provider.
When an employee receives healthcare, the employer reimburses the employee up to the allowable amount.

All reimbursements are tax-free. Employees can participate if they want but aren’t required to. You can provide an in-demand benefit that can boost your employee retention and can serve as a way to attract talent to your company.

Example: How an ICHRA Works for a Growing Business

ABC Electrical is a California-based company expanding into Arizona. Their current Kaiser Permanente group health plan only works in California, leaving their Arizona employees without in-network coverage. Instead of switching to a nationwide group plan, ABC Electrical sets up an ICHRA and designates a monthly reimbursement allowance for their Arizona employees. Each employee purchases an individual health insurance plan in Arizona, and the company reimburses their monthly premium tax-free through the ICHRA.

What Can an ICHRA Cover?

You’re in charge of determining what an ICHRA provides reimbursement for. Your company’s ICHRA coverage may include:

Insurance premiums only, for eligible plans including:
Major medical plans purchased on the Healthcare.gov exchange
Medicare : Part A+B or Part C
Catastrophic plans
Student health insurance
Qualified medical expenses only, which the Internal Revenue Service (IRS) defines in Publication 502 and include items such as doctor visits, prescriptions, dental procedures, co-pays and medical equipment
Both insurance premiums and qualified medical expenses

Once you’ve determined how much you want to allow for reimbursement, that figure will stay the same throughout your plan year. Once your ICHRA is up for renewal for a new plan year, you can adjust the allowance amount. This may be due to factors like having a bigger budget to provide more coverage for employees, or hiring more employees and needing to adjust the budget amount.

ICHRA reimbursements are paid to employees, although the funds can be used to reimburse family health insurance premiums depending on plan design.

What Are the Benefits of an ICHRA?

There are many benefits to an ICHRA, which may make it an ideal fit for your business and your employees. Potential advantages include:

Predictability and control: With an ICHRA, you set the exact coverage and allowance amount. That gives you a predictable budget throughout the plan year. Plus, plans aren’t impacted by annual rate hikes. Your employees know exactly what kind of reimbursement coverage to expect from you, too.
Freedom of choice: With some employer group plans , employees may lose coverage for their healthcare provider of choice if they’re not covered under an employer plan. With an ICHRA, your employees get to choose the exact type of health insurance they want. For employers who are having difficulty deciding which hospital system to support, such as Banner vs. HonorHealth, an ICHRA puts the freedom of choice in employees’ hands regarding healthcare provider networks.
Easy and simple: ICHRAs don’t have minimum participation requirements. They’re easy to set up. You don’t have to worry about claims liability. This is all while providing a benefit that can help you attract and retain top employees.

Arizona small businesses in Phoenix, Scottsdale, and Mesa are increasingly using ICHRAs to reduce group plan costs while giving employees more flexibility in choosing doctors and networks.

ICHRAs are fairly new, having only been available since 2020. Many professionals aren’t aware of them or know how they work. With some education, you may find your workforce prefers this kind of business healthcare coverage compared to other types of plans.

What Qualifications Must a Business Meet to Offer an ICHRA?

Good news: if you have at least one W-2 employee, you can offer an ICHRA at your business. These include part-time, seasonal and foreign employees.

Employers can offer an ICHRA in addition to a group health insurance plan, but the same type of plan must be offered to the same employee class. For example, if you offer group health insurance to your full-time employees, you wouldn’t be able to offer an ICHRA as another option. You could, however, offer an ICHRA to your part-time employees.

ICHRA for Self-Employed Businesses and 1099 Contractors

ICHRAs are commonly used by small businesses with W-2 employees, including companies with contractors or self-employed owners. While self-employed individuals cannot reimburse themselves through an ICHRA, they can use an ICHRA to provide benefits to their W-2 staff without offering a traditional group health insurance plan.

For business owners who work with freelancers or mixed employee structures, an ICHRA can be a flexible way to offer health benefits while controlling costs.

2026 ACA Affordability Update

It’s important to be aware of some changes to Affordable Care Act (ACA) affordability guidelines for 2026 set forth by the Internal Revenue Service (IRS) that could impact ICHRA desirability at your business. Employer-sponsored health plans are deemed affordable if employees pay no more than 9.96% of their household income for self-only coverage. That’s a significant increase from 9.02% in 2025, giving applicable large employers (ALEs) the ability to increase worker contribution rates for self-only coverage.

Also, the federal poverty line (FPL) safe harbor has increased to $129.90/month, from $113.20/month in 2025. This number represents the maximum monthly worker contribution for the lowest-cost self-only plan.

Being aware of figures like these could impact your decision of whether or not to offer an ICHRA and/or a different group health insurance plan. Talk with an insurance broker to walk through all your options and find the most affordable one.

ICHRA vs ACA Marketplace Subsidies (Premium Tax Credits)

An ICHRA can affect an employee’s eligibility for ACA Marketplace premium tax credits. If an employer offers an affordable ICHRA, the employee generally cannot receive premium tax credits on the Marketplace. However, if the ICHRA is considered unaffordable, the employee may opt out of the ICHRA and still qualify for subsidies.

Because of these rules, it’s important for employers and employees to compare ICHRA allowances with Marketplace subsidy eligibility to determine the most cost-effective option.

Not sure whether an ICHRA or Marketplace subsidies would make more sense for your business or employees? Use the calculator below to estimate costs and compare scenarios.

The 2026 HSA Advantage

There are more new developments in the healthcare space in 2026 for business owners and workers. This year, all ACA Marketplace Bronze plans are now health savings account (HSA)-eligible, as they’re considered high deductible health plans that can be paired with an HSA.

This makes pairing an ICHRA with an HSA a powerhouse combination for staff. As an employer, you have more flexibility in the type of healthcare coverage you’re offering your employees.

Are There Limits to an ICHRA?

No, there aren’t limits to what you set as your employer maximum contribution in an ICHRA. There are also no limits to how many employees you offer the ICHRA to, as long as the employees belong to the same employee class.

What Are the ICHRA Rules of Notification?

Like other employer healthcare coverage , you must notify your employees about ICHRA eligibility so they understand what’s available to them. You must provide a notice in writing to:

Each employee who becomes eligible during the plan year to the employee no later than the date they’re eligible
Each ICHRA participant at least 90 days before the plan year starts

If you establish the ICHRA fewer than 120 days before the first plan year starts, you must provide the notice before or no later than on the ICHRA’s effective date.

What Are the Differences Between an ICHRA, HRA and QSEHRA?

As mentioned, an ICHRA is a type of HRA, or health reimbursement account. Another type of HRA is a QSEHRA . QSEHRA stands for Qualified Small Employer Health Reimbursement Arrangement.

First, let’s look at the similarities between an ICHRA and a QSEHRA.

Both plans enable the employer to set the monthly allowance amount.
With both plans, employees purchase the healthcare of their choice.
Both plans may reimburse expenses listed in the IRS Publication 502.
With both plans, employees submit their expense documentation, after which employers review and approve the eligible requests.
Both plans provide tax-free reimbursement, both in terms of payroll tax and income tax for the participant.

The main differences between an ICHRA and a QSEHRA are:

With an ICHRA, there are no limits to how many employees may be eligible for this plan. With a QSEHRA, employers are only eligible if they have fewer than 50 full-time employees.
With an ICHRA, employers may also offer a group insurance policy to a specific class of employees that’s separate from the employee class receiving ICHRA benefits. With a QSEHRA, employers aren’t allowed to offer a group insurance policy.
With an ICHRA, the employer structures employee eligibility. With a QSEHRA, all full-time employees and their families will be automatically eligible for the benefit.
With an ICHRA, there are no allowance caps for what an employer can reimburse an employee for. With a QSEHRA, the IRS updates annual allowance caps each year. In 2026, a QSEHRA is limited to $6,450 for an individual and $13,100 for a family.

There are a few other differences between an ICHRA and a QSEHRA, including premium tax credit guidelines. Contact a business health insurance expert to walk you through what the differences may mean for your business.

Are ICHRAs Tax-Deductible?

Yes. Any reimbursements an employer makes in an ICHRA are tax-deductible. Plus, ICHRA reimbursements are received tax-free by employees.

Why Is Now a Good Time to Consider an ICHRA?

With the expiration of federal tax credits, employer-funded HRAs like ICHRAS are more important than ever.

There’s also the potential of the subsidy cliff returning, meaning more low-income workers are susceptible to having to pay high health insurance premium payments when they earn even $1 above the FPL. If you want to keep employees healthy and happy at work, an ICHRA offers in-demand healthcare benefits that help workers.

How Do I Set Up an ICHRA?

To set up an ICHRA, you’ll need to take the following steps.

Choose a start date.
Set a cancellation date for your group policy, if you plan to cancel it.
Determine eligibility, and designate employee class groups.
Set your budget and determine allowances.
Establish legal plan documents to ensure compliance with the IRS and U.S. Department of Labor. (Go with an ICHRA Administrator)
Educate your employees about your ICHRA offering.

You can also provide resources to your employees so they can purchase their own individual health insurance or family health insurance , since they’ll need that in order to get reimbursed under an ICHRA.

To get help to set up an ICHRA, contact the health insurance experts at AZ Health Insurance Brokers online, at 602.617.4107 or by email at quotes@azhealthinsurancebrokers.com . We’ll help you understand whether or not an ICHRA is the best health insurance offering for your unique business, and we can help you set one up if you choose to do so. We can also recommend alternative business health insurance coverage options so you can compare what’s available.

ICHRA FAQs

Written by Nicki Escudero

Reviewed by Ethan Pickner, Licensed Arizona Health Insurance Broker, AZ Health Insurance Brokers

Health Insurance Guide for Self-Employed, 1099 Contractors & Freelancers in AZ

Wed, 14 Jan 2026 20:11:29 GMT

If you’ve made the leap to the self-employed life, congratulations! Choosing a solopreneur career path or becoming a gig worker or freelancer has become increasingly popular in the United States, since this type of work arrangement can provide autonomy and freedom. In the U.S.:

“Forbes” reports in October 2025, there were 79.2 million Americans doing some type of independent work.

In December 2025, there were 9.05 million full-time self-employed people, according to the U.S. Bureau of Labor Statistics .

Statista reports, in general, the number of people who freelance in any capacity will climb to 90.1 million people by 2028.

Becoming self-employed can be an empowering process, one where you can see the direct results of your work efforts. You could create your own business, or choose to do the exact work you want, on your own preferred schedule.

While working for yourself can be flexible and rewarding, you’ll also need to secure your own healthcare coverage and choose an insurance plan that works for you. You may be leaving full-time employment with one company, where you had a group health insurance plan from your employer. As someone who’s self-employed, you’ll have to research, apply for, and pay for your own insurance plan. This guide explains what to keep in mind.

Key Takeaways

Healthcare without insurance is expensive. If you’re self-employed and want to maintain your health and the ability to work your business, make health insurance part of your business plan and financial planning.
Without health insurance, the cos t for surgery can be $7,500 or more. The cost for comprehensive cancer coverage can extend to hundreds of thousands of dollars. Health insurance offers coverage for regular checkups and preventive care, as well as other essential health services.
If you’re self-employed and need health insurance, you can get an affordable plan through a private Arizona health insurance broker, through the federal Affordable Care Act Marketplace, through COBRA coverage or by securing a group health insurance plan, if you have other employees. The benefit of working with a local Arizona health insurance broker is that you get personalized customer service, at no extra cost.

2026 Self-Employed Health Insurance Snapshot (Arizona)

In 2026, many self-employed Arizonans are seeing higher ACA Marketplace premiums due to the expiration of enhanced tax credits and year-over-year carrier rate increases. As a result, comparing ACA plans, private PPO options, and HSA-eligible strategies is more important than ever — especially for freelancers, 1099 contractors, and business owners without employer coverage.

Who This Guide Is For
This guide is designed for:

Self-employed business owners and sole proprietors
1099 contractors and freelancers
Consultants, gig-economy workers, and creators
Small business owners with 1–10 employees
Arizona residents buying insurance without employer coverage

What Health Insurance Options Are Available for Arizona Freelancers in 2026?

Self-employed business owners, freelancers and contractors have different options when buying health insurance . These include COBRA health insurance, government/Affordable Care Act (ACA) health insurance plans, private health insurance and group insurance, depending on if the self-employed individual employs other workers.

You may be wondering about your insurance options if you’re an entrepreneur, single-member LLC owner, small business owner, independent contractor, gig economy worker, consultant, freelancer, online content creator and/or influencer. As you manage your own personal health insurance plan for yourself and/or your family, it’s helpful to consult with a self-employed health insurance broker , who can show you all your self-employed health insurance options , like the following. Work with a broker in Arizona for local customer service that’s more readily available than a national call center.

1. What Is COBRA Health Insurance?

COBRA stands for the Consolidated Omnibus Budget Reconciliation Act. It provides coverage for former employees and, if applicable, their families, for up to 18 months when a worker loses their job. If you worked for a company with at least 20 or more employees, you’re likely eligible for COBRA, since “continuation coverage” is mandated for large employers that offer health insurance through work .

COBRA may also apply in various life-changing scenarios, such as:

Decrease in hours worked
Voluntary job loss
Transition between jobs
Death
Divorce

Self-employment alone doesn’t qualify someone for COBRA. However, if you choose to pursue self-employment because you’ve lost your job with your old full-time employer, or you go through an event like those above, you can get COBRA as you begin your self-employed journey.

Keep in mind that COBRA health coverage can be expensive. You may have to pay up to 102% of the plan’s cost, including fees for administration. That’s why, even when you’re eligible for your old work insurance plan, you may have to pay for the entire cost under COBRA . In the past, your employer may have covered a portion of the coverage.

Considerations for COBRA health insurance: COBRA might be a good option for you if you prefer to keep your old health insurance coverage as you consider your next plan. Also, if you take expensive prescriptions, or you’ve already met your deductible for the year, it may make financial sense to continue your healthcare coverage under COBRA.

2. What Are Government / Affordable Care Act (ACA) Health Insurance Plans?

The Affordable Care Act (ACA) provides government-sponsored healthcare coverage through the U.S. federal government. Anyone can enroll in an ACA plan or change their existing ACA plan during the program’s annual Open Enrollment Period , which is typically from November 1 through January 15 each year.

There are also special circumstances that could qualify for an ACA plan . These include:

Medicaid eligibility: Medicaid is a federal government insurance program that provides low-cost or free health insurance coverage to low-income individuals and households, as well as to older adults, those with disabilities and pregnant women.
A qualifying event that triggers a special enrollment period due to a specific circumstance: Special enrollment periods may open up due to life events like marriage, child adoption, having a baby, or moving.

You will typically also be eligible for an ACA plan if you qualify for COBRA. Otherwise, you may also be eligible for an ACA plan during open enrollment or if you qualify for a special event. You could get a cost-sharing subsidy or premium tax credit health insurance subsidy, depending on your household’s financial situation.

One important consideration to note for ACA plans in 2026 is that enhanced tax credits that existed in 2025 to lower the cost of health insurance have expired in 2026. There’s also a 26% average increase in what health insurers are charging for coverage on the ACA Marketplace in 2026, according to the KFF. With these factors combined, enrollees who were subsidized in 2025 could see their net monthly premiums more than double compared to 2025, depending on income, household size, and carrier.

Some states also have state-sponsored health insurance plans. Arizona has a State Plan for Medicaid and a State Plan for the Children’s Health Insurance Program (KidsCare), which are partnerships between the Arizona Health Care Cost Containment System and the Centers for Medicare and Medicaid Services.

Considerations for ACA plans: There’s a lot of diversity in the quality, provider options and costs of ACA plans on the federal marketplace. You might be interested in an ACA plan if you qualify for subsidies to save money. Also, consider that ACA plans can be more restrictive in provider choice, as many are health maintenance organizations (HMOs).

ACA plans can also be a good option for those with pre-existing conditions, because you’ll still be eligible for coverage even if you have one or more pre-existing conditions. If you need help finding the best options on the ACA marketplace, you can contact us for free expert ACA guidance through the process. We will learn all about your budget and your unique healthcare needs, and we’ll present you with all your options so you can compare them before you choose.

In Arizona, the following healthcare providers currently offer plans on the ACA Marketplace.

Even if you’re outside of Open Enrollment, you can still fill out our free form for information and other health insurance options available.

3. What Are Private Health Insurance Plans?

Private health insurance plans are offered all times of the year through private insurance specialists , like AZ Health Insurance Brokers. Insurance brokers work directly with health insurance providers and can provide information on available plans that fit your unique healthcare needs and your budget. This offers a unique advantage in local customer service options.

There’s also a lot of diversity in private plan coverage and costs. For those with pre-existing conditions, private insurance may be more expensive compared to an ACA plan. But if you don’t see doctors that frequently, you could save money compared to a COBRA or ACA plan and get healthcare coverage that provides preventive care and emergency coverage.

Considerations for private plans: A private health insurance plan may make the most financial sense, especially if you don’t qualify for ACA marketplace subsidies or COBRA coverage.

Another private plan advantage is that you gain access to a personalized health insurance broker who is always there to help you navigate your health insurance. Compared to having to deal with an insurance company, you can get excellent local customer service to support you on your self-employed journey. To get a free private health insurance plan quote within minutes, contact us here .

4. What Are Group Health Insurance Plans?

If you’re self-employed and have at least one other worker, offering group health insurance could be a possibility. Providing your employees with health insurance coverage can be a good recruiting and retention benefit. Consider:

The Society for Human Resource Management reports in 2025, 88% of workers ranked healthcare coverage as extremely or very important when considering job decisions.

According to Gallup , “well-being” is in the top two factors job seekers consider when looking for a new job, which healthcare benefits can support.

In October 2024, “Forbes” reports 67% of employees (more than two-thirds) cited employer-covered healthcare as the top benefit a job can offer. More than 80% of employees who are older than age 42 are seeking jobs that include employer-covered healthcare.

How do group health insurance or business plan options work? You’re in charge of what kind of plan you want to offer. You can manage details like amounts for deductibles and copays, as well as determine what type of healthcare is covered in the plan. Most employers that offer business health insurance pay for part of the plan’s monthly or annual premium costs. Employees are typically responsible for paying part of the premium, as well.

Considerations for group plans: If you have at least one other worker, and you plan to grow your self-employed business, you might gain an advantage when you provide group health insurance . As workers become more selective with employer benefits, offering a group health insurance plan could help you attract and keep talented workers.

5. What Are Health Savings Accounts (HSAs)?

A health savings account (HSA) can help self-employed individuals save money for healthcare costs when they’re

paired with a high deductible health plan (HDHP). HDHP plans have lower monthly premiums, and the insured can add money to an HSA account and use those contributions tax-free for medical expenses.

With higher monthly premiums, on average, in 2026, self-employed individuals may want to get an HDHP and use an HSA to help pay for medical costs, such as copays and prescription drugs. HSA plans are “triple-tax-advantaged,” as they allow for pre-tax contributions, tax-free investment growth and tax-free withdrawals for covered medical costs. This means, they can offer tax advantages for 1099 contractors in 2026.

Self-employed business owners that offer HDHP plans can also offer an HSA for employees.

Considerations for HSA accounts : If you visit the doctor regularly or have an expensive prescription you regularly take, it may make more sense to have a healthcare plan with a lower deductible, which would exclude you from being eligible for an HSA.

Another consideration for an HSA account is that healthcare needs can be unpredictable. If you want a clearer healthcare budget, it might make more sense to get a different healthcare plan, rather than an HDHP paired with an HSA.

How Can You Compare Self-Employed Health Insurance?

When you’re considering self-employed health insurance, compare options like COBRA health insurance, ACA health insurance, private health insurance, group health insurance and HSA plans.

Use the following table for a self-employed health insurance comparison at a glance.

What Family Health Insurance Options Are Available for Self-Employed Individuals?

If you’re making the leap to self-employed but still need health insurance coverage for your spouse and/or children, you have options. These also include COBRA health insurance, government/ Affordable Care Act (ACA) health insurance plans, private health insurance, HSA plans and group insurance, depending on if the self-employed individual employs other workers.

Getting health insurance for your spouse and/or family works similarly to how it would when you’re getting it for just yourself as a self-employed worker.

Choose which type of insurance you want. Decide if you want a COBRA, ACA Marketplace, private, HSA or group health insurance plan. If your household income is below a certain amount, you may qualify for subsidies through the federal government for healthcare.
Research providers. Compare health insurance providers, expenses, physician and prescription coverage, and other factors. Select the health insurance provider you want to use.
Sign up for family coverage. When you sign up for self-employed health insurance coverage, instead of selecting individual coverage, select a plan that covers your spouse and/or your dependents. Generally, the total amount for a family insurance plan will be more expensive than an individual plan, because you’re covering additional people. On the other hand, the individual cost of insurance on a family plan may be lower per individual, compared to a single individual securing health insurance.

If your spouse still has health insurance coverage through work, you’ll want to compare coverage options and prices to see if it makes sense to get insured under their plan, or bring your family under a self-employed health insurance plan. Talk with an insurance broker who can help you compare your options.

What Questions Should You Ask When Considering Self-Employed Insurance?

Getting insurance on your own can be a big responsibility. For whatever category of self-employed health insurance you’re getting, from private to ACA Marketplace, think about factors like budget, preferred providers, prescriptions and travel frequency.

For example:

How much you can budget each month for a premium: Generally, the higher premium you’re able to pay each month, the better health insurance coverage you’ll get when you actually need care, such as emergency coverage. If you’re relatively healthy and are willing to risk to pay more out-of-pocket when you do need coverage, a lower monthly premium plan could work for you.
Who your preferred providers are: If you have doctors you want to continue seeing, you should research insurance plans that include coverage for those healthcare providers.
If you take any prescriptions: The same goes for prescriptions – if you need prescription medication coverage, you’ll want to make sure the plan you get covers your prescriptions. If not, you may have options such as cheaper mail-order prescriptions or discounts through a service like GoodRx.
How often you travel: If your self-employed career has you on the move, you’ll also want to consider plans that are more likely to cover services for when you’re out of state. Some plans offer preferred provider coverage nationwide, while others give you access to walk-in health clinics around the country.

The best way to walk through these questions for self-employed health insurance is to talk with an insurance broker. It doesn’t cost anything to consult with one of the AZ Health Insurance Brokers team members . We’re here to help you learn about your options, so you can make an informed decision you’re confident in.

How Can You Choose the Best Self-Employed Health Insurance?

Depending on which category you fall into, there may be a better type of health insurance coverage to consider compared to another. Evaluate your life situation to find the most cost-effective coverage that fits your needs.

Do you need health insurance because you recently lost your job?

Typically, if you’re eligible for COBRA, you’ll also be eligible for an ACA plan. When you purchase healthcare through the ACA marketplace, you may also be eligible for subsidies. These include a premium tax credit health insurance subsidy and a cost-sharing subsidy.

There are also state-sponsored health insurance plans, depending on the state. Not all states have them, so check with yours to see what’s available.

When you might want an ACA plan: ACA plans can vary greatly in provider options and in costs. If you have flexibility in what providers you’re willing to see, and you’re eligible for subsidies, an ACA plan may make sense. You’ll be able to research all your plan options and choose the one that works best for you.

If you have pre-existing conditions, the ACA plan may also be a good option for coverage. Keep in mind, navigating the marketplace can be a little challenging with all the options that are available. You can call the ACA hotline if you have questions.

3. Private Health Insurance Plans

Private health insurance plans are offered all times of the year through private insurance specialists , like AZ Health Insurance Brokers. Insurance brokers work directly with health insurers and can give you a customized quote that provides you with the best insurance offering for your budget and health needs.

Private plans can also vary widely in price and coverage. If you have a pre-existing condition, you may pay for a more expensive plan with a private insurer. But if you’re relatively healthy, you may be able to get a less expensive plan that still covers you for emergencies and preventive care.

When you might want a private plan: If you’re not eligible for COBRA, and if you won’t get any subsidies from the ACA marketplace, a private plan can be a good option. You can get an individual insurance quote for a private health insurance plan within minutes here .

Another benefit of a private health insurance plan is that the customer service can be much better compared to having to deal directly with the insurance company. Your self-employed health insurance broker can become a valuable partner for your business success, one who’s a direct phone call away. That saves you time, stress and hassle from having to deal with impersonal customer service representatives at a big company.

4. Group Health Insurance Plans

If you’ve expanded your business to include at least one other employee in addition to yourself, you can explore group health insurance plan options. Providing your employees with health insurance coverage can be a good recruiting and retention benefit, as the Employee Benefit Research Institute reports in 2023, 83% of workers ranked healthcare coverage as extremely or very important when considering job decisions. According to Gallup , “well-being” is in the top two factors job seekers consider when looking for a new job, which healthcare benefits can support.

How do business/ group health insurance plan options work? As the business owner, you purchase the plan and decide on specifics like employer healthcare coverage, copays and deductibles. Typically, employers cover a portion of the plan’s annual or monthly premium cost, while employees cover a premium portion, too.

When you might want a group plan: If you have at least one other employee and plan to expand your business, it might benefit you as a business owner to offer group health insurance .

We recently experienced a Great Resignation, where American workers quit their jobs in record numbers . Professionals are becoming clearer on what they want from an employer. In many cases, this includes health insurance coverage. If you can offer it, group health insurance plans can help you recruit and retain top talent.

Need Help Getting Self-Employed Insurance?

Self-employed individuals have many diverse ways to secure valuable health insurance coverage. When you work for yourself, healthcare setbacks can also impact your business, so healthcare coverage is an essential part of successful business operations for self-employed individuals.

Consult with an Arizona health insurance broker to evaluate your options. We’ll talk with you confidentially about your health history and needs, your budget and what you want out of your healthcare coverage. We can then recommend the top health insurance options for self-employed workers, so you can select a plan that works for your healthcare needs, your budget and your family’s requirements.

Call us at 602.617.4107, contact us online , or email quotes@azhealthinsurancebrokers.com for more information.

Self-Employed Health Insurance FAQs

Need Help Getting Self-Employed Insurance?

Self-employed individuals have many diverse ways to secure valuable health insurance coverage. When you work for yourself, healthcare setbacks can also impact your business. That makes healthcare coverage an essential part of successful business operations for self-employed individuals.

Call us at 602.617.4107, contact us online , or email quotes@azhealthinsurancebrokers.com for more information.

Self-Employed Health Insurance FAQs

UnitedHealthcare 2026 ACA Individual & Family Health Insurance Explained

Wed, 05 Nov 2025 16:55:41 GMT

With the largest market share in the country, as reported by the American Medical Association , UnitedHealthcare is a prominent name among Arizona insurers . The company has partnered with the Arizona Care Network , which includes Dignity Health, Abrazo Health and the Phoenix Children’s Care Network. Many residents are familiar with UnitedHealthcare, especially since it’s one of the top health insurance choices for employers to offer for group health insurance , as well.

If you’re an individual in need of health insurance coverage for yourself and/or your family, and you’re not getting coverage through your work, you may be wondering about you options and whether or not UnitedHealthcare is a good fit for you. UnitedHealthcare has options for individuals who are between jobs, who just turned 26 and need short-term insurance while they look for a permanent option, who are self-employed and need health insurance , and who are looking for alternatives to the health insurance their employer offers .

For individuals and families, UnitedHealthcare offers some diverse product offerings that could be of interest. In this article, learn about what UnitedHealthcare individual and family health insurance products are available to decide if one or more could be the right fit for your individual health insurance or family health insurance choice.

Key Takeaways

UnitedHealthcare offers a variety of family individual insurance products to choose from, including short-term health insurance in Arizona, family and individual Affordable Care Act (ACA) Marketplace plans, hospitals and doctor insurance, hospital indemnity insurance and other types.
UnitedHealthcare also offers family individual dental insurance products and family individual vision insurance products for Arizona residents.
To talk through all your family and individual health insurance options, including with UnitedHealthcare, schedule a free consultation with an Arizona health insurance broker .

Arizona Health Insurance Products Offered by UnitedHealthcare

Short-Term Health Insurance in Arizona

UnitedHealthcare offers budget-friendly short-term healthcare coverage options , with monthly payment plans. These can be a good option if you’re searching for permanent individual health insurance and need coverage while you search.

Individual & Family ACA Marketplace Plans

UnitedHealthcare offers individual and family health insurance plans on the ACA Marketplace . These plans are classified into five plan categories, each of which have different levels that explain cost division between the planholder and UnitedHealthcare.

UnitedHealthcare 2025–2026 Rate Changes in Maricopa County

UnitedHealthcare’s ACA Marketplace premiums in Arizona increased across all metal tiers from 2025 to 2026. On average, prices rose between 41% and 47% , depending on the plan level.

*Average monthly premium before subsidies for a 40 year old, based on Maricopa County Marketplace rates.

Takeaway:

UHC’s rates increased more than the statewide average, but their network breadth and plan variety (Standard, Essential, Copay Focus, and Advantage) still make them a strong contender for families who prioritize Banner and Abrazo facilities or nationwide brand stability.

UnitedHealthcare plans include:

Standard: These ACA healthcare plans offer a good balance of coverage and affordability. You’ll have copays for primary care physicians (PCPs), specialists and urgent care, while other expenses are subject to your deductible and out-of-pocket maximum.

Essential: This is the most affordable option, with all medical expenses applying towards the deductible. It’s a good fit for those who rarely need medical care and who want catastrophic coverage for major accidents or illnesses.

Copay Focus: Copay Focus plans have slightly higher monthly premium costs but a $0 deductible, which means health insurance plan coverage kicks in immediately. With this plan, you pay fixed copays.

Advantage: These plans offer low deductibles and include adult dental and vision benefits. After you meet the deductible, copays continue to apply towards the out-of-pocket maximum.

**Remember**: These are just highlights. Review the full plan details on the UHC website, and consider your individual needs and budget before making a decision.

Individuals can sign up for UnitedHealthcare ACA plans with no restrictions for pre-existing conditions. ACA health insurance enrollment typically begins November 1 each year and lasts until January 15 the following year. Certain qualifying events, such as divorce or loss of insurance through work, can also trigger special enrollment periods .

When you’re considering a UnitedHealthcare individual or family health insurance plan, it’s essential to understand their hospital network in Arizona. For 2025 and beyond, there’s a notable change: UHC is no longer contracted with HonorHealth on ACA Marketplace plans.

Here’s a breakdown of UHC’s hospital network by Arizona county:

Maricopa County: Abrazo Health, Banner Health, Steward, Valleywise, Adelante Healthcare, Native Health, Valle del Sol, Wesley Community & Health Centers

Pinal County: Banner Health, Steward, Gila River Healthcare

Gila County: Banner Health, Cobre Valley Regional Medical Center, New Pioneer Medical Associates, ABC’s Pediatrics

Pima County: Carondelet Health Network, Banner Health, Northwest Healthcare, El Rio Health

Mohave County: Kingman Regional Medical Center, Western Arizona Regional Medical Center, North Country HealthCare

La Paz County: La Paz Regional Hospital

To confirm your preferred hospitals and doctors are in-network, use the following resource:

UHC Provider Lookup Tool: https://www.uhc.com/lp/aca-marketplace/gt-az

UnitedHealthcare’s Prescription Drug Coverage (Formulary)

Understanding which medications are covered by your health insurance plan is crucial. You can access United Healthcare’s formulary (list of covered drugs) through the following link:

UHC Formulary:

https://welcome.optumrx.com/rxexternal/external-prescription-drug-list?type=ClientFormulary&var=GPX524AV&infoid=GPX524AV&page=insert&par=

Hospital & Doctor Insurance

UnitedHealthcare provides Health ProtectorGuard fixed indemnity insurance to supplement a major medical plan . The program, underwritten by Golden Rule Insurance Company, pays cash for eligible, covered medical services, such as a surgical procedure, a trip to urgent care or a doctor visit. It also offers money to pay for expenses not covered by major medical plans, such as a deductible.

Dental Insurance

You can get coverage for dental services medical insurance plans don’t include, with no age limit restrictions, through a dental insurance plan provided by UnitedHealthcare, underwritten by Golden Rule Insurance Company.

Vision Insurance

You can also get vision insurance for services not covered by medical insurance plans. These are also underwritten by Golden Rule Insurance Company and have no age restrictions.

Accident & Critical Illness Insurance

These supplemental insurance plans offer financial coverage for expenses related to accidental injury and treatment, heart-related illness, cancer and other critical illnesses.

How to Get Individual Insurance Coverage Through UnitedHealthcare

If you’re interested in using UnitedHealthcare as your Arizona individual insurance provider for short-term insurance, ACA coverage or another type of insurance plan, contact AZ Health Insurance Brokers. We can help you secure individual health insurance that fits your unique individual needs and budget.

Email quotes@azhealthinsurance.com , call 602.617.4107 or contact us online , and we’ll be in touch.

UnitedHealthcare Individual Insurance FAQs

Antidote 2026 Individual & Family Health Insurance on the ACA Marketplace

Wed, 05 Nov 2025 16:46:53 GMT

If you’re looking for a federal Affordable Care Act (ACA) Marketplace plan for your health insurance, one brand to consider is Antidote. Antidote is a technology-powered health maintenance organization (HMO) that offers affordable healthcare when you use the carrier’s in-network providers. Antidote is available on the ACA Marketplace for Arizona residents in Maricopa, Pima and Pinal counties, with Arizona joining Ohio as the second state in the country to offer Antidote.

If you’re in the market for new individual or family insurance , or you simply want to compare your options so you can be confident you’ve made the best choice for a health insurer before open enrollment ends, this guide to Antidote explains what you can expect from this Arizona insurance provider. Open enrollment is from November 1 through January 15, so research your options before this window closes.

When you’re ready to sign up for ACA Marketplace insurance, use this free form to compare what’s available and get access to a personalized customer service agent who can answer any questions you have.

Key Takeaways

Antidote is a virtual-first health maintenance organization (HMO), where members can get affordable healthcare when they use providers that are covered within the network.
Because Antidote is not a preferred provider organization, if you choose to see a physician outside of the HMO network, you’ll have to pay for costs out-of-pocket. This means, if you have a preferred provider, you should check to see if they’re covered by Antidote before signing up for this health insurer.
With Antidote, you’re assigned a virtual primary care provider and can get 24/7 virtual care for free. You can typically see a provider in as few as 20 minutes through the Antidote app.

Antidote 2026 ACA Healthcare Plans: What’s Available?

Antidote offers a variety of plans in Arizona for 2026, each with different costs and benefits. There have been some price increases from 2025 to 2026, which are as follows:

Antidote 2025–2026 Rate Changes in Maricopa County

Antidote premiums increased across all metal tiers from 2025 to 2026. The average rate change ranged between 17% and 18%, depending on the plan level.

*Average monthly premium before subsidies, based on Maricopa County Marketplace rates.

Takeaway:

Antidote’s 2026 premiums increased moderately compared to other Arizona carriers, keeping it one of the more affordable options in the Marketplace. With its virtual-first model, low-cost telehealth access, and growing Arizona provider network (including Abrazo, Dignity, and Phoenix Children’s Care Network), Antidote remains a strong pick for individuals and families seeking convenience and lower premiums.

Tayler Busack with AZ Health Insurance Brokers

“Antidote has quickly become a good option for Arizonans who want affordable Marketplace coverage and don’t mind a virtual-first model. Their rates for 2026 are lower than most carriers, and many clients appreciate how simple it is to get care through the app.”

Antidote offers a variety of plans in Arizona for 2026, each with different costs and benefits. There have been some price increases from 2025 to 2026, which are as follows…

Remember, these are just highlights. Be sure to review the full plan details, and consider your individual needs and budget before making a decision.

How Does Antidote Work?

Antidote may be a good health insurance option for individuals and families who want the convenience of healthcare in their smartphone or computer, and who don’t mind being limited to physicians who are covered within the Antidote network. Some of the benefits of having an Antidote individual or family health insurance plan include:

Get 24/7 access to a virtual primary care provider, for $0 cost. With the Antidote app, you can see a healthcare provider virtually within about 20 minutes, any time of day. There’s never any cost to seeing your virtual primary care provider. If that exact person isn’t available, another doctor will help you.
Get free in-person primary care provider visits. It’s also no cost to see a primary care provider in person. When your primary care provider refers you to a specialist, you’ll get a discounted rate, or potentially no-cost care.
Virtual primary care providers can diagnose, treat and prescribe for diverse medical conditions. Virtual primary care providers can offer primary and urgent care, mental health services and chronic health services. Some conditions Antidote virtual care providers can help with include coughs, sore throats, urinary tract infections, muscle sprains, nausea, flu-like symptoms, skin infections, major depressive disorders, diabetes and hypertension.
Get affordable medications. Antidote provides $0 copay options for select prescriptions and low-cost options for other medications.

For Arizona residents, you can expect Antidote coverage for urgent care, emergency response and employed doctors in the Arizona Care Network (ACN) , which includes Dignity Health , Abrazo Health and Phoenix Children’s Care Network , as well as with HonorHealth networks. If your preferred provider is in-network with Antidote, you can continue to see them at in-network prices. If they’re not, you won’t be covered.

Considerations for Antidote

A major consideration with Antidote health insurance plans in Arizona is that you’ll be limited to their network of providers if you want healthcare coverage, since they’re an HMO. If you have doctors you know you want to continue seeing, check that they’re covered in-network with Antidote, first.

Also, because Antidote is so new to the health insurance space (with an investment from National Basketball Association star Giannis Antetokounmpo to boost it!), you should also consider how long you plan on being an Arizona resident for in the year you have coverage. If you move to any other state other than Ohio, you’ll have to find a new health insurer. Moving does typically qualify you for a special enrollment period , in which you can sign up for a new health insurer, but it’s worth considering for the potential inconvenience.

How to Sign Up for Antidote on the ACA Marketplace

When you’re ready to sign up for Antidote on the ACA Marketplace, use our free form . Open enrollment begins November 1 and lasts through December 15 for coverage beginning January 1. If you sign up between December 16 and January 15, your coverage will begin February 1.

If you experience a qualifying event for a special enrollment period , you’ll typically have 60 days before or after the event to sign up, as well. Qualifying events include having a child or adopting a child, moving, losing health insurance through work , getting divorced, and having household income fall below a certain amount .

To sign up for Antidote or compare all your ACA Marketplace options, use our form now . If you have questions about health insurance in Arizona in general, you can call 602.617.4107, contact us online or email quotes@azhealthinsuracebrokers.com .

Antidote ACA Marketplace Individual & Family Insurance FAQs

Blue Cross Blue Shield (BCBS) ACA Marketplace Explained

Fri, 31 Oct 2025 18:21:59 GMT

Whether you’re gearing up for Affordable Care Act (ACA) federal marketplace health insurance open enrollment , or you qualify for a special enrollment period on the ACA Marketplace, it’s helpful to know what your options are if you’re considering those plans. Open enrollment begins November 1 and lasts through January 15, but you can also get ACA Marketplace insurance when you go through a qualifying life change, like moving or having a child. One top insurer to consider for individual and family insurance in Arizona is Blue Cross Blue Shield (BCBS).

BCBS presents some unique advantages among insurers in Arizona. With considerable coverage throughout the state and solid partnerships with top AZ healthcare providers, it’s worth evaluating this network if you need an ACA plan . If you qualify for a special enrollment period, such as divorce or losing health insurance coverage from work, you may be able to enroll in a BCBS ACA plan at any time of year.

When you’re ready to sign up for insurance , contact AZ Health Insurance Brokers for a free consultation. We can help you find the best plan for your unique healthcare needs. When you want to sign up for ACA coverage, use our free link that also connects you with a personalized health insurance broker, in case you need any help during the process.

Key Takeaways

As the only health insurance carrier in Arizona that offers plans in all 15 counties, BCBS offers the most comprehensive health insurance coverage in the state for individuals and families.
BCBS has a statewide network with a strong brand recognition.

What Do ACA Marketplace BCBS Plans Cover?

BCBS is a prominent name in the Arizona health insurance market, as it’s the only carrier in the state that offers plans in all 15 counties. BCBS plans through the ACA Marketplace cover essential healthcare services, including:

Free preventive care with $0 primary care provider (PCP) visits, including screenings, flu shots, wellness checks and immunizations, with no copays
Doctor visits
Prescription drugs, including $0-$3 costs for generic drugs, including prescriptions for diabetes, heart conditions and mental health
$0 nurse on-call, where plan holders can talk with a registered nurse in English or Spanish at any time
24/7 online doctor visits, with English- and Spanish-speaking doctors available
Mental and behavioral healthcare, including psychiatry and counseling services
Outpatient care
Emergency care
Hospital stays
Urgent care
Maternity and newborn care
Dental insurance and vision care for children

Plan holders can also get discounts on health services and equipment, including vision services and wearable fitness devices. You could also earn up to $100 in rewards for taking preventive care measures, such as attending regular health exams and screenings.

There’s also a Blue365 premier discount program for BCBS members. Members can find deals on things like bank savings, gym memberships, apparel, pet health insurance, fitness equipment and more.

With comprehensive health insurance coverage and a variety of perks for plan holders, it’s no wonder BCBS is a top insurer in Arizona.

Types of BCBS ACA Plans

BCBS offers health maintenance organization (HMO) plans. HMO plans are lower-cost but limit plan holders to in-network providers for coverage. With an ACA StandardHealth HMO with Health Choice Plan through BCBS, members are designated a PCP, who can be changed up to six times a year. Plan holders must receive a PCP referral in order to see a non-emergency, non-urgent specialist. Seeing a doctor who isn’t covered could require full charges.

BCBS offers four categories of ACA plans. Each one will have various pricing and benefits.

BCBS 2025–2026 Rate Changes in Maricopa County

BCBS plan rates increased in 2026, following the loss of some major network contracts and overall medical cost adjustments. Here’s how average monthly premiums have changed for a 40-year-old individual in Maricopa County (before subsidies):

* Based on unsubsidized Marketplace premiums for a 40-year-old individual in Maricopa County. Actual rates vary by age, income, and household size.

Tayler Busack with AZ Health Insurance Brokers

“BCBS’s network presence in Maricopa County has declined from 2025 to 2026 with the loss of Phoenix Children’s and Dignity Health. However, they continue to have a strong network presence outside of Maricopa County and remain a reliable option for statewide coverage.”

The following are BCBS ACA Marketplace health plan offerings:

AdvanceHealth HMO: This is a lower-cost plan that includes a low monthly premium, low-cost care and online doctor visits. It’s most recommended for healthy people who want low monthly healthcare costs.

EverydayHealth HMO: For individuals and families with more frequent healthcare needs, this HMO plan offers a variety of deductibles for predictable monthly costs.

Portfolio HSA: This HMO plan is eligible to be paired with a health savings account (HSA) .

StandardHealth HMO: These plans are recommended for those who see doctors frequently or who take prescription drugs for something like a chronic condition.

When you’re signing up for a BCBS ACA Marketplace plan, you’ll see different Metal Levels: Bronze, Silver and Gold.

With Bronze plans, BCBS pays 60% of costs, and the plan holder pays 40% of expenses.
With Silver plans, BCBS pays 70% of costs, and the plan holder pays 30% of expenses.
With Gold plans, BCBS pays 80% of costs, and the plan holder pays 20% of expenses.

Some plans in Arizona will be limited to certain Metal Levels. Here's the breakdown of the plans and networks by county in Arizona.

If you need help deciding on a plan with the benefits you need, that fits your budget, AZ Health Insurance Brokers can guide you through the process. Use our form , and one of our team members will provide expert guidance.

Do You Qualify for Financial Help for a BCBS ACA Plan?

According to BCBS, 9 out of 10 Arizonans are eligible for financial help to pay for their ACA health plan monthly premiums. The following table shows if you do or may qualify for a subsidy or discount on BCBS health insurance through the ACA Marketplace.

Pros of BCBS ACA Marketplace Plans

When you’re comparing BCBS ACA Marketplace plans against other carriers, here are some advantages to consider.

Extensive coverage: BCBS is the only carrier offering plans in all 15 counties, providing a wide network and access to care throughout the state.
Strong provider network: BCBS has contracts with major hospital networks and healthcare providers in Arizona, including Abrazo Health, Barrow Neurological Institute, Dignity Health and Phoenix Children’s Hospital (select networks).
Excellent prescription drug coverage: BCBS ACA plans often provide good coverage for expensive medications listed in their formulary, potentially saving you significant costs on prescriptions.

Because of its extensive coverage, BCBS is one of the best ACA Marketplace options with the widest reach in Arizona.

Cons of BCBS ACA Marketplace Plans

There are also a couple considerations for BCBS ACA Marketplace plans that may not make it the preferred choice. Consider these potential disadvantages.

Cost: BCBS plans can be more expensive compared to other carriers on the ACA Marketplace.
HMO restrictions: HMO plans have limitations on provider choice and may require referrals for specialist visits.

There’s a wide variety of choice for BCBS plans in AZ, but there may be better options out there. Talk with an Arizona health insurance broker for assistance in selecting the best plan for your budget and needs.

Who BCBS Is Best For in Arizona

- Residents in rural or smaller counties who want the broadest statewide network

- Families who want statewide consistency and access to top facilities outside Phoenix

- People who need access to behavioral health, chronic care, and telehealth programs

- Members looking for a strong discount program (Blue365) with health and wellness benefits

How to Get Individual & Family Insurance Coverage Through the BCBS ACA Marketplace

If you want BCBS healthcare coverage as an individual or family in Arizona, you can find health plans using our free ACA Marketplace health insurance link , which also gives you access to a personalized customer representative who’s available to answer any questions you have. Open enrollment begins November 1, but special qualifying enrollment periods, such as moving or having a baby, may allow you to enroll at other times during the year. Use our link now to see what discounts you might qualify for.

If you have questions about health insurance in general, you can call 602.617.4107, email quotes@azhealthinsurance.com , or contact us online to talk with one of our team members. We can present you with all available health insurance options that meet your healthcare needs and budget.

BCBS ACA Marketplace FAQs

Ambetter Health Insurance in Arizona 2026: Everything You Need to Know

Fri, 31 Oct 2025 18:21:54 GMT

When you’re thinking about enrolling in federal health insurance coverage, one of the top insurers offered through the Affordable Care Act (ACA) marketplace is Ambetter . Ambetter is a top ACA marketplace insurer for Arizona residents and offers state-to-state healthcare coverage. Ambetter could be a good option for frequent travelers or for those who split their residence between homes, such as Arizona snowbirds.

At AZ Health Insurance Brokers, we recently helped a family in Scottsdale obtain an Ambetter policy that better fit their family’s health insurance needs. Ambetter’s contracts with Arizona healthcare providers include HonorHealth , Banner Health and others, which makes them one of the strongest health insurers in terms of doctor and provider coverage.

If you’re considering ACA healthcare coverage, you may qualify for a special enrollment period , due to life changes such as moving or having a baby. A special enrollment period enables you to sign up any time of year, as long as you meet the requirements.

Otherwise, ACA open enrollment kicks off November 1 for coverage for the following year, and lasts through January 15. If you want your ACA health coverage to start January 1, sign up by December 15 of the previous year. Otherwise, enrolling between December 16 and January 15 means your coverage will start February 1.

As you compare your healthcare coverage options on the ACA marketplace, use this guide to Ambetter family and individual health insurance in Arizona to see if it’s a fit for you. If you want to see what ACA plans you qualify for in Arizona, fill out this free form for personalized service.

Key Takeaways

Ambetter is one of the United States of America’s top ACA marketplace insurers. Ambetter is one of the best ACA insurers for Arizona residents, because it offers coverage for some of the most prominent healthcare providers in the state.
Ambetter offers state-to-state reciprocity, meaning if you have an Ambetter plan in Arizona and spend the summer or other time in a different state, you can visit a doctor who’s contracted with Ambetter in that state. That makes Ambetter a great choice for Arizona snowbirds who need health insurance.
Ambetter offers some unique health rewards programs in Arizona, including access to full memberships at YMCA. Members can also receive up to $500 to be used towards deductibles and copays through Ambetter’s My Health Pays® rewards program.

What Is Ambetter?

Ambetter is an ACA marketplace product offered by Arizona Complete Health . Ambetter AZ health insurance plans offer coverage for essential health services, and you don’t need a referral to see a specialist on an Ambetter health insurance plan in Arizona.

There are Ambetter plans offered in each of the ACA metal tiers that determine how much the insured is responsible for, versus what the insurance company’s responsible for. Ambetter plans include the following options:

Ambetter Bronze: This bronze tier plan covers essential healthcare needs. People who are insured on this tier typically see lower monthly premiums, but may experience potentially higher out-of-pocket costs for increased amounts of care.
Ambetter Silver: These silver tier plans require slightly higher monthly premiums compared to bronze plans, but they also lessen out-of-pocket costs when you do need care.
Ambetter Gold: Gold tier plans from Ambetter require the highest monthly premium payment amount but also limit out-of-pocket costs when you need care.

Ambetter 2025 Plans: A Closer Look

Ambetter offers a variety of plans in Arizona for 2026, each with different costs and benefits. Based on Maricopa County averages, here’s a look at how rates have changed year over year for the most affordable Bronze, Silver, and Gold plans (without subsidies):

These figures represent unsubsidized rates and can vary slightly by age, location, and specific carrier. Families receiving premium tax credits may see smaller changes depending on their 2026 subsidy eligibility.

To help you understand your options, here’s a closer look at the plan categories.

Ambetter Everyday: This popular Bronze plan offers copays for common services, like primary care physician (PCP) visits, specialist visit, lab work, urgent care and mental health. Expenses beyond these copays apply towards the deductible.

Ambetter Choice: This Expanded Bronze plan is an exclusive provider organization plan that enables members to use a health savings account with the plan. Once the deductible is met, all PCP, specialist and urgent care copays are paid by the insurance company.

Ambetter Standard: This plan category offers Bronze, Silver and Gold options, giving you more choices to find the right balance of premiums and out-of-pocket costs.

Ambetter Complete: Available in Silver and Gold options, Ambetter Complete offers more flexibility and lower copays compared to the Standard plans.

Ambetter Elite: This premium Gold plan offers a $0 deductible, low copays and a low out-of-pocket maximum, providing comprehensive coverage.

Remember, these are just highlights. Be sure to review the full plan details, and consider your individual needs and budget before making a decision.

All plans, no matter what metal tier they’re in, offer essential health benefits. These include coverage for essential medical care and wellness services, including:

Emergency care
Outpatient or ambulatory care
Preventive and wellness care
Mental health and substance abuse care
Laboratory services
Prescription drugs
Hospitalization
Maternity and newborn care
Therapy services
Pediatric care
Virtual 24/7 care

Ambetter members can use the Ambetter mail-order pharmacy program for medications or get prescriptions from in-network retail locations.

Ambetter also offers a Start Smart for Your Baby® maternity health program , which offers support for maternity provider search, mental health, breastfeeding and baby development.

Ambetter members can also access a health savings account (HSA) from Fidelity. Ambetter members can add savings to their HSA tax-free and use that money to pay for covered healthcare services.

Benefits of Ambetter Plans

Ambetter offers some unique health and wellness rewards programs for its members, as well as a discount program with perks for members. Some Ambetter benefits include:

Ambetter Perks Member Discount Program : Members can enjoy special rates and discounts on products and services such as restaurant dining, travel, entertainment, technology, gym memberships and food delivery programs.
My Health Pays® : My Health Pays® is a points-based rewards system that rewards members up to $500 for completing actions such as getting an annual wellness screening.
YMCA & YMCA360 Membership : Ambetter members have access to full memberships to in-person YMCA locations, as well as can access YMCA360, the virtual version of YMCA.

Ambetter health management programs in Arizona also provide telephone support, behavioral health services, educational tools, tobacco cessation programs and management programs for chronic conditions, including asthma, diabetes, low back pain, depression, hypertension and coronary artery disease.

Who Ambetter Is Best For in Arizona

Ambetter can be a strong fit for many Arizona residents, but it tends to work best for:

- Families whose doctors are in the Banner Health or HonorHealth systems

- Snowbirds who split time between Arizona and another state and want network reciprocity

- Individuals who like earning wellness rewards through programs like My Health Pays® or YMCA

- People who are comfortable with HMO-style networks and value strong telehealth options

Each of these groups can take advantage of Ambetter’s combination of network access, preventive care benefits, and reward programs while staying within budget-friendly ACA plan tiers.

Tayler Busack with AZ Health Insurance Brokers

“We’ve seen Ambetter remain one of the stronger Marketplace carriers in Arizona. Especially for families who want access to major hospital systems like Banner and HonorHealth, without having to worry about getting a referral to see a specialist.”

With lots of member resources and a variety of pricing options, you might find that an Ambetter plan through the ACA marketplace makes sense for your budget and the unique healthcare needs of your family.

How to Get Individual & Family Insurance Coverage Through Ambetter

You can enroll directly with Ambetter or through a licensed Arizona health insurance broker. Working with a local broker ensures you get personal help comparing every plan available.

If you’re interested in signing up for Ambetter, or you want to compare all your ACA marketplace plan choices in Arizona, use our free link to see your ACA healthcare options. A professional representative from AZ Health Insurance Brokers will reach out to show you what’s available and answer any questions you have, so you can feel confident you’re signing up for the best plan.

If you have questions about health insurance in general, the AZ Health Insurance Brokers team is here to help. We have private health insurance options available, as well. Contact us for free, at 602.617.4107, by quotes@azhealthinsurance.com or online .

Compare Ambetter vs Other Marketplace Carriers

Not sure if Ambetter is the best fit for your needs?

See our 2026 Marketplace Comparison Guide to compare Ambetter with BCBS, Cigna, Oscar, and other Arizona carriers. It breaks down key differences in network size, plan types, and out-of-pocket costs to help you make the best decision for your family.

Ambetter Individual & Family Insurance FAQs

Oscar Health Insurance Options for Individuals & Families in AZ

Fri, 31 Oct 2025 17:56:17 GMT

For individuals and families who are looking for health insurance options on the Affordable Care Act (ACA) Marketplace , one provider to consider in Arizona is Oscar . This innovative, technology-forward insurer offers a variety of health plans for various healthcare needs and diverse individual/family budgets.

If you’re interested in Oscar (or any other health insurance plan on the ACA Marketplace), open enrollment begins November 1 and lasts through January 15. There are also several qualifying events, such as moving or losing health insurance coverage through work, that could qualify you for a special enrollment period at any time of year.

This guide explains how Oscar coverage through the ACA Marketplace works. If you want to learn about all the ACA Marketplace health insurance options available to you and your family, fill out our free form to compare yours. You’ll gain access to a personalized ACA insurance expert who can answer any questions you have about your options.

Key Takeaways

Oscar is a technology-forward insurance carrier in Arizona that has been around for a little more than a decade. Oscar offers an extensive network of providers in the state who are covered under their plans, most of who are also covered under Cigna insurance plans.
Oscar is contracted with Arizona healthcare providers including Abrazo Health, Banner Health, HonorHealth and various Valley hospitals. Those who are insured under Oscar have lots of in-network provider options.
You don’t have to get a referral from a primary care physician in order to see a specialist with Oscar health insurance. This may be a potential benefit for individuals and families who want more healthcare provider choice and control. However, since Oscar is an exclusive provider organization, members are limited to in-network providers if they want their care covered.

Benefits of Oscar Insurance for Individuals & Families

Oscar was created to make healthcare more affordable and convenient for individuals and families in states like Arizona. Some of the benefits of using Oscar for health insurance include the following.

Convenient app: You can use the Oscar app to find doctors, hospitals and pharmacies nearby that accept Oscar healthcare plans. You can also filter providers and get matches based on your unique language preference, race, ethnicity and health history.
Free 24/7 virtual urgent care : Oscar members can get free virtual urgent care in as few as 15 minutes, for common issues such as skin conditions, sore throat, allergies, sinus infection, nausea, vomiting and UTIs. You can use the service to get a diagnosis, refill a prescription or get a new prescription, all without having to pay a copay or go somewhere.
Virtual primary care : Oscar members in Arizona can also schedule free virtual primary care visits via video. Members can also message their medical teams – which consist of a provider, a nurse and a medical coordinator – at any time through the app.
Low-cost prescriptions : Oscar members can get many commonly prescribed drugs for as low as $3 . You can get prescriptions filled or refilled directly in the app, as well as get potential same-day delivery to your home, making prescription management easy and convenient with Oscar. Pharmacy options include CVS, Costco Wholesale, Safeway and Walmart.

Oscar also has a lab network with Sonora Quest Laboratory, a common lab in Arizona. With extensive network coverage and low-cost healthcare options, Oscar may be a newer name on the scene, but it’s already gaining popularity among Arizonans.

Considerations for Oscar Insurance

There are also some things to consider before choosing Oscar as your health insurer. Oscar health insurance is an exclusive provider organization (EPO). That means:

Only in-network doctors are covered under the Oscar health insurance plan.
If you see an out-of-network doctor, you’ll likely have to pay for services out-of-pocket.
There are certain exceptions, such as when a plan holder needs emergency care, and an in-network doctor isn’t available.
You don’t need a referral to see a specialist. In-network specialists are covered under Oscar.

An EPO like Oscar may not be your preferred health insurance choice if your preferred doctors aren’t covered in-network. Generally, if a physician is covered under the Cigna network, they’ll probably also be covered under Oscar.

If you know you have doctors you want to continue to see, you should check if they’re in-network with Oscar so you understand what your costs will be.

What Oscar Health Insurance Plan Tiers Are Available on the ACA Marketplace?

Oscar ACA Marketplace health insurance plans are divided into various metal tiers, each of which have varying percentages of what the insured pays and what Oscar covers. All the plan benefits are the same – the only differences are the premium prices and the out-of-pocket costs. Plan breakdowns are as follows.

Bronze plan: This plan has a lower monthly premium, with higher out-of-pocket expenses. With this plan, 60% of covered health costs are paid by Oscar, and 40% are paid by the plan holder. This can be a good choice if you want emergency coverage but don’t expect to use your healthcare coverage that frequently.
Silver plan: This plan has a moderate monthly cost and moderate out-of-pocket expenses. With this plan, 70% of covered health costs are paid by Oscar, and 30% are paid by the plan holder. You may be eligible for cost share reductions on this plan, which could be a good choice if you’re willing to pay a slightly higher monthly premium than a bronze plan and get more healthcare covered.
Gold plan: This plan has a higher monthly premium with lower out-of-pocket expenses. With this plan, 80% of covered health costs are paid by Oscar, and 20% are paid by the plan holder. This plan may be a good choice if you use healthcare coverage frequently.

Oscar 2025–2026 Rate Changes in Maricopa County

Oscar has adjusted plan rates for 2026 to reflect overall medical usage and higher prescription costs. Here’s how average monthly premiums have changed for a 40-year-old individual in Maricopa County (before subsidies):

Within each metal tier, Oscar offers three types of plans. Each type presents different coinsurance and copay options, as follows.

Standard
Lowest monthly cost
Highest coinsurance
Mostly available in Bronze and Silver metal tiers
Available for condition-specific plans, including diabetic and COPD plan options.

*Based on unsubsidized Marketplace premiums for a 40-year-old individual in Maricopa County. Actual costs vary by age, income, and household size.*

Tayler Busack with AZ Health Insurance Brokers

“Oscar’s plans are priced more competitively compared to other carriers. When you factor in their strong network and easy-to-use app, this will be one of the more popular Marketplace carriers for 2026.”

Within each metal tier, Oscar offers three types of plans. Each type presents different coinsurance and copay options, as follows.

Simple
Lowest monthly cost
Highest coinsurance
Mostly available in Bronze and Silver metal tiers
Available for condition-specific health insurance plans, including COPD and diabetic plan options

Classic
Mid- to high monthly cost
Mix of coinsurance and copays – for example, there may be copays for labs and coinsurance for a hospital stay

Elite
Highest premium
Mostly copays, lower coinsurance
$0 medical deductible with Silver plan
Prescription deductible included

If you need help navigating all these metal tier and plan type options, fill out the ACA Marketplace insurance form . It’s free, and you’ll receive personalized service from an experienced health insurance professional who can answer any questions you have about all your options.

Who Oscar Is Best For in Arizona

- Tech-savvy members who want to manage care through a mobile app

- Families who use providers in the Banner, HonorHealth, or Abrazo systems

- People who prefer no-referral access to specialists

- Members looking for low-cost virtual care and $3 prescription options

- Snowbirds who split time between Arizona and other Oscar-covered states

How to Get Oscar ACA Marketplace Insurance in AZ

Open enrollment for Oscar ACA Marketplace insurance is upon us. If you want to sign up for health insurance through the ACA Marketplace and see how your options with Oscar compare to other health insurers in AZ , we can help. Fill out our free form to see your options and get personalized guidance throughout the signup process.

You can also call us at 602.617.4107, email quotes@azhealthinsurancebrokers.com or message us online , and we’ll contact you shortly.

Oscar Individual & Family Insurance FAQs

Imperial Health Individual & Family Health Insurance in AZ Explained

Fri, 31 Oct 2025 16:05:52 GMT

If you’re looking for health insurance in Arizona, one option is to get it through Imperial Health. Imperial Health individual insurance and family insurance is offered on the Affordable Care Act (ACA) marketplace , which offers open enrollment from November 1 through January 15 of each year. Certain qualifying events may also enable individuals to get health insurance outside of open enrollment on the ACA marketplace any time of year. These events include circumstances such as moving, having a baby, getting divorced, or losing health insurance due to job loss.

Like all health insurance companies in Arizona, Imperial Health has pros and cons to think about. Since ACA marketplace open enrollment is on the horizon, here are some considerations to help you decide if Imperial Health is the right insurance for you and/or your family.

Ready to sign up for ACA Marketplace insurance? Use our free form to get personalized assistance from an insurance expert as you navigate the marketplace.

Key Takeaways

Imperial Health is a health insurance plan provider offered on the federal Affordable Care Act (ACA) marketplace for Arizonans. Open enrollment is between November 1 and January 15 of each year, but certain qualifying experiences may trigger a special enrollment period. These include events such as moving, having a baby, or getting divorced.
Imperial Health plans are health maintenance organization (HMO) plans. These plans typically require that the plan holder secure a primary care physician (PCP), who will then make referrals to specialists.
Some of the unique benefits of Imperial Health plans are the Member Quality Rewards Program, which offers cash rewards for completing health actions like getting annual physicals and vaccines, and a pregnancy program for expectant mothers.

What Is Imperial Health Insurance?

Imperial Health offers health maintenance organization (HMO) individual and family health insurance plans that are available for Arizona residents living in the following counties: Gila, Maricopa, Pima, Pinal, Santa Cruz, Yavapai and Yuma. Plans are available on the ACA marketplace in bronze, silver and gold tiers, with characteristics including the following.

Bronze Imperial Health plans: Good value, lowest monthly premiums, highest copayments; ideal for individuals and families who want to pay less per month, but more per doctor visit
Silver Imperial Health plans: Best value, lower monthly premiums and lower copayments; ideal for individuals and families who want low monthly premiums and copayment costs
Gold Imperial Health plans: Better value, higher monthly premiums, moderate copayments; ideal for higher income for individuals and families who are able to budget for moderate monthly premiums and copayments, and who visit doctors frequently

Imperial Health plan rates have changed from 2025 to 2026 as carriers adjust for higher overall medical usage and prescription costs. Here’s how average monthly premiums in Maricopa County compare year over year (for an individual age 40, before subsidies):

*Based on publicly available Marketplace rates in Maricopa County; actual premiums vary by age, income, and household size.*

Imperial has continued to grow its presence in Arizona’s Marketplace, particularly for families who want affordable access to major children’s hospitals.

Tayler Busack with AZ Health Insurance Brokers

“We’ve seen Imperial become a go-to choice for families who want to stay with Phoenix Children’s providers or need a more affordable Marketplace option. Even with this year’s rate increases, Imperial is still one of the most competitively priced carriers in Maricopa County.”

Within each of these metal tiers, there’s a variety of plans to choose from . Like all ACA plans, Imperial Health plans meet ACA standards and include the following essential health benefits.

Behavioral health and substance abuse services
Lab and radiology testing
Maternity and newborn care
Out of area emergency room coverage
Pediatric dental care
Pediatric vision care
Physical medicine and rehabilitation
Prescription drug coverage
Primary care and specialist visits
Urgent care

Imperial Health offers options for pediatric vision care through VSP and for pediatric dental care through Delta Dental.

Because the cost of not having insurance is so high , Imperial Health is a great option to consider if you and/or your family is currently lacking health insurance. With ACA marketplace coverage from Imperial Health, you’re protected in case of life events like pregnancy or urgent care.

Benefits of Imperial Health Plans

In addition to the standard ACA health plan coverage Imperial Health offers, there are some other plan benefits that members may take advantage of. These include:

24-hour nurse advice line: Imperial Health members can call with health questions any time.
Personal care management: For those with chronic medical conditions, such as asthma, diabetes or high blood pressure, Imperial Health plans can be customized to ensure members receive the comprehensive care they need.
Pregnancy program: Imperial Health has a pregnancy program specifically to help expectant mothers and their families who are supporting them.
Dedicated customer support: Imperial Health members can get reliable customer support, including in other languages, such as Spanish.

Another benefit of Imperial Health is that you can earn rewards through the Member Quality Rewards Program . When you complete your annual health screenings and vaccinations, adults on a plan can earn up to $100 in rewards, and children can earn up to $90 in rewards. You can get rewarded simply for taking proactive care of your and your family’s health.

Altogether, Imperial’s combination of affordability, pediatric focus, and member support programs make it one of the more accessible Marketplace carriers for families in central Arizona.

Considerations for Imperial Health Plans

Imperial Health plans can provide a cost-friendly option for individuals and families who want to get coverage through the ACA Marketplace. Besides the pros, some factors to consider include:

Imperial Health plans are limited to HMO options. If you’re looking for a preferred provider organization (PPO) plan, there are other offerings for those on the ACA marketplace.
Because Imperial Health plans are HMO plans, you’ll have to see a PCP before you can see a specialist. This may limit your provider options. If you have a preferred provider who’s not covered under Imperial Health, you’ll want to look for a different plan provider.
Imperial Health’s coverage is more limited, compared to other plans. The ACA marketplace plans are only currently offered in four states (the others are Nevada, Utah and Texas) and only in seven Arizona counties. For snowbirds or those who travel frequently outside of Arizona, you may want a different individual or family health insurance option.

The good news is, the ACA marketplace experts at AZ Health Insurance Brokers can steer you towards the right choice, at no cost to you. Fill out this form to connect with our ACA insurance team now.

Who Imperial Health Is Best For in Arizona

Families whose children see providers at Phoenix Children’s Hospital
Individuals looking for budget-friendly HMO coverage
Members who value pregnancy or chronic-condition management programs

How to Get Individual & Family Insurance Coverage Through Imperial Health

If you’re curious about Imperial Health and other ACA marketplace plans for yourself or your family, the ACA experts at AZ Health Insurance Brokers can help. We’ll walk you through your best options based on your budget and the unique healthcare needs of yourself and your family.

Contact us online , call us at 602.617.4107 or email quotes@azhealthinsurance.com . If you’re interested in private health insurance options, fill out this form , and we’ll be in touch.

Not sure if Imperial is the right fit?

See our 2026 Marketplace Comparison Guide to compare Imperial with Ambetter, BCBS, Cigna, Oscar, and more.

Imperial Health Individual & Family Insurance FAQs

Cigna Health Insurance in Arizona 2026: Everything You Need to Know

Fri, 31 Oct 2025 15:39:09 GMT

In Arizona, one of the most popular insurance companies around is Cigna HealthCare of Arizona. It’s offered through group health insurance by many Arizona employers, and it’s also available for individuals and families seeking coverage. You can also compare all 2026 Arizona Marketplace carriers here .

During open enrollment for the federal Affordable Care Act (ACA) Marketplace , you can sign up for Cigna individual or family insurance between November 1 and January 15. Special qualifying events may also trigger a special enrollment period at any time of year.

For individuals and families looking for insurance , Cigna health insurance tends to be more expensive compared to other carriers on the ACA Marketplace . But for people who have preferred doctors who are covered by Cigna, and/or they’re taking an expensive medication that Cigna healthcare offers coverage for, Cigna may be a good ACA Marketplace choice.

In this blog, learn more about what to expect from Cigna ACA Marketplace plans in Arizona. When you want to compare your ACA Marketplace options, fill out our free form . You’ll see pricing and coverage comparisons and will get access to a free ACA Marketplace liaison who can help you with any questions you might have.

Key Takeaways

While Cigna is a reputable insurer with comprehensive healthcare coverage for a variety of needs, for individuals and families looking for insurance, Cigna’s ACA Marketplace pricing tends to be more expensive compared to other carriers. In Arizona, Cigna is generally an ideal choice if you have a preferred doctor who’s covered by Cigna, or you’re taking an expensive prescription that Cigna covers, but other plans don’t.
With Cigna health insurance plans, you don’t need a referral from a primary care physician to see a specialist. This can be a convenient benefit that puts more healthcare choice in members’ hands.
In Arizona, Cigna’s lab network includes Sonora Quest Laboratories , Labcorp and Evernorth . Cigna is also contracted with several Arizona healthcare providers, including Barrow Neurological Institute , Dignity Health , HonorHealth and KPC Promise Hospital of Phoenix .

Who Cigna Is Best For in Arizona

Individuals who already use Cigna doctors or Dignity/HonorHealth facilities
People who prefer no-referral plans for specialist visits
Families managing diabetes or chronic care who benefit from Cigna’s support programs
Consumers prioritizing telehealth and national brand recognition

Cigna ACA Health Insurance for Individuals & Families

Cigna offers many benefits worth considering when you’re shopping for ACA Marketplace insurance for individuals or families. Some of the advantages Cigna offers include:

Variety of prices among plan choices: In addition to $0 preventive care across all plans and $0 copays for generic drugs and virtual care, Cigna also offers $0 deductible plans.
Rewards programs: Cigna provides the Cigna Take Control Rewards® program , which enables members to earn points redeemable for a Reloadable Reward Card, which can be used for healthcare expenses. The Cigna Healthy Rewards® Program provides discounts on health products and programs.
Diabetes assistance: Members with diabetes can lower out-of-pocket costs by 40% or more. Benefits include: a maximum of $25 for a 30-day supply or $75 for a 90-day supply of insulin and some medications for type 2 diabetes; $0 for diabetes supplies on the Cigna Healthcare prescription list; $0 for select labs and exams; and $0 for diabetes management training.
24/7 virtual care: Free medical and behavior virtual care is available at any time of day or night.
My Personal Champion® program: The free My Personal Champion® program is available to members who have highly complex, specialized conditions or several health circumstances that need extra attention. Members in this program receive a “personal” champion who can provide health benefit education, oversight of benefits application, help identifying local resources and other services.

As one of the largest health insurance providers in the country and in Arizona , Cigna has lots of helpful resources for members. For those with unique health conditions or who have diabetes or other specialized care needs, Cigna could be a good option, based on the resources the insurer provides.

What Types of Cigna ACA Marketplace Plans Are Available?

Cigna offers ACA Marketplace plans on bronze, silver and gold metal tiers. Average premiums have risen from 2025 to 2026, based on rates for a 40-year-old individual in Maricopa County.

Connect Bronze: Bronze plans have the lowest monthly premiums but the highest out-of-pocket expenses. You may be eligible for premium tax credits to help with the cost.

* Based on unsubsidized monthly premiums for a 40-year-old individual in Maricopa County. Actual rates vary depending on age, income, tobacco use, and household size.

Tayler Busack with AZ Health Insurance Brokers

“We’ve seen Cigna remain a strong option for Arizonans who want access to Cigna, Dignity, or HonorHealth facilities without needing a referral to see a specialist. Even though this year’s prices have gone up, the pricing is more in line with the other carriers this year.”

Each tier has different costs and benefits, so it’s important to understand the differences to choose the right plan for your needs.

Generally, the differences between these plans are as follows.

Bronze: Bronze plans have the lowest monthly premium costs but the highest out-of-pocket expenses. Members on these plans may be eligible for premium tax credits , based on factors like income.
Silver: Silver plans are ideal for families and individuals who see doctors regularly. These plans provide a middle balance of premium costs and out-of-pocket expenses and offer premium tax credit eligibility, as well as potential cost-sharing reductions.
Gold: Gold plans are best for individuals and families who see doctors frequently and who take multiple prescription medications. These plans have the highest monthly premium but the lowest out-of-pocket expenses on healthcare. They’re also potentially eligible for premium tax credits.

When you’re deciding on your Cigna metal tier, you’ll want to consider how frequent your healthcare needs are, how much you want to pay each month on a premium, and how much you’re willing to pay out-of-pocket for healthcare costs. When you fill out our free ACA Marketplace form , our professional representative can guide you through which Cigna metal tier might be the best choice for your unique situation.

Because Cigna is one of the more expensive ACA Marketplace choices in Arizona, it may be a good idea to compare it with other plans before signing up for Cigna on the ACA Marketplace. You could potentially get similar benefits on a less expensive plan. Our team can help guide you.

How to Sign Up for Cigna on the ACA Marketplace

Open enrollment for Cigna and all ACA Marketplace plans begins on November 1 and lasts through January 15. When you’re ready to sign up for an ACA Marketplace plan , use our form . You’ll be able to see all plan options and prices and will get a dedicated representative to help every step of the way.

If you want your ACA Marketplace insurance coverage to begin January 1, 2026, make sure to sign up by December 15. If you sign up for health insurance after December 15 through January 15, your coverage will begin February 1, 2026.

There are also special qualifying events that may enable you to sign up for an ACA Marketplace plan at any time of year. These include moving, having a baby , adopting a child, getting divorced, and having your household income fall below a certain amount. If you want to see if you qualify, fill out our form .

Have questions about Arizona health insurance overall? The AZ Health Insurance Brokers team is ready to provide assistance. We can walk you through all your health insurance options, with no obligation, so you can understand your choices before deciding on a plan. Contact us online , email quotes@azhealthinsurancebrokers.com or call 602.617.4107 for more information.

Cigna ACA Marketplace Individual & Family Insurance FAQs

Arizona Health Insurance Tips: 3 Common Mistakes at Renewal Time

Sun, 28 Sep 2025 17:53:13 GMT

Every year, you typically have the opportunity to choose to renew your existing health insurance plan, or make changes and enroll in something new. At AZ Health Insurance Brokers, we help people sign up for all types of insurance, including group business health insurance for their employees, individual health insurance and family health insurance .

From working with self-employed individuals and individuals who want better insurance plans for their families, to consulting business owners on options to consider for their workforces in 2026 and beyond, our decades of experience serving diverse groups have shown common trends in regards to purchasing health insurance.

For business owners, offering health insurance can impact everything from hiring better talent, to retaining top performers. The 2025 “Forbes” Advisor survey found employer-covered healthcare is still the #1 benefit employees want, with more than two-thirds of employees believing this is the most important benefit. Business owners agree, as 68% of employers said employer-covered healthcare is also the most important benefit.

For employers that offer health insurance , we’ve rounded up the three most common mistakes business owners make when it comes to renewing health insurance plans for the employees at their companies. Consider these pitfalls and ways to mitigate risks, to keep employees happy and provide the best options for your workforce.

Key Takeaways

Making a mistake during business health insurance renewal time could result in extra costs for your business.
To avoid overpaying for group health insurance or choosing a plan that doesn’t benefit your employees, we recommend to speak with an expert group health insurance broker who can make personalized recommendations based on your ideal budget and coverage to compare plans.
You can also save money on group health insurance by adjusting your previous offerings. By looking at details like your employees’ healthcare usage trends, there may be savings opportunities year-over-year.

Group Health Insurance Mistake #1: Not Shopping Insurance

First, one of the main mistakes we see is employers not shopping around for insurance every year. Many employers simply renew the same business insurance policy they had the year prior, even if it’s no longer the best fit for their employees.

For businesses that are focused on scaling and growing, especially those that have at least 10 employees enrolling in employer-offered health insurance , it really makes sense to shop business insurance plans every year. Carriers go through cycles based on who’s buying market share for the current year compared to the previous year, so it’s important to take a fresh look at everything on an annual basis. That way, you can get all available options laid out in front of you.

This is a free service we provide for all our group health insurance providers at AZ Health Insurance Brokers. Every year, we walk our clients through all available plans, so they can be confident the one they’re choosing works for their workforce.

If your broker doesn’t help you shop for group health insurance every year, you should find one who will walk you through your options, so you can see every single option from every carrier to compare their offerings and their rates.

Sometimes it makes sense to pivot, and sometimes it makes sense to stay put. It really depends on your individual company and your risk pool.

Group Health Insurance Mistake #2: Not Offering New Options

In addition to not shopping for business health insurance , another mistake employers make is staying with the same insurance year over year, without considering new options that could meet employees’ current needs. For example, if there’s a significant increase in insurance costs, instead of just forcing employees to keep their same plan at a higher cost, an alternative would be to offer a new option that’s going to be at a similar cost to what they were paying, but that provides a little bit less in benefits.

At AZ Health Insurance Brokers, we recommend to put yourself in the shoes of your employees, so that you can make better decisions from an employee-centric point-of-view. Employers can survey employees about their thoughts on their current insurance plans and what would make them better, which is valuable information employers can use when they’re shopping for insurance. Knowing what employees want can also help businesses better position their insurance offerings when they’re trying to hire new talent.

We also recommend that employers consider budgeting for a health insurance expense increase each year. Generally, there will be between a 7% and 9% annual increase for 2025 to 2026 renewals, according to current data. If you can plan this increase in your annual budgets, you’ll be better able to maintain health insurance plans employees want without a surprise increase.

Group Health Insurance Mistake #3: Not Looking at All the Details

Finally, the third major mistake we see business owners make at renewal time is not looking at all the granular details of plans, from health insurance to dental insurance . A trusted business insurance broker can do this for you and explain details and changes quickly and clearly, which may be easier than sifting through the fine print yourself.

Why is it important to review all insurance plan terms? It’s really important to look at all the variables in an insurance plan because insurance is more than deductibles, out-of-pocket maximums and coinsurance. You need to look at factors like doctors networks, the prescription drug formulary, how emergency room visits are covered and how major diagnostics are covered.

You don’t want your staff to be blindsided by an oversight. For example, an ER copayment on a previous plan could pivot to a deductible coinsurance on a new plan. That could result in unexpected expenses for your employees, and major stress and hassle that impacts your business operations.

Top 3 Mistakes at Group Health Insurance Renewal Time

Group Health Insurance Renewal in 2026: What Arizona Employers Should Expect

Every state is different when it comes to group health insurance options, and Arizona has some unique considerations. Be aware that:

Banner|Aetna is discontinuing the brand’s federal Affordable Care Act (ACA) Marketplace offering in Arizona, with its last day on December 31, 2025. This might impact some groups, who will need to find a new employee health insurer in order to provide coverage in 2026.
UnitedHealth’s digital-focused Surest product is experiencing tremendous growth in employer insurance popularity in Arizona. Surest is a copay-only health insurance product that, according to the brand, can lower employer costs by up to 15% when employees choose lower-cost care. We’ve seen Surest in action in Arizona, helping one business with 80 employees reduce overall claim utilization by 10% in just a few months in 2025.
In 2026, Blue Cross Blue Shield (BCBS) of Arizona will remain the only statewide ACA Marketplace carrier. BCBS of AZ is the only Arizona health insurance provider that offers a statewide preferred provider organization (PPO) plan that’s available in all 15 counties.

It’s also important to be mindful that group health insurance premiums in 2026 will likely rise due to medical inflation. With carrier changes, such as the Banner|Aetna exit and more interest in Surest and level funded health plans, it’s always important to shop group health insurance every renewal cycle to ensure you’re getting the best provider for your business.

Have a question about the best group health insurance provider in Arizona for your unique business? Contact AZ Health Insurance Brokers for a free consultation .

Avoid These Group Health Insurance Renewal Mistakes: Contact AZ Health Insurance Brokers

Since health insurance consistently ranks as one of the top employer-offered benefits to workers, it’s important that employers work with a trusted health insurance provider who can help them select the best coverage for their employees. Simply renewing the same plan every year may not make sense for your workforce, as plan details, prices and other factors are always subject to change. In some cases, as with the exit of Banner|Aetna from the ACA Marketplace in Arizona in 2026, you may need to change your group health insurance offering.

When you choose AZ Health Insurance Brokers as your group health insurance partner, you can be assured we’ll:

Shop all current insurance plans and present you with relevant options to consider.
Walk you through any price increases and explain how you can make plans that are in your budget work for your workforce.
Alert you to any changes and all term details that could impact your business and health insurance selection.

If you want to start offering group health insurance to your employees, or you already are, and you want to make sure you’re offering the best plan at your business, call AZ Health Insurance Brokers. We offer free consultations for business owners and look forward to helping you.

Business Health Insurance Renewal FAQs

HSA-Eligible Plans in Arizona: Who Should Use One & How to Maximize It

Sat, 13 Sep 2025 15:53:44 GMT

For some people who want to maximize their healthcare savings, it makes the most sense to pair a high deductible health plan (HDHP) with a health savings account (HSA). HDHPs are sometimes called HSA-eligible plans , because unlike higher-cost low deductible health plans, HDHP holders can use an HSA to save for healthcare expenses, tax-free.

HSA-eligible plans may make sense for both employers and individuals and families who need health insurance. In this post, learn what HSA plans Arizona are available, including both Affordable Care Act (ACA) federal marketplace HSA-eligible plans and private HSA insurance Arizona.

Key Takeaways

An HSA-eligible plan is a high deductible health plan (HDHP) that can pair with a health savings account (HSA). HSA participants and, potentially, their employers, can contribute to an HSA tax-free, to accumulate savings for the plan holder to pay for medical costs tax-free.
Not all HDHPs are HSA-eligible. To find an HDHP plan that works with an HSA in Arizona, you’ll want to search for an HDHP plan that states “HSA” in the plan title to ensure it’s HSA-eligible.
Other requirements for HSA eligibility include: an individual must be younger than the age of 65 years old and must not be claimed as a dependent on another health insurance plan.

First: What Is an HSA-Eligible Plan?

In order for a health insurance plan to be considered HSA-eligible , it must meet rules set forth by the Internal Revenue Service (IRS). The HDHP must both:

Set a minimum deductible for what the plan holder pays for healthcare services and items each year before the HDHP starts to pay out
Designate a limit, or maximum, for out-of-pocket expenses an individual and family would pay per year on additional healthcare services and items

In addition to using an HDHP, someone on an HSA-eligible plan may open an HSA. This savings account lets the individual (and potentially an employer, if the plan is through work) set aside money on a pre-tax basis for qualified medical costs.

Who Should Use an HSA-Eligible Plan?

Using an HSA-eligible plan may make sense in a variety of situations. These include:

You don’t currently require a lot of healthcare services and items, and you don’t anticipate that you will in the future.
You’re good at saving, so you can build up savings in an HSA, and then benefit from tax-free contributions and withdrawals when needed.
You think you could benefit from a lower monthly premium and by rolling over an unused HSA balance year after year.

If you are someone who currently requires a lot of medical care, or you anticipate you might have a lot of future medical bills due to age or health conditions, the stability of a traditional health insurance plan with a lower deductible may make more sense. While HDHP plans do provide the benefit of lower monthly premiums and the potential to accumulate savings in an HSA, unexpected medical costs on an HSA-eligible plan could mean higher out-of-pocket expenses until your deductible and out of pocket maximum has been met.

But, if you’ve been consistently relatively healthy, and you can commit to saving in an HSA, you could lower your health plan costs overall with an HSA-eligible plan.

Real Arizona HSA Plan Examples

At AZ Health Insurance Brokers, we help clients in very different situations find the right HSA-eligible plan. Here are a few examples:

Case Study 1: A 35-year-old with a pre-existing condition wanted an HSA-eligible plan so he could max out contributions and take advantage of the tax deductions. Ambetter ended up being the best fit since his doctors were in-network and the plan supported his ongoing health needs.

Case Study 2: A healthy family of high-income earners wanted to keep premiums down while still having a strong national network. For them, a private UnitedHealthcare (UHC) HSA-eligible PPO plan made the most sense — it gave them the balance of cost and flexibility they were looking for.

Case Study 3: Another client saw a naturopathic doctor regularly and knew insurance wouldn’t cover many of those expenses. We recommended a high deductible health plan (HDHP) paired with an HSA, so they could use pre-tax dollars to cover their naturopathic care and supplements.

These examples show there’s no one-size-fits-all answer. The right plan depends on your health, income, and how you actually use care. That’s where having a broker run the comparisons can save you time, money, and stress.

Pros & Cons of HSA Plans

If you’re considering using an HSA plan, consider these pros and cons to help you decide.

Pros of HSA Plans

Triple tax advantage: Contributions to, investment growth of HSA funds and withdrawal of HSA funds for qualified expenses are all tax-free.
Lower monthly premiums: HDHPs typically cost less in monthly premiums compared to traditional low-deductible health insurance plans.
Long-term savings: You can potentially grow long-term savings, since unused HSA funds roll over year to year and never expire.
Flexibility: HSA funds can cover medical, dental, vision and even certain Medicare expenses in retirement.
Portability: Your HSA stays with you, even if you change jobs or health plans.

Cons of HSA Plans

High up-front costs: Deductibles and out-of-pocket maximums with HSA-eligible plans are higher than traditional health insurance plans.
Not ideal if you need frequent care: Families or individuals with ongoing health issues may pay more out-of-pocket compared to traditional health insurance plans.
Contribution limits: The IRS places a limit on how much you can contribute to an HSA annually.
Requires discipline: In order to realize the financial benefits, you need to actively save into the HSA account.

Arizona HSA-Eligible Carriers

If you work in Arizona, your employer may offer group health insurance that’s HSA-eligible. Individuals and families also have more options for health insurance, even when their employer offers it. The following are HSA-eligible plans that self-employed individuals, and families and individuals who want a different choice outside their work plan, can consider.

Ambetter

Ambetter is one of the most popular Affordable Care Act (ACA) marketplace plans for individuals and families, making it one of the best HSA plans for self-employed AZ professionals.

Ambetter is contracted with Arizona healthcare providers such as Banner Health and HonorHealth. That gives its HSA-eligible plan holders more provider coverage. You also get Arizona YMCA membership with Ambetter plans, and you can earn up to $500 to be used towards your deductible through the Ambetter My Health Pays® rewards program.

Open enrollment for Ambetter on the ACA Marketplace is between November 1 and January 15 every year. If you qualify for a special enrollment period, due to an event such as pregnancy or moving, you may be able to enroll at a different time.

Blue Cross Blue Shield (BCBS)

Blue Cross Blue Shield (BCBS) also offers several HSA-eligible plans. These include:

BCBS HMO on the ACA Marketplace: This health maintenance organization (HMO) plan limits plan holders to in-network providers for coverage, but it also costs less compared to preferred provider organization (PPO) plans. The BCBS Portfolio HSA HMO Bronze plan has a deductible of $7,050 and an out-of-pocket maximum of $7,050.
BCBS PPO on the ACA Marketplace: This ACA Marketplace PPO plan gives plan holders more provider choice. The BCBS PPO Gold plan has a deductible of $2,500 and an out-of-pocket maximum of $4,500. December 31, 2025 is the last day this plan will be available.
BCBS private PPO: You can also get an HSA-eligible BCBS PPO health insurance plan through a private insurance broker. With a private plan it is predicated on being relatively healthy.

BCBS is a popular health insurer in Arizona, because it’s the only carrier to offer plans in all 15 Arizona counties. The variety of options could be appealing when you’re looking for an Arizona HSA-eligible plan.

Banner|Aetna

Available through the end of 2025, Banner|Aetna offers ACA Marketplace HSA-eligible health insurance. If you currently have a Banner|Aetna plan in AZ or get one in 2025, you’ll need to migrate to a different carrier beginning in 2026. You can do this through a private health insurance broker , or by looking for another plan during ACA open enrollment .

Banner|Aetna’s Bronze 2 HSA plan has a current in-network deductible of $5,695 for an individual and $11,390 for a family. The out-of-pocket limit is $7,495 for an individual and $14,990 for a family.

Cigna

Cigna is one of the most popular insurance companies in Arizona, and it has private plans that are HSA-eligible. You don’t need a referral to see a specialist on Cigna’s PPO plans. Their healthcare partners include Dignity Health, HonorHealth, Labcorp, Sonora Quest Laboratories, Barrow Neurological Institute, Evernorth and KPC Promise Hospital of Phoenix.

Private Healthcare Systems (PHCS)

Private Healthcare Systems (PHCS) is a health insurance plan that provides members access to nationwide healthcare providers and hospitals, such as Abrazo Health in AZ, at pre-negotiated rates. Some plans offered through PHCS are HSA-eligible. PHCS will rent their network, it’s important to talk with a broker to make sure you understand the plan you're signing up for with PHCS.

UnitedHealthcare (UHC)

UnitedHealthcare (UHC) is also a popular Arizona choice for HSA-eligible PPO plans through private insurance. The UHC Choice Plus PPO sets a deductible of $3,750 for an individual and $5,000 for a family. The out-of-pocket limit is $5,750 for an individual and $7,000 for a family.

Keep in mind that in order to get coverage under any of the private HSA-eligible plans listed above, applicants must usually meet general health requirements. Talk with a private insurance broker for a free private health insurance consultation .

Arizona HSA Eligible Plan Comparison

Private vs. ACA Marketplace HSA Options in Arizona

When you’re choosing an HSA-eligible plan in Arizona, you’ll often compare ACA Marketplace options with private plans. Some of the differences include:

Which is best? If you qualify for subsidies, an ACA Marketplace HSA plan will typically save you more money. If you want provider network flexibility, and you’re in good health, a private HSA plan may be the smarter choice.

Looking for an HSA-Eligible Plan? Contact AZ Health Insurance Brokers

Whether you’re interested in an HSA-eligible plan on the ACA Marketplace, or you want to compare your private health insurance HSA-eligible options, AZ Health Insurance Brokers is here to help. We can help you sign up for ACA health insurance for free, or send you customized individual or family private health insurance plan options that fit your budget.

Call us at 602.617.4107, fill out our form online or email info@azhealthinsurancebrokers.com for HSA-eligible health insurance options.

HSA-Eligible Health Plan FAQs

Nicki Escudero

Freelancer and Author

Nicki Escudero is an experienced journalist and freelance writer with over two decades of experience reporting on health insurance, business, and finance for leading publications, including The Arizona Republic, American Art Collector, Phoenix New Times, Phoenix Magazine, and Scottsdale Modern Luxury. Her expertise includes analyzing complex financial topics and translating them into accessible, informative content for diverse audiences. Nicki is a graduate of Northern Arizona University and currently resides in the Washington, D.C. area.

How to Buy Health Insurance in Arizona in 2025 | AZ Brokers

Sun, 17 Aug 2025 17:05:13 GMT

Health insurance in Arizona is essential, in case you get in an accident, need emergency treatment, or want to take proactive steps to protect your health. According to KFF , uninsured patients were charged up to 4x what health insurers and public programs actually pay for hospital services. At least one-third of uninsured people must pay for full medical costs up-front before they can even see a doctor. When you’re in need of life-saving services, not having the funds to pay for treatment can be debilitating.

Health insurance helps protect you for whatever comes your and your family’s way. You have lots of options for health insurance coverage that’s affordable and meets your needs.

In this guide, we explain the different routes you can take for health insurance coverage in Arizona and things to consider as you sign up for a plan for 2025 and beyond. Open enrollment for health insurance takes place November 1, 2025, through January 15, 2026, but you have options to sign up for Arizona health insurance any time of year. Keep reading to decide which plan works best for you.

Key Takeaways

There are three ways to get health insurance in Arizona: through the federal Affordable Care Act (ACA) Marketplace during open enrollment or any time if you qualify for a special life event; through a private insurance broker any time of year; and through a group health insurance plan through an employer, during the enrollment period.
Before you select a health insurance plan, you should consider what doctors you prefer to see, what prescriptions you and your family are currently taking or anticipate needing, any upcoming procedures and surgeries you may have scheduled, and what you can afford to pay. These factors will help you look for insurance plans that cover the doctors you want to see, as well as cover your current and upcoming medical needs.
An advantage of working with a private health insurance broker in Arizona is that you can tell the broker all your details (healthcare needs, budget, preferred doctors), and they’ll do the work to match you up with health insurance plan possibilities. This is a free service Arizona health insurance brokers offer to clients. You can also sign up for private health insurance at any time of year, without having to wait for a time period like open enrollment.

3 Ways to Get Health Insurance in Arizona

First, it’s helpful to be aware of the different ways you can obtain health insurance in Arizona for yourself and for your family. For all of the following methods, the AZ Health Insurance Brokers team can help answer any questions you have and ensure you get the coverage you need.

1. Affordable Care Act (ACA) Marketplace

The Affordable Care Act (ACA) Marketplace healthcare exchange is run by the federal government on HealthCare.gov . From November 1 through January 15, you can apply for a healthcare plan through the Marketplace’s open enrollment period, and potentially save money, depending on your unique lifestyle and health conditions. There are also certain events, such as marriage or moving, that may qualify you for a special enrollment period at any time of year.

The Marketplace is a good option for Arizonans who qualify for government subsidies, which are discounts based on income. It can also be a helpful option for people who have pre-existing conditions, since anyone is eligible to get a Marketplace plan, regardless of their current health state.

Most Marketplace plans are health maintenance organization (HMO) plans, which means the covered medical providers are restricted. There are a few preferred provider organization (PPO) plans available through the Marketplace, but these are generally more expensive compared to the HMO plans. The only PPO plan on the Marketplace that works for Arizona is Blue Cross Blue Shield.

2. Private Insurance

Private health insurance , which you can obtain through an Arizona insurance broker like AZ Health Insurance Brokers, can be a great option for Arizonans who are relatively healthy and who don’t qualify for many or any of the Marketplace discounts due to their income levels. Private insurance is also an ideal solution for Arizona self-employed professionals who aren’t interested in Marketplace plans , but who need to obtain insurance because they’re self-employed.

Private insurance also provides more PPO health insurance options in Arizona. Private insurance can help you get health insurance coverage for the Arizona medical providers you want to see, instead of being restricted like you would be in a Marketplace plan.

Another benefit of PPO plans through an Arizona health insurance broker is that these plans typically work across state lines. PPO plans can be a good option for snowbirds who split residences between Arizona and another state and for Arizonans who travel frequently.

3. Group Health Insurance

Group health insurance is Arizona health insurance that’s offered through an employer, generally for businesses that have two or more employees. Group insurance plans can vary depending on what the employer has chosen, so employees may be restricted with an HMO or get more provider choice through a PPO.

Generally, Arizona group health insurance offers different plans to choose from. One downside with group health insurance is that it can be expensive to get the best coverage. Also, some Arizona employers may restrict the plans available to ones that have a high deductible.

Many Arizona professionals choose to get private insurance even if their employer offers healthcare coverage , because what’s offered is too expensive. In some cases, an Arizona group plan doesn’t provide adequate coverage for the employee and their dependents.

How to Choose an Arizona Health Insurance Provider

With Arizona Marketplace health insurance, Arizona private health insurance and Arizona group health insurance options available, you may be wondering which provider is the best one to go with. As you compare your options, consider the following.

1. Which Arizona Doctors Do You Want to See?

If you have a preferred Arizona doctor you want to have continued coverage for, check each plan to see if your preferred doctor(s) are covered. A PPO gives you more choice, but some Arizona HMOs may offer coverage for your preferred providers. If you don’t have a preference, an HMO might work.

2. What Prescriptions Do You Have?

If you have prescriptions now or anticipate you may have them in the near-future, you’ll want to choose a plan that offers coverage for those prescriptions. Prescriptions can be very expensive without healthcare coverage. Factor these in to your choice of Arizona health insurance.

3. Do You Have Upcoming Procedures/Surgeries?

Medical procedures and surgeries are another consideration when choosing Arizona health insurance. You may have a preferred Arizona doctor and/or treatment center, so you’ll want to make sure those are covered under the insurance plan you choose. Check out our Arizona hospital health insurance coverage blog for more info. As you compare plans, also look at deductibles and out-of-pocket maximums.

We generally recommend people who have upcoming surgeries or procedures to look into using a health savings account (HSA) plan , since these typically have the lowest out-of-pocket maximum. If your employer doesn’t offer HSA plans, you could save by comparing Arizona private insurance options. Certain silver and gold plans through the Marketplace may also work.

Conversely, if you’re relatively healthy, and you don’t have any upcoming medical procedures planned, Marketplace bronze and silver plans, as well as private health insurance, may be better options when you don’t plan to meet a deductible with your healthcare needs.

4. What Is Your Income?

Again, Marketplace plans make the most sense for Arizonans whose income qualifies them for subsidies. If you can estimate your income for 2025, you’ll be able to anticipate whether or not you’ll qualify for government subsidies for Arizona healthcare and a discount off your premium.

If you likely won’t qualify for subsidies, you won’t be able to save on Marketplace plans. Keep in mind that if you state a lower income on the Marketplace plan, but you end up making more money, you’ll still have to pay back the difference in subsidies from the income you listed compared to your actual income come tax time.

Also, if you list a lower income, you’ll most likely be asked to show proof of income. If your income is too low, you might get directed to Medicaid.

Need Help With Arizona Health Insurance? Contact AZ Health Insurance Brokers

Navigating the Arizona health insurance market can be confusing. Ideally, you want the most comprehensive coverage for your unique medical situation, at the lowest price.

AZ Health Insurance Brokers can help you compare your options. We offer free, no-hassle health insurance consultations, so you can understand everything you qualify for in Arizona health insurance-wise, how much it will cost, and what type of coverage you’ll get.

Whether you’re getting a discount based on your income and you need help selecting and signing up for a plan, you want help with a private plan, or you want group health insurance quotes for your Arizona business, reach out to AZ Health Insurance Brokers.

Contact us online , call 602.617.4107 or email quotes@azhealthinsurancebrokers.com . We’re happy to help guide you and get you the coverage you need.

Arizona Health Insurance FAQs

Signs Your Business May Be Outgrowing Its Professional Employer Organization (PEO)

Wed, 16 Jul 2025 21:18:58 GMT

For some businesses, using a professional employer organization (PEO) to outsource human resources (HR) functions makes sense. A PEO can manage tasks including benefits, payroll, workers’ compensation and employee training. This can free up time and resources for businesses, though the investment is often significant.

Some businesses, especially those with 20 to 100 employees, may find a PEO works for a certain amount of time, but then the costs don’t make sense, especially when a business starts growing and could save money with other solutions.

At AZ Health Insurance Brokers, we have helped more than 25 businesses successfully transition off a PEO, with one recent client of 35 employees realizing approximately $100,000 in annual savings through reduced health insurance premiums and various administrative fees. Every business is unique, and savings can vary depending on your specific circumstances, but it’s worth it to explore the potential.

In this article, learn the signs you may be outgrowing your PEO. Discover why leaving one could be financially advantageous, as well as provide other pros, like better employee benefits and customer service.

Key Takeaways

PEOs make sense for some businesses, but not all. Companies that are currently using a PEO should examine if they still need one, especially as they grow.
Moving away from a PEO to a turnkey group health insurer solution with HR partner functions can dramatically lower expenses on things like administration fees, especially for employees who don’t use all PEO services.
Compared to an organization exiting a PEO on their own, which can become complicated quickly due to complex systems and lack of transparency, it’s easier and often less expensive to use a turnkey solution that combines group health insurance services and HR functions.

What to Consider With PEOs

PEOs may be a good initial solution for businesses that need outsourced HR, but over time, they can make business operations more complex and expensive. Some things to consider with PEOs include the following.

Fee increases: Every year, it’s likely that PEO fees will increase, as increases are common due to inflation. This isn’t the only increase you can expect with a PEO. If your medical plan rates increase, as well, those are extra expenses, in addition to administration fee increases.
Risk pool volatility: Initially, a PEO may have a great medical rate. But over time, especially as employees use their healthcare benefits, medical rates may increase dramatically due to an increased risk pool. At AZ Health Insurance Brokers, we tend to see large increases in PEOs over time, with some annual increases exceeding 35%, depending on the risk pool.
Extra administration fees: With PEOs, the business pays 100% of administration fees. With other types of group health insurance, administration fees may be a shared cost with another party, which saves the business money.
Lack of flexibility: PEOs usually only present a limited number of carrier and plan design options. As your workforce evolves, you may want the ability to choose different types of health plan coverage that your existing PEO doesn’t offer. Outside of a PEO, it’s easier for employers to get more tactical with their employee health coverage decisions.
Complex fees: In most cases, we see businesses don’t even know what they’re paying in PEO fees, or if they do, what kinds of benefits those fees provide, exactly. Generally, fees charge a percentage of payroll, and/or a fee of around $120 per employee per month for an administration fee. These fees are charged for each employee on payroll, regardless of whether or not they’re actually using the PEO services.
Lack of customization: In addition to the costs and rigidity of plans, PEOs may restrict employers in terms of the employee experience they provide their workforce. Taking control of HR functions and working with a more personalized benefits partner can give you the opportunity to customize your approach with employees, which most PEOs don’t offer.

For smaller companies, especially those with employees who are located in multiple states, using a PEO can make sense. A PEO can relieve some of the burdens sma ll businesses face associated with compliance and other HR functions.

But as companies grow, the fees and lack of transparency and flexibility may mean it makes more sense for businesses to move on from a PEO and find another solution. AZ Health Insurance Brokers offers a turnkey solution for exiting a PEO. We can help your business.

6 Signs You May Be Ready to Leave Your PEO

If you’re wondering whether or not you should stay in your PEO, there are some signs that could mean exiting is a good idea. Pay attention to these.

You’re paying more than $100-$150 per month per employee in administration fees.
Your renewal increases have exceeded 20%+ annually.
You don’t use the full suite of PEO services (e.g., training, compliance, etc.)
You want more control over your health plan design.
You can’t explain your exact PEO pricing breakdown.
Your team is multistate or remote, but service feels rigid or inconsistent.

If two or more of these signs sound familiar, it’s time to compare your options.

You can also consult the table below to see the pros and cons of using a PEO versus using a health insurance broker that also acts as an HR partner.

When Exiting a PEO Makes Sense

If your financial experts determine you’re spending too much with a PEO, and/or you want to get the same high-quality HR services without having to rely on a PEO, AZ Health Insurance Brokers can help. Here’s how.

We set up all health insurance coverage options for employees: At AZ Health Insurance Brokers, we specialize in business health insurance coverage for organizations of all sizes. We can present you with all medical coverage options for workers , and help you make an informed decision that meets the needs of your business budget and your employees.
We provide an extension of HR: We’ll also recommend best-in-class strategic HR partners, whose systems integrate with ours, to create a similar cohesive feel to the PEO without all of the administration fees . We can help you field staff questions and ensure medical plans and other employee benefits, like life insurance coverage , align with your company culture. We’ll help you create a solution not only for insurance, but also for 401(k) benefits, payroll, workers’ compensation and other HR functions.
We offer improved customer service: By aligning AZ Health Insurance Brokers’ group health insurance coverage with services provided by our HR partners, we remove most of the stress associated with pivoting away from a PEO. Most of our clients find the customer service drastically improves by choosing us as partners.

Wherever you are on your terms with your PEO, AZ Health Insurance Brokers can help you navigate the complexities of exiting one, so you can use a simpler and more cost-effective solution. Contact us for a free consultation on how to exit a PEO .

AZ Health Insurance Brokers Can Help With PEO Exit Strategies

Many businesses stay with a PEO because the task of exiting can seem so daunting. At AZ Health Insurance Brokers, our turnkey solution for exiting a PEO has helped many of our clients achieve better group health insurance outcomes and lower costs, while retaining the same HR functions they had with a PEO.

We can step in to help with all HR verticals, including medical, payroll, HR, 401(k) deployment and more, and create an integrated solution and continuity among software. We can help your business deliver benefits employees want, while keeping costs low.

For more information, contact us online, call us at 602.617.4017 or email quotes@azhealthinsurancebrokers.com .

PEO Exit FAQs

When Can You Buy Health Insurance?

Sat, 07 Jun 2025 04:20:08 GMT

Can I Buy Health Insurance at Any Time?

Health insurance is a must-have for most people, 24/7, 365 days a year. Even those who maintain optimal health the majority of time could experience a costly accident that requires expensive treatment. Hospital visits, emergency care, surgery – all these costs add up quickly if you don’t have health insurance.

If you’re currently not covered, you may be wondering about what your health insurance options are. While some plans do have annual enrollment deadlines, there are other options that could get you covered any time of year.

Business owners may have similar questions for their staffs. For example, what happens if you open your business at a different time than the annual enrollment period for individuals?

We’ve got you covered with all the details in this blog, which covers health insurance deadlines for individual health insurance, family health insurance and business owner insurance.

Key Takeaways

Generally, you can sign up for business health insurance as soon as you’re hired. You may have a time window in which to sign up, if you don’t sign up right away.
If you’re interested in individual or family insurance, and your employer doesn’t offer coverage/you want other options, you can sign up for private insurance at any time of year.
The federal Affordable Care Act (ACA) Marketplace has an open enrollment period between November 1 and January 15 every year. If you miss the open enrollment period and want ACA health insurance, you may qualify for a special enrollment period if you experience a life change, such as job loss or marriage.

Individual Health Insurance Deadlines

First, it’s helpful to know you have different options when it comes to individual health insurance , as well as family health insurance that provides coverage for both you and our family. Each option will have its own deadline. Let’s break down the options and timelines to be aware of.

Group Health Insurance Through an Employer

One option is to sign up for a group health insurance policy that’s offered by your employer. Generally, if health benefits are offered, you can sign up for business health insurance as soon as you’re hired, whenever that happens to be.

If you don’t sign up right away, but you change your mind later, most employers also offer an annual open enrollment period. During this time, you can sign up for health insurance coverage , or change your enrollment to a different business health insurance plan.

There are also special “qualifying events” that could enable you to enroll for business health insurance coverage or change your plan beyond the open enrollment period. These events may include:

Job loss or reduction in hours worked
Divorce or legal separation
Loss of dependent status
Marriage
Birth or adoption of a child

Generally, employees get a special enrollment period of at least 30 days after these qualifying events to enroll in an employer group plan .

However, it’s not a guarantee that an employer will provide health insurance . As the Kaiser Family Foundation points out, only 54% of all firms offered some health benefits.

Small firms with fewer than 200 workers are significantly less likely to offer health insurance benefits. If you aren’t offered health insurance, you need other options.

Also, you may not be interested in the health insurance coverage your employer offers . That may be due to a variety of reasons. Your preferred doctors may be out of network, for example, or the plan financing doesn’t work well for you or your family.

If you’re interested in options beyond group health insurance through work , you can look at Affordable Care Act (ACA) Marketplace plans and private health insurance .

Affordable Care Act Health Insurance Coverage

The ACA created a federal Marketplace for health insurance coverage that includes essential healthcare, such as hospitalization, prevention and wellness, and emergency and ambulatory care. Individuals can shop health insurance options on the Marketplace for coverage for themselves and their family members. There’s a variety of plans available, so you can customize the level of coverage you receive.

Most individuals will have a variety of providers they can choose from, depending on which county they live in. Sometimes, your preferred provider won’t be available if you’re considering Marketplace plans.

The Marketplace has an open enrollment period from November 1 through January 15 each year. If you sign up by December 15, your coverage starts January 1. If you sign up after that through January 15, you’ll have an effective start date of February 1.

There are also some special events that may enable you to sign up for Marketplace coverage outside of the open enrollment period. These include:

Life changes, such as moving, getting married, adopting a child, or having a baby
Qualification based on Medicaid, Children’s Health Insurance Program (CHIP) or estimated household income: individuals, families and children with certain incomes may qualify for Medicaid , CHIP or Marketplace health insurance at any time

If a Marketplace plan doesn’t appeal to you, you still have another option: private insurance.

Private insurance

Private insurance is an insurance plan coordinated through a private insurance broker . You can apply for private insurance at any time, with no deadline. This makes it a popular option, in addition to other benefits.

With private insurance, you can talk with your broker about your exact health insurance needs for you and your family. Your broker can help guide you through your options to make the most cost-effective choice.

You can also change your health coverage whenever you want with a private insurance broker. Another benefit is that your broker is available to answer any questions you have, any time. With some health insurance providers, there’s a lack of personalization with customer service. With private health insurance, your broker is there to serve you.

Private insurance plans can apply to both individuals and families. They’re a great option to consider when you need health insurance, but it’s not offered through work, and/or if you’re not interested in the plans the Marketplace has to offer. Many times, you can get the same or even better coverage than the Marketplace, for less money, through a private insurance broker.

Business Group Health Insurance Deadlines

If you’re a business owner who wants to offer health insurance to employees , you can do this as soon as your start your business, or at any time during the year. There are lots of different health insurance and health coverage options available to business owners . These include:

Each type of business health coverage has its advantages. To learn more about what might work best for your unique business, contact us , and we’ll be in touch.

Need Health Insurance for Yourself, Your Family and/or Your Employees? Learn About Your Options

Any time of year, you have options for health coverage. At AZ Health Insurance Brokers, we learn about your unique needs and help you pick out a plan that delivers the best value to you and your family or your business and its employees.

Call us at 602.617.4107, email us at quotes@azhealthinsurancebrokers.com or fill out the form here , and we’ll be in touch.

Health Insurance Enrollment Deadline FAQs

Banner|Aetna Health Insurance in AZ Ends in 2026

Wed, 04 Jun 2025 17:02:11 GMT

If you’re enrolled in a Banner|Aetna family health insurance plan or individual healthcare plan through the Affordable Care Act (ACA) federal marketplace in Arizona, it’s important to be aware that the last year these Aetna plans will be active is 2025. Banner|Aetna members on ACA family and individual plans should begin thinking about what health insurance plan they’ll migrate to, whether that’s another plan on the ACA during open enrollment , or to a private health insurance plan through an Arizona health insurance broker , if you want to switch earlier.

Open enrollment on the ACA Marketplace is between November 1 through January 15. Certain life events may qualify you for a special enrollment period , so you may have several options for health insurance in AZ .

This guide explains more about what Banner|Aetna health plans in the ACA Marketplace offered and how to find a new plan with similar benefits. If you’re currently using Banner|Aetna and are interested in changing to another ACA Marketplace plan, contact our team for free expert ACA Marketplace guidance .

Key Takeaways

Banner|Aetna is a soon-to-be discontinued ACA Marketplace health insurance provider in Arizona. All Banner|Aetna ACA members will need to find a new insurance carrier/plan for 2026 and beyond, since the brand will stop providing individual and family insurance through the ACA Marketplace on December 31, 2025.
If you want to change to another ACA Marketplace plan, you can do so during open enrollment from November 1 through January 15. You may also be able to change earlier if you qualify for a special enrollment period, or if you change insurance to a private insurer.
You and/or your family may qualify for subsidies or no-cost insurance through the ACA Marketplace, depending on your household income and if someone in your household has a disability. Talk with an ACA insurance expert for guidance.

Your Next Steps: Navigating the Change from Banner|Aetna

Now that you know Banner|Aetna individual and family plans are exiting the Arizona ACA Marketplace, it's natural to wonder about your next steps for securing health insurance coverage for 2026 and beyond. You generally have two primary paths to consider, and our team is here to help you explore both:

1. Re-shop on the ACA Marketplace During Open Enrollment:

For many current Banner|Aetna members, waiting for the annual ACA Marketplace Open Enrollment Period (OEP) is the most straightforward option. This period typically runs from November 1 through January 15.

Actively Shop, Don't Rely on Auto-Enrollment: While the ACA Marketplace (Healthcare.gov) may automatically enroll you into a comparable plan if you do nothing, it's highly recommended that you actively shop during OEP. An automatically assigned plan may not be the most cost-effective or best fit for your specific health needs and preferred providers.

Compare All Available Carriers: Open Enrollment allows you to compare plans from all other carriers available in your Arizona county, ensuring you find the best value for your budget and healthcare requirements.

Subsidies Still Apply: If you currently qualify for a subsidy or financial assistance based on your income, those same eligibility rules will apply to other ACA Marketplace plans you choose.

2. Explore Private Health Insurance Options:

Another viable path, particularly for those who are relatively healthy and may not qualify for substantial (or any) income-based discounts on the ACA Marketplace, is to consider private health insurance.

Year-Round Enrollment: Unlike the ACA Marketplace, private health insurance plans can often be applied for and secured at any time of the year, providing more flexibility outside of rigid enrollment periods.

Tailored Solutions: Private plans can sometimes offer more tailored benefits, broader provider networks, or different pricing structures that may be more advantageous depending on your health status and financial situation.

Personalized Broker Guidance: Navigating private insurance options can be complex. Our experienced brokers can provide free, personalized quotes and guidance to help you understand if a private plan offers better value or coverage for your unique needs.

Regardless of which path you choose, starting to think about your options now and seeking expert advice can help ensure a smooth transition and the best possible coverage for you and your family.

How Does Banner|Aetna Work for Individual & Family Insurance?

Banner|Aetna is a joint health insurance venture that combines the powers of the Aetna® health insurance company and the Banner Health system. Every ACA Marketplace plan includes coverage for essential benefits, including:

Preventive and wellness services
Chronic disease management
Laboratory services
Prescription drugs
Pediatric services, including vision and oral care
Mental health and substance use disorder services
Emergency services
Hospitalization
Ambulatory services
Pregnancy, newborn and maternity care
Rehabilitative and habilitative services and devices

There are also options to add on adult vision and dental insurance coverage , including 100% preventive dental care coverage that includes two yearly cleanings, plus basic and major services. Vision coverage includes a $10 copay eye exam and a $150 allowance for eye care items at select retailers.

In some cases, you may qualify for a subsidy or for no-cost Banner|Aetna ACA Marketplace health insurance. Depending on your and/or your household’s income, as well as if there’s someone in your family with a disability, you could receive a discount or no-cost health insurance. You can use the HealthCare.gov subsidy table to see potential discounts.

Banner|Aetna ACA Metal Tiers

Banner|Aetna ACA plans are assigned a specific metal tier: Gold, Silver or Bronze. These tiers determine how much a plan holder is responsible for in premiums versus cost of care, and how much the insurance plan covers. Generally, the costs you can expect from various metal tiers include the following.

Bronze: With bronze plans, you’ll pay the lowest in monthly premiums, but you’ll owe more when you do need care. These plans have the highest deductibles of all plans.
Silver: These plans offer a great balance between how much you’ll pay in monthly premiums and how much you’ll pay when you do need care.
Gold: Gold plans have higher monthly premium costs than Silver plans, but you’ll pay less when you do need care.

When you’re determining the right metal tier to choose for a Banner|Aetna ACA Marketplace plan, it’s important to consider both how much you want to pay in monthly premiums, and what your anticipated healthcare needs will be over the next year. If you see the doctor regularly, a higher metal tier could help you save overall. If you anticipate only needing emergency and preventive services, a lower tier could work.

How to Get ACA Marketplace Insurance in AZ

If you’re interested in signing up for another insurer on the ACA Marketplace, we can help. Use our free form to see which plans you’re eligible for and to compare costs and benefits. A personalized representative from AZ Health Insurance Brokers will be available to guide you through the signup process and to answer any questions you have.

Remember that while open enrollment begins November 1, you may be eligible for ACA insurance if you qualify for a special enrollment period. If you have any questions about insurance in Arizona at all, we’re here to help. Message us online , call 602.617.4107, or email quotes@azhealthinsurancebrokers.com . We’ll be in touch.

Get a Free Quote for ACA Marketplace Insurance

Banner|Aetna Individual & Family Insurance FAQs

UnitedHealthcare’s Surest Insurance: What Is Surest Insurance? Is Surest Insurance Good for Healthcare?

Tue, 06 May 2025 15:45:17 GMT

UnitedHealthcare (UHC) has consistently been at the forefront of innovation in the health insurance industry, and their new Surest group health insurance product is no exception. Marketed as a highly flexible, transparent health plan, Surest represents a significant departure from traditional insurance models that require deductibles, and other offerings, like health savings accounts and qualified small employer health reimbursement arrangements (QSEHRA) , positioning itself as potentially the most disruptive product to hit the market in the last decade or so.

The reasons for this are manifold, ranging from its novel approach to cost transparency and coverage options, to its focus on consumer empowerment and healthcare outcomes that have resulted in positive Surest medical plan reviews. In this blog, learn more about how Surest insurance works and if it might be worth getting for yourself or your employees. Contact Arizona Health Insurance Brokers for assistance.

Key Takeaways

Surest insurance is a groundbreaking group health insurance product launched by UnitedHealthcare that requires only copays, no deductibles.
Surest insurance is available to groups with 2 or more members. There are various pros and cons of Surest insurance, from flexibility to coverage options.
While Surest insurance reviews show a major advantage of Surest is that costs are transparent through the app, they can also vary widely based on the provider. That can be a potential downside for members.

What Is Surest Insurance? Surest Insurance Pros & Cons

Surest is a group health insurance product available to businesses with groups of at least 2 members that requires only copays from members, no deductible and no co-insurance. Employers provide it on a fully insured , self funded and level funded basis . Members can look up providers on the UHC Choice or UHC Choice Plus (PPO) networks through the Surest app and see exact copay information for each service right in the app, including mental health services. Coverage extends to more than 1.8 million healthcare providers and more than 5,600 hospitals across the U.S.

Surest insurance steers members to the most effective provider, in terms of both quality and cost. Copays will vary based on provider, which ultimately helps put more power in the member’s hands, but that could also be a negative if someone’s preferred provider is comparatively more expensive.

However, it’s worth noting UHC reports members typically pay 54% less of out of pocket compared to other types of health insurance plans. There’s also an out-of-pocket limit that can help protect members from overpaying overall.

Because members use the app to find care and pay only copays, Surest helps reduce balance billing. This makes the program even more convenient for members and is one reason for positive Surest health insurance reviews.

There are also significant health insurance expense savings available to employers who use Surest. According to UHC , the Surest health plan led to lower claim costs exceeding $400 per member per year. Overall, employers can see up to 15% lower costs, according to Surest. For instance, we recently helped a business with 80 employees implement Surest. By effectively steering members to the most cost-effective solutions for their health needs, Surest helped keep unnecessary spend down for the organization, directly aiding in their future renewal relief.

How Does Surest Insurance Work?

To use Surest, members can follow these steps to compare care options.

Open the Surest app.
Type in the issue the member needs help with – “sinus infection”, “ADHD,” “office visit” or “prescriptions”, for example.
Choose the exact issue to narrow your search – for example, “inflammation of sinus” or “sick sinus syndrome”.
See treatment options, such as virtual visit, medical office visit, urgent care and retail clinic visit.
Once you choose your preferred type of treatment, you’ll see a map with providers and the amount a copay will cost.
Click on the available options to see provider information (including ratings), addresses and scheduling information.

You can schedule your treatment right in the app, and you’ll know exactly how much you’ll pay for your visit.

Why Surest, Why Now?

Health insurance has long been criticized for its opacity, complexity and lack of consumer-friendly options. Traditional plans often leave patients guessing about costs, in-network providers and the extent of their coverage until after they’ve received care. This uncertainty can lead to financial stress, deferred care or patients being blindsided by unexpected bills.

UHC recognized these pain points and designed Surest to address them directly. Is Surest a good health plan? With cost-effective plans and complete transparency into pricing and provider options, consumers have more power and control over their choice of healthcare. This can help them better manage their budgets and select the best level of care for their unique situation.

Key Features of Surest Health Insurance

Is Surest insurance good? Surest has many advantages that have already made many employers and individuals consider it among their top healthcare choices. Some benefits include the following.

Cost Transparency

One of the standout features of Surest health insurance is its emphasis on upfront cost transparency. Unlike traditional plans, which often come with confusing deductibles, copays and coinsurance, Surest provides clear, fixed prices for services.

This means that members can know the exact cost of a procedure, doctor’s visit or medication before they make a decision, allowing for informed choices based on both quality and cost.

Steering Members to Appropriate Care

Surest incorporates tools that help guide members to the most appropriate and cost-effective care, which has led to positive Surest UnitedHealthcare reviews. By providing detailed information about providers and treatment options, the plan encourages members to choose high-quality, lower-cost options.

This steering not only improves the care experience for members, but it also helps employers and groups manage their claims more effectively. By reducing unnecessary or overly expensive treatments, Surest can help keep overall healthcare costs in check, leading to more sustainable premiums and better financial outcomes for both the insurer and the insured.

No Deductibles

Another radical departure from the norm that’s led to positive UHC Surest reviews is Surest’s elimination of deductibles. Deductibles have long been a standard feature of most health insurance plans, requiring policyholders to pay a significant out-of-pocket amount before their insurance coverage kicks in.

By removing this barrier, Surest allows members to access care without worrying about hitting a financial threshold first, which can encourage more timely and preventive care.

Personalized Coverage Options

Surest also offers a high degree of flexibility and personalization. Members can tailor their coverage to suit their needs, opting for a base level of coverage, and then add on additional benefits, as needed.

This customizable approach ensures that individuals are only paying for the coverage they truly need, rather than being locked into a one-size-fits-all plan that may include unnecessary services.

Enhanced Consumer Engagement

The Surest platform is designed to engage consumers more actively in their healthcare decisions, which has led to positive United Healthcare Surest reviews. Through an intuitive app or online portal, members can compare providers, services and costs, all while accessing real-time information about their benefits.

This level of engagement encourages consumers to take a more proactive role in managing their health and healthcare expenses.

Why Surest Is Disruptive

The disruptive potential of Surest lies in its ability to challenge and potentially upend traditional group health insurance models. By prioritizing transparency, flexibility and consumer empowerment, Surest addresses many of the long-standing frustrations that consumers have with the health insurance industry.

In a group health insurance market where complexity and confusion have often been the norm, Surest’s straightforward approach can be seen as a breath of fresh air. It not only simplifies the insurance experience, but also aligns more closely with the consumer-driven trends that are shaping other industries. As more consumers demand more control over their healthcare decisions, products like Surest that offer clarity and choice are likely to gain traction.

Moreover, Surest health plan reviews could pressure other insurance carriers to adopt similar practices or risk losing market share to UHC. If successful, Surest could spark a broader shift in the group health insurance industry toward more transparent, consumer-friendly products, making traditional plans less competitive.

UHC’s Surest product represents a bold and innovative step forward in the group health insurance landscape. By addressing key consumer pain points and offering a level of transparency and flexibility previously unheard of in the industry, Surest has the potential to be a game-changer. If it succeeds in gaining widespread adoption, it could reshape the health insurance market, setting a new standard for what consumers expect from their coverage. In an industry often resistant to change, Surest’s disruptive potential cannot be overstated.

AZ Health Insurance Brokers is here to help our clients navigate Surest insurance pros and cons reviews and evolving changes in the insurance industry. Whether you’re a business owner who wants to stay on top of insurance choices for your employees, or you’re an individual who wants the most cost-effective health insurance coverage for yourself or your family , an expert health insurance broker from our team can help. Call 602.617.4107, email quotes@azhealthinsuracebrokers.com or fill out our online form , and we’ll be in touch.

UnitedHealthcare Surest FAQs

How to Add a Newborn, Step-Child or Adult Child Onto a Health Insurance Policy

Thu, 01 May 2025 14:04:11 GMT

If your family’s expanding, congratulations! Whether you’re welcoming a new baby home, or you’re growing your brood with the addition of step-children or adopted or foster children, you’ll want to keep your family members safe and protected health-wise.

That means ensuring they have adequate health insurance, which might mean adding them onto your own family health insurance policy , or an individual health insurance policy you or your spouse holds.

If you have older children who have moved out, but who need health insurance because they’re in college or lost their policy through work, you can also add a child to a plan as long as they’re younger than the age of 26.

In this article, learn how to add a newborn, step-child or older child to an existing policy you or your family has in place.

Key Takeaways

You have 60 days after the birth of a baby to sign them up on a health insurance plan in your family. Otherwise, the special enrollment period for health insurance will end, and you’ll have to wait until the next open enrollment. To sign your newborn up on your insurance policy, you’ll need their full name, date of birth and Social Security number, once you receive it.
As long as you sign your baby up for a health insurance policy within the 60-day period after their birth, their health insurance policy will apply retroactively to the date of their birth.
If you’re expanding your family to take on new dependents, such as a step-child or adopted child or foster child whom you’ll claim as a tax dependent, you can also include them in your household’s family insurance policy. You can also add older children who are not dependents to a health insurance plan until they reach the age of 26.

First: Who Can You Add to a Family Health Insurance Plan?

Healthcare.gov outlines who you may be able to include in your household and, thus, in your family health insurance plan. These include:

Dependent children, including adopted and foster children
Children, with shared custody
Non-dependent children who are younger than the age of 26
Children younger than age 21 whom you take care of

In addition to a spouse, you may also be able to include an unmarried domestic partner, as well as any children you have together.

Note that unborn children aren’t included on that list. You can add a newborn baby to a plan as soon as they’re born. The good news is, they’ll get healthcare coverage from their birth onward, as long as you enroll them in a health insurance plan within 60 days of their birth.

Once you know you want to add someone who qualifies to your family health insurance plan, follow the steps below.

1. Notify Your Broker/Agent

As soon as you know you’ll be adding a baby or a new child to your family, let your health insurance broker or carrier know. If you get health insurance through work , talk with your human resources representative who set up health insurance for you. Otherwise, contact your broker or the provider directly.

You have 60 days once a baby is born to backdate and add your infant onto your policy. If you wait until after the special enrollment period has ended, your child won’t be able to get insurance coverage until the next enrollment period , which could result in a costly gap in coverage. Plan for health insurance as soon as you can in a pregnancy, so you can sign up quickly post-birth. Take comfort in that as long as you get the coverage during the specific time, anything that happens within that 60 days will be covered retroactively.

For other types of health insurance additions, such as step-children, adopted/foster children or older children younger than 26 whom you want to add to a health insurance plan, you may qualify for a special enrollment period within 60 days of an event, such as an adoption. If you’re adding an older child to your health plan, you can do so during open enrollment, or if they qualify for a special enrollment period, such as if they’ve lost their health insurance through a job. Talk with your broker about your unique situation to see when you qualify for adding an older child to an existing individual or family health insurance plan.

2. Provide the Appropriate Information

If your family is having a baby, you’ll need your newborn’s full name and date of birth to add them to your policy. When you receive their Social Security number, reach back out to your broker. They’ll need to add that, as well, to the application. If you’re asked to upload a copy of the Social Security number card, your agent/broker can upload this for you.

When you want to add a step-child or older child to a plan, you’ll also need to submit the required documentation to your insurance agent. This typically includes legal proof they’re your step-child, dependent or non-dependent child, such as a birth certificate or marriage certificate for your spouse, as well as items such as proof of residency and/or financial dependency.

3. Review Coverage Options

Any significant life change is a great opportunity to review your insurance coverage and make sure it’s still a plan that works for you, as well. You may have signed up for the wrong health insurance plan for a growing family, but you can switch to something better. Talk with your agent/broker about what other plans might be worth considering, so you can compare your options.

Keep in mind, if you’ve already met your deductible on your current plan, it may make sense to stay on the same policy. Once you meet your deductible, you’ve already made enough payments for insurance coverage to kick in. Changing plans may require re-having to pay toward a deductible. Talk with your broker if you have questions.

4. Get Confirmation

Once you’ve provided all the personal identifying information for your baby or for adding a step-child or older child to your plan, your agent/broker will confirm the addition of your newborn, dependent or older child to your policy. For newborns, their health insurance coverage begins starting from their date of birth, as long as the baby is added within 60 days of being born.

For additions of step-children or older children to a health insurance plan, coverage will typically begin as soon as they’re officially added to the plan.

Contact Us for Help Signing Your Child Up for Health Insurance

If you’ve recently expanded your family or plan on doing so soon, give the team at AZ Health Insurance Brokers a call. We can help you sign up for health insurance, dental insurance , and/or a life insurance policy to protect your legacy for your family. We can show you different plan options that may make more sense compared to your current plan.

We can ensure your new baby or older child or step-child gets signed up for your health insurance plan as soon as possible, whether they’re due to be born, have recently arrived, are already here, or are integrating into your family. Contact us online , call 602.617.4107, or email quotes@azhealthinsurancebrokers.com . We’ll be in touch.

Child & Baby Health Insurance FAQs

What Is an Irrevocable Life Insurance Trust? Pros & Cons of ILITs

Wed, 05 Mar 2025 16:11:05 GMT

An irrevocable life insurance trust (ILIT) is a powerful estate planning tool that can hold a life insurance policy and pass the death benefits to heirs, completely free of income and estate taxes. With an ILIT, the owner of the trust can leverage the annual gift tax exclusion, with gifts being used to pay life insurance premiums in the trust, which can be a significant financial advantage. With tax exemption limits for estate taxes anticipated to be drastically decreased in 2026 , now may be a good time to consider an ILIT for your family’s estate planning strategy .

There are both pros and cons to using an ILIT to ensure your loved ones are protected should you or your spouse pass away. This guide explains what an ILIT is, advantages and disadvantages of an ILIT, and what using an ILIT might look like.

Key Takeaways

An ILIT protects a grantor’s term life insurance or permanent life insurance premiums and death benefits from being subject to estate and income taxes.
By using an ILIT, a family can ensure their beneficiaries get access to funds without having to sell high-value assets to cover expenses after death. ILITs are generally considered legacy-building tools, rather than financial planning tools for the here and now.
While the 2017 Tax Cuts and Jobs Act (TCJA) raised the federal estate tax exemption maximum amounts to $27.22 million per couple and $13.61 million per person, in 2026, those limits are expected to be reset to $5 million indexed to inflation, approximately $7 million, in January 2026. That means, this year is an ideal time for individuals and families to consider using an ILIT as part of their financial planning strategy.

Irrevocable Life Insurance Trusts Explained

An ILIT is a trust that’s created to hold life insurance , where the trust owns the life insurance policy, rather than an individual. An ILIT is separate from the grantor’s estate and isn’t included in the estate’s value.

Typically, the grantor will pay the trust. The trustee will use those funds to pay life insurance premiums. When the grantor passes away, the trustee receives the life insurance payout and distributes the funds to the life insurance beneficiaries.

Like the name implies, an ILIT is irrevocable. That means, once it’s established, it typically can’t be terminated or altered. Because of the permanent aspects of this type of financial tool, the grantor should be completely sure it’s the type of financial vehicle they’d like to use.

Pros of Irrevocable Life Insurance Trusts

The main benefit of ILITs, especially in 2025, is that this type of trust can minimize taxes for the grantor and their family. Some reasons to consider using an ILIT include:

Minimize estate taxes: Usually, the death benefits of a life insurance policy will be included in the gross estate. With an ILIT, the death benefit proceeds aren’t a part of the gross estate, so they’re not subject to federal and state estate taxes. This means, proceeds from an ILIT could even be used to help pay estate taxes, which makes an ILIT a strong financial protection tool for beneficiaries who may be left having to pay estate taxes and other expenses once the grantor passes away.
Avoid gift taxes: In an ILIT, contributions by the grantor are considered gifts. This enables the grantor to leverage the annual gift tax exclusion of $19,000 per beneficiary in 2025, when the gifts are used to pay premiums on the life insurance in the trust. Married couples who file jointly can give an individual up to a combined $38,000 in 2025 without having to pay gift taxes.
Control over death benefits: Grantors can use the trust document to determine how and when they want their life insurance policy death benefit to be used and for which beneficiaries. This helps with legacy planning, as an ILIT also helps take advantage of the grantor’s generation skipping transfer tax (GSTT) exemption if they want to name people who are more than 37.5 years younger than them (such as grandchildren) as beneficiaries.
Avoid probate: Another major benefit of using a trust is that your family will avoid probate and legal action in court about the distribution of your assets. This can lessen the burden of losing a loved one for a family, since finances have already been managed prior for protection against issues like divorce and creditors.

For families of individuals who may be subject to considerable taxation, an ILIT can help the grantor and their family avoid taxes now and in the future. As the temporary tax cuts from the 2017 TCJA are expected to reset in 2026 , a wider income bracket will mean more people will have to pay more federal estate taxes. An ILIT can mitigate this development.

Cons of Irrevocable Life Insurance Trusts

ILITs are lifetime commitments once they’re created. They may not always make sense depending on your unique situation. Consider these potential cons.

Permanence: Once the terms of an ILIT are signed, they’ usually can’t be revoked or changed. This presents a level of risk to the grantor, who usually won’t be able to change their mind regarding the terms in the future.
Potential taxation: If the grantor passes away within 3 years of the creation of an ILIT, the ILIT’s life insurance policy may be included in the estate. If that happens, the payout could be subject to estate taxes.
Loss of policy ownership: Once your life insurance policy is integrated in an ILIT, you surrender ownership and control of the policy to the trust and trustee. Again, you won’t be able to make changes to the life insurance policy once it’s part of an ILIT.

If you feel comfortable with the terms of an ILIT, it can be a positive financial vehicle for you and your family. But if you want the ability to make changes to your life insurance policy in the future, you may want to explore other options.

Example of an ILIT in Action

For a look at how an irrevocable trust might play out, here’s an example of a couple that might be considering one.

John, 54, and Lisa, 52, have a $26 million estate and three children. They’re aware that under current laws, their estate wouldn’t be subject to estate taxes if they both passed away today. However, they also know that current tax laws are set to change on January 1, 2026, potentially cutting the lifetime estate tax exemption in half. This change could expose a significant portion of their estate to estate taxes.

Thankfully, John and Lisa still have time to create a plan to protect their wealth from unnecessary taxes while the exemption remains at its current high level.

John and Lisa’s Estate Overview

Here’s a breakdown of John and Lisa’s estate:

$19 million in privately held stock and real estate
$7 million in other assets, including their home, retirement accounts, bank savings and investments

So far, John and Lisa haven’t used any of their lifetime tax exemptions or made annual gifts to their children. They also aren’t ready to give away ownership of their stock or real estate just yet, but they still want to find a way to minimize future taxes on their estate.

The Challenge for John and Lisa

If John and Lisa’s estate grows at a modest 3% annual after-tax rate, their wealth could increase to $77.6 million by their life expectancy in 37 years. Under current tax laws, this could result in $19.2 million in estate taxes – about 25% of their total wealth.

To protect their estate, John and Lisa are considering an ILIT. This strategy creates a tax-efficient way to transfer significant wealth to their children.

Exploring Solutions

To evaluate the benefits of an ILIT, John and Lisa considered purchasing a $15 million survivorship life insurance policy. This type of policy pays a death benefit when the second spouse passes away, providing the family with liquidity to cover estate taxes and other costs.

The couple analyzes four payment options for funding the policy:

A single payment up-front
Payments spread over 10 years
Payments spread over 20 years
Payments spread evenly until Lisa turns 100 years old

Each option was reviewed to determine which approach would have the greatest financial benefit, while minimizing the impact on their annual gifting limits and lifetime exemption.

The Best Strategy for John and Lisa

After reviewing the options, the 10-year payment plan emerged as the most efficient way for John and Lisa to transfer wealth to their children. Here’s how the plan works.

John and Lisa would make annual gifs of $108,000 to the ILIT over 10 years. This amount comes from the annual gift tax exclusion of $18,000 per child, per parent, for their three children.
They would also use $75,000 of their lifetime exemption each year to cover the premiums, for a total of $750,000 over 10 years.

By funding the ILIT this way, they ensure that the $15 million life insurance policy will be fully paid in 10 years, without significantly impacting their overall estate.

Alternative Strategy for Comparison

John and Lisa also considered a more conservative approach: using only the $108,000 annual gifts to fund the policy, without tapping into their lifetime exemption.

Under this plan, it would take 18 years of annual gifts to fund the same $15 million policy. While this approach avoids using any of their lifetime exemption, it extends the funding period and delays the benefits.

John & Lisa’s Final Decision

After careful consideration, John and Lisa chose the 10-year gifting strategy. Here’s why:

The 10-year plan allows them to transfer the greatest amount of wealth to their children.
It protects their estate from the high costs of future estate taxes.
The life insurance proceeds provide the liquidity needed to cover taxes and estate expenses without forcing the family to sell assets.
The ILIT ensures the proceeds are distributed according to John and Lisa’s wishes, providing peace of mind and financial security for their heirs.

Why an Irrevocable Life Insurance Trust Works

An irrevocable life insurance trust is a powerful tool for families like John and Lisa, who want to:

Reduce estate taxes
Protect their wealth for future generations
Maintain control over how their assets are distributed

By acting now, John and Lisa are taking advantage of today’s favorable tax laws to secure their family’s financial future.

Need Help Deciding If an ILIT Is Right for You? Call the AZ Life Insurance Experts

Our team can help you explore financial arrangements, including life insurance policies and life insurance retirement plans (LIRPs) , that help protect your family now and in the future. We can help you select a life insurance plan, such as a whole life insurance policy , term life insurance or universal life insurance policy , and determine how life insurance fits in with your estate planning .

To learn more about your options regarding life insurance, call the AZ life insurance experts at 602.617.4107, or contact us online .

Irrevocable Life Insurance Trust (ILIT) FAQs

How to Navigate Taxable Life Insurance Benefits & Minimize Your Tax Burden

Thu, 27 Feb 2025 03:42:56 GMT

Are life insurance benefits taxable? Generally, life insurance plan beneficiaries receive life insurance death benefits tax-free, but certain scenarios may trigger taxation. This guide explains when a taxable life insurance benefit occurs, including coverage in estates exceeding tax thresholds, interest income on installments and other factors.

Key Takeaways

Life insurance death benefits are generally non-taxable, but they may become taxable in specific scenarios, such as in a three-party Goodman triangle, or when they’re included in a large, taxable estate.
Cash value growth within life insurance policies is tax-deferred, but withdrawals exceeding the amount of premiums paid, or policy loans, can become taxable under certain conditions.
With few exceptions, life insurance premiums aren’t typically tax-deductible. Strategies like using an irrevocable life insurance trust (ILIT) can help you avoid taxes on life insurance proceeds.

When Are Taxes Triggered With Life Insurance Death Benefits?

A life insurance death benefit provides financial compensation for beneficiaries, to support the financial impact of a loved one’s passing. Fortunately, in most cases, these benefits aren’t taxable for the beneficiary. But like many tax-related matters, there are some exceptions to the rule. Consider the following scenarios.

The Three-Party Policy Scenario

When three parties are involved in a life insurance policy , this becomes a “Goodman triangle” scenario. In a Goodman triangle, the parties involved are the insured, the policy holder and a beneficiary who’s not the policy owner. When the insured passes away, the death benefit becomes a taxable gift from the policy holder to the beneficiary.

To avoid the Goodman triangle and the resulting tax implications, the policyholder should also serve as the insured party, so that the life insurance policy scenario is reduced to two individuals.

Interest Income From Deferred Payouts

If the beneficiary chooses to receive life insurance proceeds in installments or delays the payout, rather than receiving the death benefits immediately in a lump sum, that could potentially trigger tax implications on the life insurance death benefits.

This typically happens when interest accrues on the life insurance proceeds. That interest, when it’s applied to future life insurance premium payments or when it’s withdrawn, can be subject to taxes.

Life Insurance Taxes Due to Estate Inclusion

Life insurance proceeds may also be taxable when they’re part of a large estate. If your life insurance policy is included in an estate that exceeds the federal estate tax exemption amount, federal and state estate taxes, as well as income taxes, may apply.

There are ways to avoid this tax obstacle. One method is to transfer ownership of the policy to an insurance trust. It’s important to note that the policyholder needs to survive for 3 years after this transfer to effectively exclude the proceeds from their taxable estate.

How Taxes Affect Cash Value Growth in Life Insurance

In addition to potential taxes on death benefits, there may be tax implications related to cash value growth in life insurance. While term life insurance policies don’t offer cash value growth, permanent life insurance policies can have a cash value component that accumulates on a tax-deferred basis. However, cash value withdrawals and life insurance policy surrenders can trigger taxable events, such as the following scenarios.

Tax Implications of Withdrawing Cash Value

The cash value in a whole life insurance policy, which is a type of cash value life insurance, can serve as a useful financial resource, such as a cash value account. But withdrawing money from this reserve can result in tax implications.

Withdrawals up to the amount of total premiums paid into a life insurance policy are income tax-free. But if you withdraw more than the premiums paid, or you opt to surrender the policy altogether, the excess amount becomes taxable as ordinary income. Also, any gains, such as dividends, that are withdrawn from a policy’s cash value are taxable as ordinary income.

How Loans Against Life Insurance Cash Value Affect Taxes

Did you know that you can borrow against the cash value of your life insurance policy? This may be a helpful financial strategy in certain situations. The good news is, loans against the cash value of life insurance policies aren’t treated as taxable income.

However, tax implications may arise if the life insurance policy ends before the loan is repaid. In these cases, the remaining loan amount can become subject to taxation. Even though loans can be a flexible option, consider the potential tax consequences before you decide to take a loan against your policy’s cash value.

The Impact of Premium Payments on Taxes

Life insurance premiums are generally not taxable and can’t be deducted on tax returns. However, certain scenarios involving employer-paid premiums and state premium taxes can influence your tax liability. Consider the following.

Are Life Insurance Premiums Ever Tax-Deductible?

While you typically can’t deduct life insurance premiums when you’re doing your taxes, there are some exceptions. For example, you may be able to deduct life insurance premiums as a business expense if the payer is not directly or indirectly a beneficiary of the policy. It’s important to consult with a tax professional to understand your unique circumstances.

How to Avoid Taxes on Life Insurance Proceeds

There are ways to minimize or even avoid taxation on life insurance proceeds. One such strategy involves the use of irrevocable life insurance trusts, also known as ILITs. Here’s how.

Benefits of Using a Trust for Life Insurance

An ILIT can be a beneficial financial tool, depending on your unique situation. By owning the life insurance policy and being named as the beneficiary, an ILIT ensures life insurance proceeds aren’t considered part of the policyholder’s taxable estate. This way, death benefits will bypass estate taxes.

There are other benefits of ILITs. They provide additional financial protection, by excluding life insurance proceeds from the reach of creditors, and allow a trustee to responsibly manage and control the trust’s distributions. This strategy can be particularly advantageous for estate planning across multiple generations.

How Do Taxes Affect Life Insurance Settlements?

Life insurance settlements can also be subject to tax implications. Terms depend on the insurance company, so consult with yours to understand the specifics.

For example, while viatical settlements are intended for individuals with life-threatening illnesses and are typically tax-exempt, life settlements may incur taxes based on the excess of the amount received over total premiums paid. To be exempt from federal income tax, viatical settlement transactions require certain documentation, including a physician’s statement about the policyholder’s illness and life expectancy.

How Do Taxes Impact Group Term Life Insurance Policies?

Group life insurance coverage provided by employers is a common employee benefit. But this type of coverage can also have tax implications.

For employer-provided group-term life insurance, the first $50,000 of coverage is excluded from taxation under IRC section 79 . However, plans that provide more than $50,000 in coverage may have tax implications for the recipient. If the policy is considered carried by the employer, it may result in a taxable benefit, even if employees pay the full cost charged to them.

Tax-Free vs. Taxable Life Insurance Policy Dividends

Life insurance policies often pay dividends to policyholders, typically seen as a return of premiums and, as such, aren’t subject to taxation. However, interest that accumulates on life insurance dividends may result in taxation if it leads to the policyholder getting more returns, compared to what they paid in premiums. Additionally, the excess dividend amount received over the amount paid in premiums for the policy is considered taxable income.

Need Help Navigating Life Insurance Taxes?

There are many ways to maximize your life insurance death benefit while minimizing your tax burden, including using ILITs and being aware of scenarios that trigger taxation.

Every individual’s tax situation is unique. It’s always important to consult with a tax professional who can guide you through the intricacies of your personal tax situation. In addition to providing financial security for your loved ones, you can make smart life insurance decisions that improve your finances in the present.

If you have questions about life insurance policies, contact us online or by email at info@azhealthinsurancebrokers.com , or by phone at 602.617.4107. We can refer you to a life insurance specialist who can help.

Life Insurance Taxes Frequently Asked Questions

Blue Cross Blue Shield (BCBS) of Arizona Group Health Insurance Plans Explained

Thu, 20 Feb 2025 19:51:56 GMT

For employers who are considering a reliable insurer for group health insurance in Arizona , Blue Cross Blue Shield (BCBS) of Arizona may be worth evaluating. It’s one of the most well-recognized insurers in Arizona, particularly for businesses that are interested in fully insured plans for business groups of 51 or more employees.

In this article, learn about some of the benefits BCBS of Arizona provides among business health insurers, some things to consider for business health insurance , and how to get group health insurance for your employees.

Key Takeaways

For business owners looking for fully insured plans for groups of 51 or more employees in Arizona, Blue Cross Blue Shield (BCBS) of Arizona is a top choice.
BCBS provides robust member resources, including health education, wellness programs and 24/7 nurse hotlines. Another advantage of BCBS of Arizona is its strong local focus and involvement in community health initiatives. BCBS has a deep understanding of local healthcare needs. Their partnerships with local providers can enhance the quality of care and support for employees.
One consideration when evaluating BCBS of Arizona for employees is that while the provider is strong locally, its network may not be as beneficial for businesses whose employees frequently travel out of state.

BCBS of AZ Pro: Competitive in AZ, Especially in the 51+ Fully Insured Category

In February 2025, “Forbes” ranked BCBS as the Best Provider Network in the country, with a 4.2 out of 5 stars rating. BCBS has also been ranked #1 in member satisfaction among commercial health plans in the U.S. Southwest region by J.D. Power .

Some of the reasons BCBS has received so many notable accolades include:

In Arizona, 98% of hospitals and 96% of physicians are included in the statewide provider network.
1 in 3 people are covered by a BCBS company nationwide.
BCBS has the largest provider network, with more than 1.7 million in-network providers.
BCBS has better-than-average quality ratings, according to “Forbes”.
BCBS provides health insurance for businesses with 2 to 300+ employees, with three tiers of plans for various-sized businesses.

In particular, the BCBS Mid-Sized Business plan for 51 to 300 employees and Large Business plan for 300+ employees are popular in the state of Arizona for their range of benefit designs and network options, which include potential dental insurance coverage . As both a nationally renowned brand and provider with a strong local reputation, many Arizona business owners choose BCBS as their insurance provider for their workforces.

BCBS of AZ Pro: Strong Local Focus & Community Involvement in AZ

BCBS has deep roots in Arizona, both with local healthcare providers and with community initiatives that support the overall well-being of populations within the state. In addition to virtually all hospitals and physicians in Arizona being within the BCBS statewide network, BCBS consistently participates in programs that bolster resident health. Some examples include:

In July 2024, the BCBS of Arizona Foundation for Community & Health Advancement announced a $75K grant opportunity to address the loneliness epidemic . The grant will go toward a project that builds community and social connections, which ultimately improves health.
In June 2024, the BCBS of AZ Foundation awarded more than $1 million to 28 organizations working on projects to address the state’s most pressing health challenges.
In June 2024, Fiesta Bowl and BCBS of AZ awarded $95,000 to 28 Arizonans in the post-secondary and GED tracks though an Empowering Diversity scholarship .

These are just a few recent examples of BCBS of AZ’s community involvement, partnering with health-focused organizations and nonprofits that support community development. In total, the foundation has provided more than $20 million in funding so far, with 449 community partners and 15 Arizona counties served.

When AZ employers choose BCBS of AZ, they’re also selecting a provider that’s heavily involved with the well-being of the local community.

BCBS of AZ Pro: Member Resources

As one of the largest health insurance providers in the U.S., another major advantage of using BCBS is that members can access many helpful resources that support their health and wellness. BCBS member education and resources include:

Treatment cost estimator, which includes information on health treatments that are covered and what members may have to pay
Registered nurses on-call 24/7 to answer common medical questions
BlueCare Anywhere, which provides virtual access to board-certified medical professionals 24/7
Sharecare , a health and wellness hub with resources on longevity, lifestyle choices and mental health
Care Managers , who are independent licensed healthcare professionals, such as registered nurses or licensed clinical social workers, whom members can reach out to for assistance with improving healthcare outcomes o navigating the healthcare system

BCBS of AZ members can get help with their health 24/7 and learn tips on how to make healthy choices. This extra layer of support could benefit your workforce and also lead to less absenteeism.

BCBS of AZ Pro: Prosano Health Solutions

Another interesting benefit of BCBS of AZ is the company’s Prosano Health Solutions , a services-oriented subsidiary with several Advanced Primary Care Centers throughout the state. The model includes one-stop access to primary care, lab services, same-day appointments, virtual options, behavioral health practitioners and a selection of prescription medications.

Employer groups can enroll in the AZ BCBS BlueSignature Prosano plan to give their employees access to the Advanced Primary Care Centers, in addition to a national PPO. This is another potential value-add for employees.

BCBS of AZ Con: Frequent Travelers May Be Better-Suited to Other Plans

The one minor consideration employers should make with BCBS is that if you have a workforce that frequently travels, there may be better plans with more comprehensive network coverage, depending on where workers travel. You’ll want to research the reach of BCBS compared to where you workforce travels to most frequently.

BCBS of AZ Could Be a Good Group Health Insurance Choice

With a strong local and national presence, abundant health and wellness resources for members, and community initiatives, BCBS could be a good choice for group health insurance for your workforce. If you’re at business insurance renewal time , it’s also one to consider switching to.

To learn more about all employer health insurance options that are available to your business, contact AZ Health Insurance Brokers for a free group health insurance consultation. Contact us online , email quotes@azhealthinsurancebrokers.com or call 602.617.4017 to connect.

Get a BCBS Commercial Quote

Blue Cross Blue Shield (BCBS) of Arizona Group Health Insurance FAQs

I Think I Signed Up for the Wrong Insurance Plan – What Should I Do?

Fri, 14 Feb 2025 19:58:07 GMT

Signing up for the wrong health insurance plan happens frequently. There are a lot of health insurance plan details and specifications to consider. When you’re under pressure to sign up before the enrollment deadline, it may result in making the wrong choice.

If you’re unsure about the insurance plan you chose at work or on your own , or you’re having regrets because you found a better health insurance plan option, you may be wondering what your next steps are. Do you have to wait until the next health insurance enrollment period? Are you stuck with a health insurance plan you no longer want? This guide explains what to consider when signing up for health insurance .

Key Takeaways

Some common reasons for realizing you’ve signed up for the wrong health insurance plan include: your preferred doctor’s not in-network, you’re paying too much for health coverage you don’t need, and your prescriptions aren’t covered by your insurance plan.
When you’ve signed up for the wrong insurance plan or one that doesn’t cover your preferred doctor(s) or prescriptions, you have options. You may be able to find low-cost prescriptions by using coupons or signing up for an international mail-order. You may find that your current plan actually does make financial sense because of the premium and deductible costs when comparing the plan against out-of-pocket copay costs. You may be able to sign up for a new private plan, even outside of traditional Affordable Care Act (ACA) open enrollment dates. Talking with an expert health insurance broker can help you navigate your options.
If you aren’t sure if you signed up for the right or wrong insurance plan, talk with an expert health insurance consultant who can compare your budget, plan coverage and alterative options to see if there’s a better option available.

1. Evaluate Your Current Health Insurance Plan

First, evaluate your current health insurance plan to determine that there really may be a better option available to you. Consider specific health insurance details, including:

Health insurance monthly premium cost
Health insurance deductible
Health insurance plan doctors available
Health insurance plan copay costs
Health insurance plan out-of-pocket maximum

Think about the answers to these questions:

Does your current plan fit your and your family’s healthcare needs?
Can you see the doctors you want to see?
Do your healthcare plan’s costs fit your or your family’s budget?

It’s also important to look at the type of health insurance plan you signed up for. The three main types of health insurance plans are health maintenance organization (HMO), preferred partner organization (PPO) and exclusive provider organization (EPO). You may want to switch from one type to another based on the details explained below.

HMO

An HMO health insurance plan requires that you select a primary care physician who is your main healthcare provider.

If you need to see a specialist doctor, your primary care provider will need to refer you to that specialist in order for your healthcare expenses to be eligible for health insurance coverage. If you see a healthcare specialist without a referral, or one who’s outside of the HMO network, you’ll likely be responsible for all the costs associated with your visit or treatment.

PPO

A PPO plan has a preferred list of providers for all types of physicians. If you’re on a PPO plan, you’re not required to see a primary care provider, and you don’t need a referral to see a healthcare specialist.

If you see a doctor on the preferred list of providers, you’ll likely have a larger option of your bill covered, compared to if you choose to see a doctor who’s not on the preferred list of providers.

EPO

An EPO plan is like a hybrid of an HMO and a PPO. EPOs may be less expensive than other plans, but they may be more restrictive in the doctors you can see. You don’t need a referral to see a specialist on an EPO plan, but you will be responsible for covering out-of-network costs.

2. Compare Your Current Plan to Other Available Plans

Once you’ve clarified the details of your current plan, you can compare them against what else is available. To understand the other options that may be available, look at your current insurance provider’s options to see what other types of plans they offer.

Answer the same questions above to compare your answers. In particular, pay attention to the following.

Are you paying a lot of out-of-pocket costs?

If your health insurance out-of-pocket costs are high, you may want to consider switching to a health insurance plan that has a higher monthly premium but that offers lower out-of-pocket costs.

You may find yourself in a situation where you’re paying a lot of out-of-pocket expenses because you require frequent medical visits, or you need a lot of prescriptions filled. If your family’s health situations require a lot of healthcare and/or prescriptions, you may want to look for a plan with lower out-of-pocket costs.

Are you paying high health insurance premiums, but you’re not close to reaching your deductible?

If you pay high monthly premiums, but you never come close to meeting your deductible, you may be able to get the healthcare coverage you need with a plan that has a lower monthly premium amount and a higher deductible.

Keep in mind that choosing a higher deductible health insurance plan could cause issues if there’s an unforeseen emergency or an expensive medical event you have to deal with. Make sure to weigh the cost versus the risk to make a decision you’re comfortable with.

Are your preferred doctors out-of-network?

If your preferred doctors are out-of-network with your plan, you’ve likely signed up for the wrong plan. You can try to find a plan in which your preferred providers are in-network. Otherwise, you may have to pay a lot out-of-pocket, depending on how frequent your visits are.

3. Begin the Process to Change Plans

When you determine you want to switch health insurance plans, you can begin the process to change what you have. You may currently have a plan through your employer or through your spouse’s employer. Or, you might be on an Affordable Care Act (ACA) plan . Or, you might have a private health insurance plan , like through an individual health insurance plan or family health insurance plan .

If you have a group insurance plan through work, or your spouse does, contact the human resources department to check about the possibility of modifying your choices.

When that’s not an option, you may qualify for a special enrollment period for healthcare insurance. Special enrollment periods are offered to those who have experienced a qualifying life event, such as a marriage, divorce, death or job change. You typically have up to 60 days after a qualifying life event to switch healthcare plans.

If you’re outside of the health insurance open enrollment period, and you don’t qualify for a special enrollment period, you may have access to private health insurance plan options that could better meet your needs. The insurance experts at AZ Health Insurance Brokers can help you determine:

Whether or not there’s a better health insurance plan available to you, in terms of healthcare coverage, costs or both
How you can get better healthcare coverage if you missed the open enrollment period

There’s no cost to talk with a health insurance expert at AZ Health Insurance Brokers. Call 602.617.4107, contact us online or email quotes@azhealthinsurancebrokers.com .

Wrong Health Insurance Plan FAQs

Term Life Insurance Guide: What Term Insurance Is & Benefits of Term Life Insurance

Fri, 14 Feb 2025 15:19:22 GMT

What exactly is term life insurance , and how can it fit into your long-term financial planning? Term life insurance is designed to provide your beneficiaries with financial security for a specific duration, typically ranging from 10 to 30 years.

Term life insurance offers straightforward, cost-effective plans. It’s often considered a temporary but essential part of a well-rounded financial strategy. It also provides peace of mind for families that in case you lose a loved one who has provided financially, a spouse or family member can continue to have the same quality of life.

In this guide, learn about the specifics of term life insurance lengths, term life insurance premium costs and life insurance policy comparisons to help you decide if term life insurance aligns with your financial goals.

Key Takeaways

Term life insurance offers a straightforward, cost-effective solution for temporary financial protection, with level premiums and a guaranteed death benefit during the specified term. Unlike other types of life insurance, term life insurance does not offer cash value accumulation.
Term life insurance policyholders can select term lengths that align with their financial obligations and milestones. Term life insurance policyholders have options to renew or convert their policy upon the term expiration.
The cost of term life insurance premiums is influenced by multiple personal factors, including age and health, with additional riders available to enhance and personalize coverage, as well as features like return of premiums, for added financial benefits.

Term Life Insurance Explained

Term life insurance offers a guaranteed death benefit during a specified term, should the unforeseen death of the policyholder occur during the term. The death benefit can be used to pay for everyday expenses such as food, mortgage payments and health insurance , as well as to cover outstanding debts, on items such as student loans and credit card debt.

Compared to permanent life insurance policies, term life insurance offers simplicity and affordability. It provides peace of mind without the complexities of cash value accumulation .

Term life insurance is a powerful financial safeguard. It offers predictability with level premiums and the assurance the policyholder’s loved ones/beneficiaries will be supported financially in the wake of the loss of the policyholder.

Term life insurance premiums remain fixed throughout the duration of the term, offering predictability and a simple way to budget for life insurance. Death benefits may be paid at any time during the term.

How Term Life Insurance Compares to Permanent Life Insurance

Term life insurance differs in several ways compared to other types of life insurance, like permanent options including whole life insurance and universal life insurance . Some differences include:

Affordability: Term life insurance tends to be the most affordable type of life insurance policy, compared to options like permanent life insurance . Also, there’s a potential return of term life insurance premiums paid if the policyholder outlives the policy.
Length: While permanent life insurance is designed to offer lifetime coverage, term life insurance typically only lasts a specified term. Once the term ends, coverage also ends, unless the policyholder renews or converts the term life insurance policy.
Lack of cash value: Term life insurance doesn’t offer cash value accumulation or investment components like other policies might. This typically results in lower prices for term life insurance premiums.

For individuals who are looking for a simple form of life insurance that offers financial protection for a specified term, term life insurance can be an affordable option.

How to Choose Term Length in Term Life Insurance

Term lengths in term life insurance may range from a decade to 40 years. To determine the right term that works for your life insurance needs, and to provide essential financial protection for your loved ones, it’s helpful to anticipate major life events and the financial needs of your loved ones over time.

Some life situations to consider include:

Your age: This affects how long you anticipate working and when you’ll retire. Your income may impact your family significantly, especially if you’re the primary breadwinner in your family and if your spouse and/or children rely on your income.
Dependents: If you have children, you will want to consider their future financial needs, such as college tuition costs and leaving a legacy in terms of financial providing, in case you pass away.
Outstanding debts and financial obligations: One of the main reasons why people choose to obtain life insurance is to ensure the loved ones they leave behind are able to financially cover outstanding debts and financial obligations, such as a mortgage payment and credit card debt. If you are currently working on paying off what you owe, you’ll want to factor in those amounts as you calculate a term life insurance coverage period and policy amount.
Your health: Term life insurance policies may require a medical exam, which means the state of the policyholder’s health will impact their premium costs. There are some life insurance options that don’t require a medical exam. Depending on how comfortable you are with undergoing a medical exam and with having your current state of health impact your life insurance premiums, term life insurance may or may not be the best option.

Many term life insurance policies will offer an option for renewal and/or conversion once the term of the policy is coming to an end. There may be yearly renewable term policies available that don’t require medical exams. Some term life insurance policyholders choose to convert a term life insurance policy into a permanent life insurance policy. Before you commit to a term life insurance policy, talk with providers about what future options are available.

How Much Does Term Life Insurance Cost?

Generally, term life insurance is less expensive the younger you are when you sign up for a policy, and the better condition your health is in. For example, a 25-year-old in good health can get a relatively cheap term life insurance policy, compared to a 50-year-old who smokes cigarettes. The earlier you sign up for term life insurance, the easier it is to lock in the lowest rate for the life of the term life insurance policy.

Term Life Insurance Cost Examples

To illustrate cost estimations for how much life insurance costs, the following examples detail potential pricing scenarios.

Term life insurance pricing example #1

James and Emily, both age 33 and in excellent health, are balancing a busy household with two children and dual incomes of $80K each, totaling $160K annually. They currently have a mortgage of $400K, vehicle loans amounting to $60K and other debts totaling $35K, with monthly debt payment obligations reaching $6k.

The solution(s): Given their situation, the following are practical term life insurance policy recommendations for their needs.

$2M term life insurance policy: Each of them securing a term life insurance policy with this death benefit would comprehensively address their debts and provide significant financial support for the surviving spouse to handle monthly expenses comfortably. Given their excellent health, they would likely each qualify for a preferred rate. A 20-year term policy would likely cost about $70 per month per person.
$500K term life insurance policy: This more economical term life insurance option still offers substantial financial protection. The death benefit would assist in clearing existing debts, in the event of one spouse’s untimely passing. Opting for a 20-year term life insurance policy, the estimated monthly premium for each policyholder would be approximately only $25 a month at a preferred rate.

Term life insurance pricing example #2

Richard, age 63, and Janet, age 59, are approaching a new chapter in their lives. With their children independent and financially stable, Richard is nearing retirement and the loss of his company-provided life insurance. The couple currently has a $225K mortgage balance and $20K in additional debts, with monthly expenses totaling $4.5K. Despite being in good health and on some routine medications managed by his primary care physician under his family health insurance plan, Richard faces new life insurance needs.

The solution(s): Considering their desire to minimize costs during retirement, the following are tailored life insurance recommendations for Richard and Janet.

$600K term life insurance policy: This life insurance policy would allow Richard to comprehensively cover their debts while providing Janet with a stable financial cushion for ongoing expenses, potentially unmet by her future Social Security benefits. Given Richard’s good health, he may qualify for a standard-plus rate, with an estimated monthly premium of $500 for a 20-year term.
$300K term life insurance policy: As a cost-effective alternative, this life insurance policy would enable the couple to pay off their mortgage and eliminate their debts. For a 20-year term at a standard-plus rate, the monthly life insurance premium would be approximately $260.

You can see the drastic difference in monthly premium costs based on age. We encourage individuals and families who are interested in strong financial planning to consider life insurance as an essential component.

Living Benefits and Riders in Term Life Policies

Term life insurance policies may include the option to add riders that add a layer of protection and personalization to the term life insurance coverage. Some common riders that can be added to term life insurance policies include:

Accidental death benefit rider: This adds an additional layer of financial protection, should tragedy strike due to a qualifying accident. Accidental death benefit riders may offer coverage up to the age of 70 or later.
Waiver of premium rider: The waiver of premium rider may ensure that term life insurance coverage endures even when the policyholder encounters a disabling circumstance that might otherwise compromise their ability to maintain coverage.
Critical illness rider: A critical illness rider may enable the policyholder to take out life insurance financial benefits while they’re alive , if they need financial coverage for critical illness treatment.

Other rider types include a child rider, a disability income rider and a long-term care rider. Riders added on to a term life insurance policy extend the financial coverage of the life insurance policy beyond the traditional death benefit.

Term life insurance policyholders may also have the option to add a return on premium feature in a term life insurance policy. This feature means premiums paid throughout the policy may return to the policyholder if they outlive the term. This feature transforms a life insurance policy into a risk-free investment in one’s future , as it offers both protection during the term and a potential financial windfall at its conclusion.

Riders and features like these enable term life insurance policyholders to further customize their plans based on their unique needs.

Adjusting Life Insurance Coverage Over Time

As your life’s financial needs evolve, you may be able to change your term life policy features, as well. Some life events that may motivate you to change your term life insurance policy include:

The birth of a child
Buying a new home
Starting a business
Paying off debts
Planning for retirement

By regularly reviewing and adjusting your term life insurance coverage, you can ensure it continues to meet changing needs throughout your life. This adaptability makes term life insurance a versatile tool in one’s financial repertoire, providing temporary yet essential protection during key periods of life.

Transitioning to Permanent Life Insurance

Another option to consider is transitioning a term life insurance plan to permanent life insurance. This transaction may offer several benefits, including:

Secures lifetime life insurance coverage
Requires no new medical examination
Premiums honor original underwriting classification

If you’re interested in lifetime insurance coverage, keep in mind the option to transition a term life insurance policy to a permanent life insurance plan for enduring coverage.

How Term Life Insurance Claims Work

As you select a term life insurance provider, it’s helpful to evaluate company ratings to discern an insurer’s financial strength and ensure the company stands on solid ground and is capable of meeting their obligations.

The process of claiming the death benefit under a term life insurance policy typically requires the following steps.

Notify the term life insurance broker or term life insurance company of the insured’s passing.
Complete claim forms provided by the term life insurance company.
Submit a certified death certificate and any other required documents.
Provide any additional documentation requested by the term life insurance company.
Wait for the term life insurance company to review and process the claim. This typically takes about a week or two, although it may take longer, depending on the circumstances and state regulations.

Once the term life insurance claim is approved, the insurance company will fulfill its promise by paying the death benefit.

How to Purchase Term Life Insurance

Term life insurance can be an important part of a comprehensive financial plan. To purchase the best term life insurance plan for your unique financial situation, it’s important to carefully assess your and your family’s financial goals and work with a life insurance broker who can help you evaluate term life insurance policy options, company reputations and the fine print of term life insurance coverage details.

To choose a term life insurance policy, or other type of life insurance policy, that perfectly aligns with your financial goals and provides the protection your family deserves, book a free consultation with our life insurance experts today. We’re ready to assist you in navigating your options to select a plan that ensures peace of mind for years to come. Reach out so we can help you make an informed decision that works for you and your loved ones.

Term Life Insurance FAQs

What to Consider with Small Business Group Health Insurance

Thu, 06 Feb 2025 14:23:17 GMT

Small Business Group Health Insurance Guide

Offering health insurance at your small business can help you attract and retain top talent, as a 2024 survey of 2,000 U.S. adults found one in three Americans would turn down a dream job if it didn’t provide good health insurance options. Nearly three-quarters (73%) consider healthcare an important factor when they’re on the job search.

If you want to keep your top employees and attract better candidates to your small business, offering health insurance can bolster your value. This guide on small business group health insurance explains what you need to know.

Key Takeaways

If your small business has at least two full-time employees (including yourself), you’re able to offer small business group health insurance. The one exception for small business group health insurance eligibility with two full-time employees is for small businesses that are co-owned by spouses. Health insurance for employees can be a major factor impacting recruitment and retention.
There are many group health insurers small business owners can consider using in Arizona. These include: UnitedHealthcare , Humana, Blue Cross Blue Shield (BCBS), Cigna and Aetna (also known as Banner|Aetna in Arizona). Small business owners may also use a third-party administrator such as Angle, Trustmark or healthEZ to access group health insurance plans from providers such as Cigna and Aetna.
In addition to carrier choice, small business owners can choose between plan types such as fully insured plans, where prices are based on employees’ ages and county, and level funding plans, which are underwritten based on employees’ past and current health.

What Is Small Business Group Health Insurance?

Small business group health insurance plans are available to any employer with more than 2 full-time staff, including for K-1 partnerships . There is an exception: a business co-owned by spouses isn’t eligible for small business group health insurance. As the employer pool grows, the ability to purchase more affordable plans increases at certain milestones.

Small group plans provide actual healthcare coverage for employees and their dependents, such as a spouse and child/children. Business owners purchase these plans, which must comply with Affordable Care Act (ACA) rules that apply to small group health plans, including:

If you provide health insurance to your workforce, you must offer it to all eligible workers when they become eligible for health coverage. There’s a 90-day maximum waiting period, which is the period that must pass before coverage for an employee or dependent can become effective.
Employers must provide workers with a standard “Summary of Benefits and Coverage” (SBC) form , which provides details on what their health plan costs and what it cover.
Most plans can be offered on a pre-tax basis to both the employer and employees under Section 125 .

As a small business owner, you’re in charge of choosing the plan provider and how much you’ll cover for the plan’s monthly or annual premium cost. The employee would be responsible for contributing the remaining portion of the premium. Employers can offer between three to five plans, depending on the insurance provider.

Business owners can purchase health insurance coverage at any time during the year. Your employees can join the plan during open enrollment or during a special enrollment period, such as when they first become eligible for the plan.

If you’re not able to cover premiums towards types of insurance beyond medical (such as dental insurance , vision, disability, accident, etc.), you can still offer this coverage to your employees as part of their work health insurance plan. They’ll be able to choose the amount of coverage they want and can cover the costs themselves.

How to Get Small Business Group Health Insurance

The type of group health insurance that’s available to you will depend on how many employees you have. As you grow your company and your workforce, you can also evolve your small business health insurance offerings based on employer milestones you reach and the health insurance provider you choose.

In most cases, we recommend getting fully insured or level funding insurance plans for a small business. These are defined as:

Fully insured , also known as community rated, plans are based on age and county, not your employees’ health or pre-existing conditions.
With level funding plans , the insurance carrier underwrites the policy based on your employees’ past and current health.

You can get small business health insurance through a broker , who can walk you through all your available options and present you with the most cost-effective ones that make sense for your business.

There are also professional employer organizations (PEOs) that can help with securing small business group health insurance. These can be pricier than working with a broker , but they can also provide other human resources (HR) functions, like administering 401(k) plans.

Types of Small Business Group Health Insurance Available

Depending on how many employees you have, here’s what’s currently available from each provider in Arizona. These offerings will differ from state to state.

5 enrolled employees: You can look at underwritten strategies using health applications for your employees.
10 enrolled employees: UnitedHealthcare and Humana will underwrite with no applications, as long as the group has prior coverage. If there’s no prior coverage, applications are required.
15 enrolled employees: Blue Cross Blue Shield (BCBS) will underwrite with no applications, as long as the group has prior coverage. If there’s no prior coverage, applications are required.
20 enrolled employees: Cigna will underwrite with no applications, as long as the group has prior coverage. If there’s no prior coverage, applications are required.
25 enrolled employees: Aetna will underwrite with no applications, as long as the group has prior coverage. If there’s no prior coverage, applications are required.

Once your small business exceeds 50 active full-time staff members, your group becomes an applicable large employer (ALE). The “community-rated” aspect to fully insured plans, which bases coverage on age and county, goes away. All health insurance rates will then be based on factors like utilization, health and pre-existing conditions.

In other words, all group health insurance offers for businesses with 51 or more full-time eligible staff will be underwritten. If you have 100+ enrolled employees, you’ll also need to fill out a Form 5500 for each line of coverage in excess of 100 enrolled.

Once you exceed 300 employees, partial self-funding starts to make more sense. That’s because the risk you incur is more spread out. With partial self-funding , you “rent” an insurance carrier network and pay for claims as they’re incurred. You also purchase reinsurance (also called stop-loss insurance) to cap your risk.

The opportunities for savings in this case may be larger. A business health insurance broker can help you navigate your options based on your unique circumstances.

Benefits of Offering Small Business Group Health Insurance

As a small business owner, you have several options regarding what type of health coverage you offer to employees . These include health savings accounts (HSAs), which employees contribute to for their healthcare coverage.

Another form of health coverage is a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) . A QSEHRA is a type of health reimbursement arrangement (HRA) that enables small employers to provide their employees with untaxed reimbursement of specific healthcare expenses.

There are also Individual Coverage Health Reimbursement Arrangements (ICHRAs) , which is an HRA where workers can buy health insurance on the individual market and get reimbursed through an employer-funded account.

When you offer group health insurance, you don’t have to offer an HSA or contribute under a QSEHRA. You’re only required to pay 50% of eligible employee coverage towards the cheapest plan.

In addition to cost savings, offering a group health insurance plan to employees can help you retain a healthier staff. Your employees may be more likely to proactively manage their health, knowing they have reliable coverage in place to take care of them. That can decrease absenteeism and improve productivity, which can boost your business results.

Interested in Group Health Insurance? Contact AZ Health Insurance Brokers

If you want to offer health insurance to your small business employees, contact AZ Health Insurance Brokers . We’ll walk you through the options you have based on the size of your workforce.

Get recommendations for the most cost-effective plan for you as a small business owner and options that can help you attract and retain your top talent. Call 602.617.4107, or email quotes@azhealthinsurancebrokers.com for information.

Small Business Insurance FAQs

PEOs for Businesses: What Is a PEO? Should Your Business Use a PEO?

Tue, 28 Jan 2025 18:06:54 GMT

For small businesses that are having some challenges with human resources (HR) functions, a professional employer organization (PEO) may be a solution worth considering . PEOs act as outsourced HR teams. They can manage administrative tasks, like:

Group health insurance benefits
Payroll
Workers’ compensation
Employee training

In some cases, a PEO can improve efficiency and make financial sense for small businesses. In others, you could save money handling these tasks in-house or by working with a more specialized partner, especially for group health insurance administration.

In this guide, learn more about what a PEO is, pros and cons of PEOs to consider, and signs it may be time to exit a PEO and how to do so.

Key Takeaways

Professional employer organizations (PEOs) can provide scalable support to small businesses in human resources functions.
PEOs have both pros and cons, related to HR administrative control, business expenses and time and resource requirements.
For many small businesses that are using PEOs for health insurance benefits administration , it may make more financial sense to partner with a group health insurance broker , which results in financial savings and improved benefits for employees.

PEO Explained

What is a PEO, exactly? A PEO provides outsourced HR administrative support. Areas a PEO might manage include:

Benefits administration, including health coverage such as HRA 105 plans , qualified small employer health reimbursement arrangements (QSEHRA) , individual coverage health reimbursement arrangements (ICHRA) and health savings accounts (HSAs) and business insurance plans , including self- funded insurance , level funded insurance and fully insured health plans for group insurers such as UnitedHealthcare Surest , Aetna , Cigna , UnitedHealthcare and Blue Cross Blue Shield (BCBS) of Arizona
Tax compliance
Government compliance
Payroll administration
COBRA insurance
Safety programs and OSHA compliance
Training and development courses
Risk management services

PEOs may work with diverse companies across the country, technically providing support to thousands or more employees. For a business that doesn’t want to hire a full-time, dedicated HR or administrative team, the business can outsource tasks related to the above categories to a PEO.

PEOs can draw on their vast resources and regulatory compliance expertise to ensure small businesses stay compliant with local, state and federal regulations. They can also free up small business owners to work on the tasks they want to focus on.

Pros of a PEO

PEOs may provide benefits to some small business owners. Typically, a PEO makes the most sense for owners of multi-state businesses with fewer than 25 employees, who want to offer very rich benefits for their staff. Some benefits of PEOs include:

Multiple tasks handled in one place: PEOs can manage a variety of HR tasks on behalf of the business, including 401(k) plans, health benefits and more. Instead of having to source multiple vendors, a business can work with a single PEO to get things done.
Regulatory compliance: PEOs are experts in nuanced compliance regulations. This makes it easier for small businesses in multiple states to gain the peace of mind they’re operating lawfully wherever they do business.
Potential cost savings: In certain scenarios, a small business may be able to save money using a PEO. For example, instead of hiring in-house HR staff members that require an annual salary plus benefits and overhead, a PEO eliminates those costs.

PEOs are simple to roll out, and they’re scalable. While they may provide some benefits, small business owners should also be aware of when a PEO might not be the best solution.

Cons of PEO

There are many different PEO providers available, and choosing the wrong one could result in significant expenses for a business, as well as potential problems. Some PEO disadvantages to consider include:

Investment: Often with PEOs, up-front costs and fees aren’t always transparent. A business owner may sign a contract with a PEO, only to be surprised by fees later on. Plus, for some business tasks, like administering group health insurance , it’s actually much more expensive to use a PEO compared to working with a specialist like a health insurance broker . Business owners should weigh costs compared to what they need to choose the best solution.
Exit challenges: Small business owners should keep in mind that if they do one day want to exit a PEO, it can be challenging to do so without incurring significant fees and/or a loss of staff accumulations. For example, if a portion of some employee’s deductible has been satisfied, that may not translate to your new insurer.
Lack of customization: Because PEOs work with different businesses, small business owners may find that customization options are lacking. It may be more beneficial to work with a vendor that can offer personalization based on the unique needs of a business, rather than a PEO that offers generalized services for all clients.
Communication issues: Another potential PEO downside is that it may be difficult to get quick answers to questions and clarity for any issues a business may have. Since PEOs are working with multiple clients, a small business owner may find service and response times are slower than what they need.

For small business owners who are looking for a true partner, PEOs may not offer the personalized service they need. Plus, PEOs can be more expensive than other options and can be difficult to leave on smooth terms. For these reasons, small business owners should carefully consider all options before signing up with a PEO.

How to Choose a PEO

When you’re comparing the multitude of PEO vendors out there trying to sell you services, follow these steps to improve the likelihood of a successful partnership.

Assess your needs. Understand your specific HR needs, including payroll processing, benefits administration, compliance management and any other services you require. Make a list of must-have services versus those that are nice to have.
Research potential PEOs. Look up PEO providers online, and/or ask colleagues for recommendations. Create a list of ones that offer what you’re looking for. Contact those for a free consultation.
Evaluate your financial stability. As you consider the costs, look at your financial projections to ensure you’ll be able to pay for PEO services during the contract length you’re considering.
Consider technology and integration. If you’re already using specific software and systems, enquire to see if the PEOs you’re interested in can integrate with your existing business tools.
Review compliance expertise. Make sure the PEOs you’re interested in are experts in compliance for the locations you’re currently operating in, and any areas you’re interested in expanding into.
Assess employee benefits. Look for PEOs that offer the employee benefits you’re interested in providing to your workers, like business health insurance , dental insurance , term life insurance , whole life insurance , universal life insurance and burial insurance .
Understand service level agreements (SLAs). Have a lawyer review any potential SLAs and answer any questions you have, so you’re completely clear about what each partnership would entail.
Compare costs. Understand the true costs of the PEO and the value each one can bring to your business. Compare the potential return on investment you can expect with each PEO.
Seek references and recommendations. Ask potential PEO partners for similar clients they have that you can talk to for references and recommendations.
Negotiate contract terms. If you’re interested in a PEO but need to adjust the contract, negotiate to get closer to the deal you’re interested in.
Trust your instincts. As a small business owner, you’ve cultivated strong business instincts that have helped you open and run your business. If your gut is pointing you one way or driving you away from a PEO, investigate further to come to a decision you’re confident in.

You can also utilize professional networks like LinkedIn to ask your colleagues for recommendations for PEOs. Take your time with researching, since, as mentioned, PEO contracts can be difficult to exit and may result in extra costs when the fit’s not right.

When to Exit a PEO

There are many signs your business may be outgrowing its PEO . As companies, grow, they’ll typically pay more in PEO administration fees. While the scalability of a PEO can be a benefit, it can also result in exorbitant costs that outweigh the benefits.

There are other reasons you may want to exit a PEO. You may find that communication is lacking, or the PEO isn’t living up to the results they promised in the consideration phase.

When you determine it’s time to end a PEO partnership, the first step for how to exit a PEO is to review the contract terms, including exit terms. Notify the PEO, and work with a lawyer for help when needed.

To ensure your employees retain the benefits they’re used to, contact new health insurance benefits brokers for a seamless transition. You’ll want to ensure compliance continues to be met, so work with new partners who are compliance experts where you operate.

Want to Exit a PEO? Contact AZ Health Insurance Brokers

The team members at AZ Health Insurance Brokers are experts in helping small businesses exit PEOs. We assist small business owners with guidance, recommendations and strategies to create a solution that has similar functionality to a PEO, without the expensive costs.

If you’re interested in offering small business health insurance , life insurance and/or other types of benefits to employees, contact AZ Health Insurance Brokers for a free consultation. Contact us online , call 602.617.4107 or email quotes@azhealthinsurancebrokers.com for more information.

PEO FAQs

What Is Self Funded Insurance for Businesses?

Thu, 23 Jan 2025 15:47:36 GMT

If you want to offer healthcare coverage to your employees , you have several options for group health insurance plans to provide. In addition to traditional fully funded healthcare plans , where you pay a set premium to a health insurance provider in exchange for a specific coverage level, there are also self-funded plans that could provide more flexibility and lower costs.

Healthcare coverage in any type of plan is a vital benefit for today’s workforce. An August 2024 survey of 1,000 job seekers by Resume Genius found comprehensive health insurance was the second-most sought-after benefit, second to only higher than average salary. Strong health insurance offerings can help your business stand out to recruit top talent and retain your workforce.

As you consider your options, learn about how self-funded healthcare plans work and why they might be a good fit for your business. Contact our Arizona health insurance brokers team if you need help navigating all your options.

Key Takeaways

Self funded health insurance plans allow the employer to control the entire dollar amount of their healthcare spending.
Generally speaking, this type of health insurance plan is a good fit for larger companies with 500 or more employees. However, with increasing costs of insurance, this product will likely, over time, become more and more popular in the market.
In most cases, self funded plans are actually “partially” self funded, since the majority of employers who use a self-funding model have stop-loss insurance in the background to protect them against the costs of a single large claim or a series of small claims.

Self Funded Group Health Insurance: How It Works

Self funded insurance for businesses, otherwise known as self insurance, is a funding strategy that allows employers to capture some of the profits from their healthcare plan. With a self funded plan, the employer takes on most or all of the benefit claims expenses. The company or a third party administrator (TPA) manages payments, additionally the employer is responsible for paying the claim amounts.

With a self funded insurance plan, an employer has the potential to:

Customize healthcare coverage to meet their unique business needs
Save money compared to traditional, fully insured health plans, especially with relatively healthy workforces
Gain more flexibility, since self funded plans may not be subject to specific state requirements

Many employers will be familiar with fully insured plans, where an employer pays an insurance premium that goes toward an insurance pool that pays claims across a group of employers. With self funded insurance, the employer pays for claims out-of-pocket, which could improve cash flow compared to a fully insured plan that requires a set payment each month.

The self insured employer will also typically pay administrative fees and for optional stop-loss insurance, which protects employers against large claims or a large number of small claims that cost beyond a certain threshold.

How Reinsurance Works With Self Funded Plans

The term “reinsurance” refers to insurance that insurance companies take out to protect themselves against large claims. In a self funded health plan, reinsurance takes the form of stop-loss insurance, which is the employer’s responsibility. An employer may choose to get stop-loss insurance for situations like the following.

Individual “specific” deductible: Setting a stop-loss insurance amount for an individual “specific” deductible protects the employer against a single member’s large claim. For example, if an employee is diagnosed with a serious illness, and the specific deductible is $100,000, the employer’s maximum liability will be $100,000 for that claim.
Aggregate deductible: Setting a stop-loss insurance amount for an aggregate deductible protects the employer against a variety of smaller claims. For example, if 100 employees visit the emergency room throughout the year, and the aggregate deductible is $1 million, the employer’s maximum risk for all claims is $1 million.

The lower the threshold is for reinsurance, the higher the stop-loss premium will be. For example, an employer that has a specific deductible of $25,000 will pay more in premiums compared to an employer that has a specific deductible of $100,000. However, paying more in premiums for a lower specific deductible may lower the financial risk for the employer.

When crafting a self funded plan strategy, there needs to be a balance between risk and forecasting that’s appropriate for clients, depending on their own unique circumstances. Partial self funding, which uses stop-loss insurance, can be more complex than other types of group insurance plans , which is why it’s important to work with Arizona health insurance brokers who understands client needs.

Self Funded Insurance Costs & Factors to Consider

Beyond reinsurance, there are other fixed costs associated with self-funded insurance. These include:

Administrative fees: Self funded insurance plans typically require administrative fees, as an insurance expert will need to execute the plan between the insurance carrier and the employer. TPAs can be a good fit for self-funded health plan employers to ease some of the burden. They can both help customize the plan creation, as well as process claims for the employer as they come in.
Consulting fees: Depending on who you talk to when creating your self funded plan, there may be consulting fees required in order to get advice and make the right selection. At AZ Health Insurance Brokers, we offer free consultations to businesses, so you can understand all your options and be confident in the plan selection.
Possible network fees: There is a possibility that the health insurance carrier you choose will charge an insurance network fee. This isn’t the case for all plans, but it’s something to be aware of as you shop for self funded health plan carriers.

Also, related to stop-loss insurance/reinsurance, you risk level and funding decisions will impact your overall budget for self-funded health plans. Employers can decide to “fund to max” or fund to expected risk. A decision to fund to the max helps build a larger claims fund pool and reserves for later use. Funding to expected risk may mean an employer may owe more money periodically, but there may be potentially less of a financial burden.

To optimize your budget and save the most money, while ensuring your employees have the health coverage they need, it’s helpful to talk with an AZ health insurance broker for expert guidance.

Should Your Business Use Self Funded Insurance?

Self funded health plans are becoming more popular, as more businesses seek to gain control over the details of their group health insurance plans for their employees. Compared to a traditional fully funded plan, you can work with a TPA to design your plan and decide on the risk and financial responsibility you want to take on with your plan.

Like any health insurance plan for business , we encourage you to talk with a business health insurance expert at AZ Health Insurance Brokers to learn about all your group health insurance options. Our team can help you learn about offerings including health savings accounts (HSAs), health reimbursement arrangements (HRAs), individual coverage health reimbursement arrangements (ICHRAs), qualified small employer health reimbursement arrangements (QSEHRAs), dental insurance for businesses and various brands for business insurance, including UnitedHealthcare for employers .

For a free consultation, contact us online , call 602.617.4107 or email info@azhealthinsurancebrokers.com .

Self Funded Group Health Insurance FAQs

HRA 105 Plans: What They Are & How They Can Benefit Your Business

Wed, 15 Jan 2025 15:15:56 GMT

HRA 105 Plans: Benefits for Businesses

Key Takeaways

Health Reimbursement Arrangements (HRAs) allow small business owners to provide tax-free healthcare reimbursement to employees, offering financial savings compared to traditional group health insurance plans.
Types of HRAs: Explore different types of HRAs available, including HRA 105 (Section 105), Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) and Individual Coverage Health Reimbursement Arrangement (ICHRA).
Flexible Coverage Options: HRAs offer flexibility in coverage, allowing reimbursement for various medical expenses, including insurance premiums, deductibles, copays, and more.
A Section 105 Health Reimbursement Arrangement (HRA 105) serves as a popular method for business owners to deduct their health insurance premiums and medical expenses.
HRAs are accessible to various business entities, including limited liability companies, partnerships, C-corporations, and S-corporations, offering flexibility in healthcare options for a diverse range of organizations.
Contact AZ Health Insurance Brokers to explore whether setting up an HRA 105 plan is the right choice for your business, and to learn about available options.

Health reimbursement arrangements (HRAs) enable small business owners who employ other people to provide tax-free healthcare reimbursement to their employees. For small business owners who want to provide healthcare coverage to employees, an HRA plan can provide financial savings compared to traditional group health insurance plans , while adding a valuable benefit to a business.

This guide explains:

What an HRA 105 plan is
Who qualifies for an HRA 105 plan
What the potential benefits of an HRA 105 plan are

Read on to discover if setting one up for your business makes sense.

What Is an HRA 105 Plan?

An HRA 105 is named after Section 105 of the Internal Revenue Code (IRS). It allows that when employers reimburse employees (and their household members, if they qualify) for healthcare costs, the employer can deduct those contributions from their taxes.

HRA plans are available to all types of businesses, including:

Limited liability companies
Partnerships
C-corporations
S-corporations

HRA plan coverage is only available to employees. These plans aren’t available to self-employed professionals who are the sole employees of their businesses.

There are different types of HRAs available. One is a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA ), which is limited to small businesses with fewer than 50 full-time employees that don’t offer group health insurance. Another is an Individual Coverage Health Reimbursement Arrangement (ICHRA) , which gives employees the power to purchase individual-market insurance of their choice, like through AZ Health Insurance Brokers , and get reimbursed for coverage up to a certain amount.

With HRAs, there are no reporting requirements on income tax returns for employees. HRAs can be offered with other employer health plans, such as flexible savings accounts (FSAs) and health savings accounts (HSAs).

What Does an HRA 105 Cover?

HRA coverage depends on the type of HRA that’s offered. The employer may determine what the plan will cover, which can include only insurance premiums, only qualified medical expenses or both insurance premiums and qualified medical expenses. Medical expenses that may be eligible for reimbursement include:

Amounts paid for health insurance premiums, including dental insurance and vision insurance
Amounts paid for long-term healthcare coverage
Direct primary care (DPC) arrangements and health care sharing ministry (HCSM) memberships
Amounts that aren’t covered under another health plan
Over-the-counter drugs and medicine
Deductibles and copays
Prescriptions, eye drops, flu shots, sleep aids, vaccinations, chiropractic care, dental surgery, physical therapy, medical operations and more
Sports medicine treatments and rehabilitation services for work-related or personal injuries (For quality sports medicine care in your area, Rep Sports Medicine offers expert advice)
Cosmetic procedures, such as Botox injections and fillers, may be eligible for reimbursement if they are deemed medically necessary, but are very rare. For expert advice and treatments on BOTOX and Fillers in the Scottsdale area, check out Injections by Megan .
Plastic and reconstructive surgery procedures that are medically necessary may also qualify for HRA reimbursement. For board-certified plastic surgery consultations in Phoenix, Phoenix Plastic Surgery provides expert surgical care with Dr. Prucz's precision-focused approach.
Holistic and naturopathic care , such as detoxification programs, nutritional therapy, or wellness-based t reatment plans that support overall health. For individuals seeking integrative care options, Natural Medicine Detox in Phoenix provides personalized naturopathic support.

If this type of plan sounds more appealing than your current employee healthcare plan coverage, you can look ahead to changing your plan for the next year.

Benefits of Having an HRA 105

HRA 105 plans can offer some significant benefits, depending on the healthcare needs of your employees and what you want to offer for your business. In addition to giving employers a recruitment and employee retention advantage, as employees cite employer-covered healthcare as the top benefit they're looking for in work , the following are some additional potential benefits of having an HRA 105 plan.

Cost savings

One of the main advantages is potential cost savings compared to offering traditional group health insurance plans . With a traditional small business group health insurance plan , you’ll pay health insurance premiums to provide your employees coverage, regardless of what type of health benefits your employees actually use. With an HRA 105, you have control of how much you’ll reimburse, which can save you money, especially when employee health costs stay low.

That also saves you on paying the difference on yearly rate increases with health insurance premiums. Since you’re in charge of your limits, you can keep your expenses predictable each year.

Tax savings

HRA 105 plans give employers a cost-effective way to provide health coverage without having to increase the amount they spend on payroll or income taxes. For example, if an employer can’t afford group health insurance , they might increase wages to give employees extra money for healthcare costs. With an HRA 105, they can simply reimburse employees for healthcare costs and save on taxes since the benefits are tax-free.

Companies that satisfy tax requirements may also be able to fully deduct HRA 105 plans from taxes as a business expense. Since some HRAs can be added to group health insurance, as well, they provide employers with extra health coverage options that can meet the needs of their unique workforce.

Healthcare Choice Control

HRAs plans give employers more choice and freedom in how they design their employee health coverage. They also provide more cost control to employers, since unused funds stay with employers, instead of being paid as premiums in a group plan.

They also provide flexibility to employees, who are able to choose the healthcare coverage they want and get reimbursed for it, instead of being restricted to the provider their employer offers.

Set Up an HRA 105 to Save

If you’re interested in setting up an HRA for your employees, contact AZ Health Insurance Brokers . We can help you understand:

Whether an HRA 105 plan makes sense for your business
What type of HRA 105 plan would be best for your employees and your business
If you should use an HRA 105 plan with another type of healthcare coverage for your business

Healthcare coverage matters to workers today. It can be the difference between attracting and retaining top talent for your business, or losing someone to your competitor.

Call us at 602.617.4107, email quotes@azhealthinsurancebrokers.com or contact us online to learn about all your options.

Business Insurance FAQs

Got a question? We’re here to help.

Third-Party Administrators in the Medical Insurance World Explained

Tue, 07 Jan 2025 15:38:36 GMT

For businesses that want to offer health plan benefits to their employees , one option that’s different from a traditional group health insurance plan is using a third-party administrator, or TPA, for short. A TPA in medical insurance can provide flexible plan designs with potentially better rates compared to other group insurers. But there are considerations to keep in mind, like a lack of name brands and potentially higher rates when the plans are run poorly.

If you’re a business owner considering health benefits for your workforce, this guide to TPA for medical insurance explains how these programs work, so you can determine if one’s feasible for your business.

Key Takeaways

Unlike a traditional group health insurance plan that may lock employers into rigid plan features, a TPA in medical insurance will customize plan characteristics based on the needs of the business. This means TPAs typically offer more plan design flexibility.
Some potential advantages of using a TPA is that a business could end up spending less on a health plan, especially with a healthy workforce, as well as get more personalized customer support and claims negotiation compared to a traditional group health insurance plan.
The disadvantage of a TPA is that your employees often won’t get access to big brand-name insurers. Rates may also be more expensive, but could also be less expensive, compared to traditional group plans.

How a TPA in Health Insurance Works

When a TPA handles health plans for an employer , those benefits are typically either self-funded or level funded. With fully insured group health insurance , an employer pays a fixed premium every month for a set number of benefits. With self-funded plans, the employer pays for employee claims. With level funded plans, the employer has a set premium, but may be able to capture profits from the healthcare plan at the end of the year if there’s a surplus.

Self-funded health benefits are paid for by the company. Most self-funded group plans will be partially self-funded, which means there are other pieces of insurance in place to protect them in case of large claimants.
Level funded health benefits are partially self-funded, where an employer pays into an insurance claims account, pays for stop-loss insurance when claims exceed a certain amount, and pays for health plan administration. While level funded plans may appear and be executed like fully insured plans, the carrier takes on the risk.

Looking at data like the company’s employee demographics, claims history and anticipated needs, a TPA will create a unique health plan that includes provider networks, pharmacy programs and other healthcare coverage. For companies that lack the resources to dedicate to health administration management in-house, a TPA can help manage health benefits, including acting as an outsourced claims processor, to ensure employee satisfaction.

Advantages of a TPA for Employer Health Plans

There are a few reasons to evaluate using a TPA for an employee health plan , even just during the consideration phase. Some advantages of these plans include:

You can get another option for a quote. You can compare plan options and prices to other plans you’re considering, which can give you a better idea of how offers stack up against each other and what makes the most sense for your business.
You could get potentially better rates. With self-funding and level funding options, depending on factors like the size and health of your workforce, you may be able to lower your costs compared to a fully insured plan with a higher set price for more coverage than you and your workforce actually need.
Plan designs are flexible. Another potential advantage for small businesses is that a TPA can offer more flexibility in the plan design. These types of health plans are typically very customizable, so employers can gain more control over the plan features and pricing.
There may be better claims management. Some TPAs will have the ability to negotiate large health insurance claims for their clients, which could ultimately keep utilization down and save business owners money.
You may receive better customer service. Because TPAs don’t tend to be as big as popular brands like UnitedHealthcare and Aetna , that may result in a higher level of customer service and care than a business might get when they’re just a number at other companies. TPAs may offer a higher level of support and customer service than what a small business may get with a traditional group plan.

Even if you think it’s unlikely you’ll use a TPA for a health plan, consulting with one could offer benefits in that you’ll be able to compare what you learn to other plans you’re considering.

Disadvantages of a TPA for Employer Health Plans

TPAs may not provide all the advantages listed above to every employer. Because employer-provided healthcare is such a serious benefit for employees, keep the following pitfalls associated with TPAs in mind.

Your employees likely won’t get name-brand healthcare. The actual health insurers likely won’t be as recognizable as big names like Cigna or Blue Cross Blue Shield (BCBS) when you use a TPA for a group health plan. However, employees may still get access to the same medical provider network as a big-name carrier, so the actual difference in what’s covered may not be significant, other than the insurer name.
There may be higher rates associated with TPA plans. For mismanaged plans, employers may encounter potentially higher rates, especially in annual increases. What may seem low now could go up significantly if the plan isn’t managed well.
A smaller risk pool could increase costs. With a larger risk pool, healthcare costs are spread out over a larger number of covered employees, which can result in more predictable risk and lower overall health insurance costs for a business. With a smaller risk pool in a plan managed by a TPA, insurance rates may be higher, because there’s less predictability due to a smaller group of individuals.
It may be more difficult to get accepted into a TPA platform. Since TPAs typically are smaller than large traditional insurers, they may also be more selective in which groups they allow onto their platform. Even if you find a TPA you’re interested in, you may face more competition in getting accepted.

TPAs can help businesses manage self-funded or level funded health plans, but they also come with a cost. When a business works with a traditional health insurer, administration processes are simple because the insurer helps take care of those duties. A TPA in health insurance adds another layer to a business, which could positively or negatively impact employee sentiment, depending on how health plan administration is carried out.

Need Help Deciding If a TPA Is Right for Your Business?

Expanding health benefits to your employees, or choosing a better health plan selection compared to what you currently offer, can have a positive impact on your business. A TPA can help with some of the administrative details of health plans, but there are also risks like higher rates and increased risk.

AZ Health Insurance Brokers can help you navigate the complexities. We can educate your business about group health insurance options in Arizona, and help you decide if working with a TPA can help save your business time and money while offering better solutions for your employees. We’re your advocate in helping your business succeed, especially with important benefits like health insurance plans.

To learn more about TPA options in Arizona and if one’s right for your business, contact us online , call 602.617.4107, or email info@azhealthinsuracebrokers.com .

Third-Party Administrator (TPA) in Health Insurance FAQs

Why You Should Partner with a Benefits Firm for Employee Group Health Insurance

Mon, 30 Dec 2024 18:25:25 GMT

Most business owners are aware of the advantages offering group health insurance to workers provide . According to an October 2024 report by “Forbes” , 67% of employees named employer-covered healthcare as the most important benefit, with more than 80% of employees older than 42 years old looking for roles that include this benefit.

More than two-thirds (68%) of employers agree healthcare ranks number one out of employer benefits. That means, for businesses that don’t offer this benefit, they may lose out on top talent to competitors that do.

Whether you’re thinking about offering group health insurance to employees at a corporation, or you’re a smaller business that wants to take care of a few employees, you may be wondering the best route to go. When you work with a business health insurance brokerage like AZ Health Insurance Brokers, you can streamline the process. Your employees can get coverage more easily with less hassle.

In this guide, we explain the benefits of working with a health insurance brokerage firm when you want to offer business health insurance to employees.

Key Takeaways

Compared to administering a group health insurance plan on your own in-house, partnering with a benefits firm can simplify the process and save you time and resources. There’s no cost to working with a brokerage firm to get group health insurance. The health insurance brokerage gets paid by the insurance company.
One major benefit of partnering with a brokerage firm for group health insurance is that you gain an advocate who will research the best plan options and rates for your unique workforce. The firm will also be readily available to assist your business when you need it, offering potentially stronger customer service compared to working with a big brand on your own.
A health insurance brokerage firm can learn about your business needs and create a custom health insurance plan offering based on those. You may be limited to more rigid healthcare plans when you don’t partner with a brokerage firm.

1. A Brokerage Firm Can Help You Save Money

A brokerage firm has all the latest group health insurance information to help you obtain the most competitive rates. You’ll want to avoid overpaying, so you can keep costs low while providing your employees with the health insurance benefits they want from their employer.

It’s in a health insurance broker ’s best interest to give you the best options, so you can create a long-term partnership. That means, you’ll get more choices and more accommodations when selecting a health insurance plan for your team.

Compared to going to a single provider to offer health insurance, working with a broker means you get to compare all your options. You can develop your knowledge about what’s available, so you can make the most cost-effective and beneficial decision for your employees.

When new plans emerge, your broker is in your corner to alert you to all the choices you have available. They can get you set up quickly and ensure you meet the deadlines you need to. You can always be confident your broker is working on your behalf to help you save and keep your employees covered.

2. A Brokerage Firm Becomes Your Partner

One of the main advantages to working with a brokerage firm to provide business insurance is that you get a main point of contact you can always turn to with questions or concerns. If you need clarification on something, you can call them up and speak to a real person quickly. There’s no waiting on hold or scrambling to get the information you need.

As your relationship with your brokerage firm develops, they’ll get to know your business and its unique needs on a deep level. This helps them anticipate your future needs and proactively offer solutions that can help.

When you’re initially setting up employee health insurance plans, your broker can help you create a custom offering that fits your business. You can easily make adjustments to your plan whenever you need to and get in touch with your firm quickly when you need assistance.

You can think of a business health insurance brokerage firm as one of your business partners. They help you provide an in-demand service to employees, which can help you improve recruiting efforts and business retention.

Your brokerage firm can also provide employee education on new insurance plans, from benefits materials, to training. They’ll help you understand the value of the plan(s) you’re offering, so employees can make the decision that’s in their best interest.

3. A Brokerage Firm Provides a Local Option

You’re not required to work with a brokerage firm in your exact geographic location, but you do have that option. That can provide extra benefits, like:

Being able to communicate with your business health insurance partner on local time
Your local brokerage firm having deeper knowledge of state and local laws and regulations
Giving your business the ability to support another local business, which bolsters your community

Each state, county and city may have different rules regarding employee health insurance. A local broker will have expert knowledge on the regulations in your business headquarters, as well as in locations throughout the country, which can be helpful if you have multiple locations and/or a workforce that frequently travels.

4. You Can Always Optimize Your Broker Partnership

Before you even select an initial broker, your business has the ability to compare brokerage firms to evaluate the best option. All group health insurance brokerages should offer a free business health insurance consultation. It can help to have several consultations with brokers you’re interested in to see what they come back with in terms of options.

The following steps can help you find an optimal group health insurance brokerage firm.

Research brokerage firms, and come up with a list of several (at least three to five) to talk with.
Have a free consultation with each brokerage firm. You should also come up with your own questionnaire that you send to each firm so you can compare their answers.
Conduct follow-up interviews based on the comparisons, then select a firm.

Even after you’ve selected a broker, you can continue to explore new options each year. If you find a better offer but want to continue your partnership with your current broker, you can present new options you’ve been offered to see if any adjustments are available with your current broker.

Work With a Broker to Make Offering Employee Health Insurance Easier

Business health insurance can be a complex undertaking. You want to ensure you offer the right coverage, while also protecting your business finances. A broker makes it easy to do so.

To reiterate, by working with a business health insurance broker, you can:

Quickly get the information and guidance you need regarding health insurance options
Ensure compliance related to federal, state and local regulations
Minimize total costs for providing health insurance to employees
Get effective employee training for their health insurance benefits
Gain a partner who can answer questions and provide clarification and updates whenever you need them

If you want to start offering health insurance to employees, or you want to compare your options, contact AZ Health Insurance Brokers for a free consultation. We work with businesses in Arizona and around the country to help them find a group health insurance plan that works for their employees and their unique business needs.

Email quotes@AZHealthInsuranceBrokers.com , call 602.617.4107 or fill out this contact form , and we’ll be in touch.

Group Health Insurance Benefits Firm FAQs

Business Insurance From Aetna: What to Expect

Thu, 31 Oct 2024 18:12:05 GMT

In 2024, AZ Big Media’s biggest and most comprehensive business opinion poll ranked the top group health insurers in Arizona based on public voting. Banner|Aetna ranked number two in the state for business health insurance providers, second only to Blue Cross Blue Shield (BCBS) of Arizona . Aetna ranked highly due to factors like its comprehensive coverage options, strong focus on wellness and preventive care, and its user-friendly technology.

For new business owners who are evaluating insurers for group health insurance options, and for existing business owners who want to make sure they still have the best provider for their workforce, Aetna may be worth considering. This guide to Aetna group insurance, available for workforces with two or more employees, explains the advantages and considerations for this business health insurance provider.

Key Takeaways

Aetna is a highly ranked business insurer in Arizona. Many small to midsize businesses, as well as large enterprises, use the provider for their workforce insurance. Aetna offers both health maintenance organization (HMO) plans and preferred provider organization (PPO) plans.
One advantage of Aetna for group health insurance is that the provider offers a wide range of integrated services, including health, dental, vision and pharmacy benefits, providing comprehensive coverage options.
Aetna also has a strong focus on wellness and preventive care programs, including discounts on gym memberships, wellness coaching and chronic disease management.

What Does Aetna Business Insurance Offer?

As one of the largest health insurers in the country and as a partner with CVS Health®, Aetna offers innovative wellness programs and benefits for members. This can result in a healthier workforce and lead to:

Less absenteeism
Improved employee engagement
More referrals for your business

Aetna has an extensive provider network of primary care physicians, specialists, hospitals and behavioral health providers. Individual Banner|Aetna members may already be aware of benefits such as highly-rated Medicare Advantage plans.

For businesses, Aetna offers both preferred provider organization (PPO) and health maintenance organization (HMO) plans. There are also self-insured funding plans designed for small businesses.

Some of the main benefits of Aetna health insurance coverage for businesses include:

Health discounts : Aetna offers members and their family members discounts on weight-loss programs, meal plans, online health coaching, gym memberships, nutrition products, massage therapy, chiropractic visits, acupuncture, hearing aids and hearing exams. Members who don’t have eye vision coverage can also get discounts on eye exams, eyeglasses and contact lenses.
Performance Network: The Aetna Performance Network throughout the central Valley is a network of doctors and hospitals that enables members to pay a lower percentage of their medical cost for using in-network providers. The Aetna Performance Network includes specialties for cardiology, gastroenterology, general surgery, orthopedics, neurology, neurosurgery, obstetrics/gynecology, cardiothoracic surgery, vascular surgery, otolaryngology, plastic surgery, urology, allergy/immunology, dermatology, endocrinology, infectious disease, nephrology, ophthalmology, rheumatology and pulmonary critical care.
Telemedicine visits : Aetna members can access virtual primary care and virtual mental health services, with 24/7 on-demand care.
Mental health support : Aetna provides numerous mental health resources online, as well as offers both virtual and in-person mental health care options.
Free or low-cost MinuteClinic® services : As a CVS partner, Aetna offers free or low-cost MinuteClinic® services for members who need immediate care for illnesses and accidents. Members can schedule an appointment online, including for nights and weekends.
Digital health tools : Aetna’s user-friendly technology includes robust online tools and mobile apps for managing health benefits, finding providers, and tracking claims. Members can take a digital health assessment, work on health goals, use health decision support, engage in social communities and more using Aetna’s digital health tools.
Care management : Members get connected with a care manager, who’s a registered nurse who advocates for individuals’ unique healthcare needs and can connect members with social worker resources, behavioral health specialists, pharmacists, registered dietitians and other relevant healthcare professionals. Members can also access a 24-Hour Nurse Line to get healthcare information any time.
Vaccine coverage : Aetna plans include coverage for flu shots, as well as for non-seasonal vaccines, including pneumonia and shingles.

In addition to offering traditional health insurance coverage, employers can choose to bundle dental insurance and vision insurance coverage into plans. Aetna dental coverage includes both dental maintenance organization and preferred provider organization options. Vision coverage includes coverage for exams and eyecare.

Considerations for Aetna Business Health Insurance

While Aetna is one of the top providers for group health insurance in Arizona, employers should be aware that the network size isn’t as robust as UnitedHealthcare or Cigna. While this likely won’t be a problem for the majority of employees, if you have a workforce that frequently travels out of state, you may want to consider group health insurer options that provide coverage for employees in those states.

If you have a smaller workforce, another consideration is to survey employees on their preferred providers. If the majority of your employees prefer a different insurer due to the healthcare providers they’re using, Aetna may not be the best choice for your business.

Need Group Health Insurance? Contact AZ Health Insurance Brokers

If you need group health insurance for your business, the AZ Health Insurance Brokers team can help. From small to large businesses, we have health insurance options that fit every type of employer in Arizona.

Depending on your unique workforce needs, the size of your team, your budget and other factors, we can present you with all the group health insurance options that work for you. Call 602.617.4107, or email quotes@azhealthinsurancebrokers.com or contact us online . We’ll be in touch to help.

Aetna Group Health Insurance FAQs

Cigna Group Health Insurance Plans: What They Offer

Tue, 29 Oct 2024 18:21:58 GMT

As one of the top 10 largest insurance companies in the world and fourth-largest in the United States , Cigna Healthcare is a popular health insurer choice for employers . In Arizona, businesses that plan to enroll at least 20 employees in group healthcare may choose Cigna as a business health insurance option.

Business owners who want to offer group health insurance as a top benefit to take care of employees, increase retention, improve brand sentiment, and reduce absenteeism may be wondering which insurer to choose. This guide to Cigna group health insurance in Arizona explains some of the top advantages of Cigna and considerations to keep in mind.

Key Takeaways

Cigna is a popular insurer in the U.S., offering group health insurance plans in Arizona. With a significant international presence, as well, it’s an excellent choice for expatriates and for those who travel frequently.
Cigna group health insurance plans focus heavily on preventive care, with various rewards to encourage regular health checkups and screenings. This can lead to a healthier workforce overall and potentially lower overall healthcare costs for employers.
Cigna’s comprehensive wellness programs are a standout feature of their group health insurance plans. These programs include incentives for healthy behaviors, chronic condition management and telehealth services.

Characteristics of Cigna Group Health Insurance for Employees

In Arizona, employers with 20 or more employees have the option to choose Cigna as their group health insurance provider. Cigna offers plans for:

Small employers (up to 50 employees and 51-99 employees): Small group health insurance plans for up to 50 employees are traditional, fully insured plans that offer $0 dedicated virtual urgent care, $0 preventive care visits and $0 for many generic prescription drugs. They also provide an estimated $250 in annual savings per year on essential customer medications. There are other small business health insurance plan options for up to 99 employees that include large provider networks, behavioral health support, virtual care and other services.
Small to midsize employers (100-499 employees): These Cigna small to midsize business health insurance plans include LocalPlus® and Cigna Open Access Plus (OAP) plans, both of which don’t require a primary care provider (PCP) or referral to see a specialist, as well as health maintenance organization (HMO) plans that coordinate care through a PCP to lower costs and improve health outcomes.
Midsize to large employers (500-2,999 employees): In addition to LocalPlus® and Cigna OAP plan availability, Cigna’s midsize to large employer health insurance plans also include a medical network plan, where care is coordinated by a PCP.
Large employers (3,000+ employees): For large employers with 3,000+ employees, Cigna offers Cigna OAP and LocalPlus® plans, as well as preferred provider organization (PPO) plans.

Cigna also offers additional products and services for business health insurance plans, including:

Vision and dental insurance
Accidental injury, critical illness and hospital care insurance
Savings and spending accounts, such as health savings accounts (HSA)
Integrated funding solutions, including medical stop loss insurance

Whether your business wants to keep healthcare costs low and opt for an HMO plan, or you want to give employees more healthcare choice and offer the most extensive healthcare options available, there’s a variety of plans to choose from with Cigna business health insurance .

Pros of Cigna Group Health Insurance

Cigna is one of the best health insurers an Arizona business can choose for their employees, but that means the insurer also tends to be a little pricier compared to other options. Health insurance coverage can positively impact business expenses related to turnover, absenteeism and productivity, so some businesses are willing to pay more for better health insurance coverage for their employees because it could lower costs overall.

Some of the advantages of Cigna group health insurance include:

Preventive care: Cigna promotes preventive care, such as going to annual checkups and attending preventive health screenings. These practices can help lower health insurance costs overall, when employees take good care of their health and identify issues because they become more costly.
Standout wellness programs: Cigna’s comprehensive wellness programs are a standout feature among group plans. Cigna offers benefits including telehealth services, chronic condition management, a health engagement team, access to personalized coaching, treatment decision support and personalized digital tools.
Customer service: Cigna generally receives positive feedback for its available and helpful customer service and support.
Global presence: Because Cigna has a significant international presence, companies with global employees or workers who travel a lot may find it’s an excellent choice.

Cigna generally offers reliable service, robust support and proactive wellness and prevention services. For a workforce you’re genuinely invested in keeping healthy, Cigna can be a good choice for a group health insurance provider .

Considerations for Cigna Group Health Insurance

While Cigna offers some of the best group health insurance available in Arizona, we generally see this provider as a more costly solution compared to other group insurers.

However, this isn’t always the case. There are several factors that will impact how much you pay for group insurance for your employees. These include the type of plan you choose (HMO vs. PPO, for example), how many employees you have, what add-ons you select and other factors.

Talk with an Arizona health insurance broker to learn about all your options among group health insurance providers, so you can make a cost-effective decision for your team that provides the coverage they need.

Want Group Health Insurance for Your Employees? Contact AZ Health Insurance Brokers

If you want to offer insurance to your workers, or you’re considering changing insurers, the team at AZ Health Insurance Brokers can help. We can provide you with information on all the health insurance providers in Arizona that fit your budget and what you’re looking for.

Cigna Group Health Insurance FAQs

How to Choose the Right ACA Healthcare Plan

Mon, 28 Oct 2024 13:42:07 GMT

Every year, the federal Affordable Care Act (ACA) opens enrollment for health insurance coverage application from November 1 through December 15. When you sign up for health insurance during this time, your coverage will start the following January 1. Then, if you sign up after December 15 through January 15, your coverage will begin the following February 1.

While we recommend to connect with a health insurance broker who can walk you through all your options and help you find the most affordable plan for your unique healthcare needs, you can also use these tips when you’re looking for health insurance coverage through the ACA.

Key Takeaways

The Affordable Care Act (ACA) offers health insurance plans for individuals and families in the United States. If you don’t get health insurance through work, or you’re looking for other options, the ACA may offer more affordable care for the services you need than what you’re currently getting with a health insurance plan.
Open enrollment for ACA health insurance begins November 1, 2024. If you sign up by December 15, 2024, your coverage will start January 1, 2025. If you sign up after December 15, 2024, and by January 15, 2025, your coverage will begin February 1, 2025.
Available ACA healthcare providers in Arizona depend on what county you live in. Use the ACA Healthcare form to find healthcare providers in your area and to compare all your options, as well as to get free personalized assistance from an insurance expert to guide you through the sign-up process.

First: What Is the Affordable Care Act?

The Affordable Care Act went into effect in 2010. It helps “make affordable health insurance available to more people”. Part of achieving that mission is to offer subsidies, also known as premium tax credits, to households with incomes up to 400% of the federal poverty level when they purchase ACA health insurance.

The ACA also expanded Medicaid program coverage to adults who have income below 138% of the federal poverty level . This helps more people obtain Medicaid coverage , which is federally funded healthcare coverage for people with unique needs.

Some people may choose ACA coverage even when they don’t fall into groups like those above. ACA healthcare plans may be a convenient option for people who don’t receive healthcare coverage through their employer, or if they’re self-employed , for example.

What ACA Healthcare Providers Are Available in Arizona?

ACA coverage and related providers depend on the county you live in. For example, here’s a sampling of insurers in Arizona’s two most-populated counties.

For Maricopa County , providers include: Ambetter, Antidote, Blue Cross Blue Shield , Banner Aetna, Cigna, Imperial, Oscar and UnitedHealthcare . *Medica exits for 2025*
For Pima County , providers include: AMBetter, Antidote, Banner Aetna, Blue Cross Blue Shield, Imperial, Oscar, and UnitedHealthcare.
For Pinal County, providers include: AMBetter, Banner Aetna, Blue Cross Blue Shield, Imperial, Oscar, and UnitedHealthcare.

All ACA healthcare plans provide coverage for essential healthcare needs, including ambulatory and emergency care, hospitalization, pediatric services, preventive and wellness services, laboratory services, rehabilitative services and more.

It’s important to know that if you’re considering getting an ACA plan, even if you stay with the same insurer you’ve previously had, say, with an employer, not all doctors are in-network with ACA healthcare plans. You can call your preferred doctor’s office to check if they’ll accept your health plan, or you can call the Marketplace Call Center at 1.-800.-318.-2596 for help.

If you need health insurance, but your preferred doctors don’t provide coverage under the ACA, you still have options. You can get a private insurance plan for yourself or your family any time of year, including outside of ACA open enrollment.

How to Select an ACA Plan

During open enrollment, you can go to this website to browse health insurance plans available to you based on your ZIP code. Health insurance coverage through the ACA is available in bronze, silver, and gold tiered categories.

Bronze: A bronze plan typically requires paying around 40% of your healthcare costs, while the insurance company will typically pay around 60% of your healthcare costs. Bronze plans offer the lowest monthly premium but will cost the most when you need care. They’re a good choice if you are relatively healthy and you don’t anticipate major healthcare costs. If you want coverage for worst-case medical scenarios but want to keep your monthly costs the lowest possible, this is an ideal plan.
Silver plan: A silver plan will typically require plan holders to pay about 30% of healthcare coverage, while the insurance company will cover around 70% of healthcare costs. Plan holders will have a higher monthly premium than a bronze plan, but the costs on healthcare deductibles will be lower. If you visit the doctor periodically, a silver plan could save you money. There may also be cost-sharing reductions available that could help you save on a silver plan, as well. Silver policies are most popular for people that qualify for a CSR (cost sharing reductions).
Gold plan: A gold plan will have a higher monthly premium than bronze and silver plans, but you’ll have lower costs when you need care. On gold plans, the health insurer typically pays 80% of costs, while the insured pays 20%. Gold plans may be a good choice if you use a lot of care, since the deductible is typically lower that bronze and silver plans.
The ACA also offers catastrophic health plans for select populations. These plans have low monthly premiums and very high deductibles. They’re available for people who are younger than 30 years old, as well as for others who qualify for an affordability or hardship exemption.

Put simply, if you anticipate having relatively fewer medical costs, a bronze or silver plan can lower your premium costs and provide you with the basic coverage you need. If you get frequent medical care, a gold plan may make more sense.

Have a Health Savings Account? You Can Still Get an ACA Plan

Now’s a good time to mention a health savings account , or HSA. An HSA works similarly to a flexible savings account. It’s used for healthcare costs. Employees whose employers offer an HSA can add money to their account and use those tax-free contributions to pay for healthcare costs.

If you know you’re going to need coverage for out-of-pocket expenses your health insurance won’t cover (like going to a naturopathic doctor or miscellaneous expenses for example), or you need extra funds to pay for healthcare costs toward your deductible, you can use HSA pre-taxed funds for those expenses.

This is a popular option if you know you’ll meet your deductible for a surgery or for maternity needs, and they generally have a lower out-of-pocket maximum. You can have both an HSA and an ACA high deductible health plan, so having both could be a good option when you’re considering coverage when you factor in monthly premiums and your out of pocket maximum.

ACA Open Enrollment Is Here: Research Plans Now

If you’re considering an ACA plan, don’t miss out on open enrollment. You can visit here to look up plans you qualify for in your area. You can also search doctor names to filter plans that are in- network with your doctor(s).

Have questions about ACA plans? The AZ Health Insurance Brokers team is here to help. Give us a call at 602.617.4107, email us at quotes@azhealthinsurance.com or contact us by filling out the form online .

ACA Healthcare FAQs

Private Family Health Insurance Explained: What It Is, Benefits & More

Fri, 04 Oct 2024 15:07:25 GMT

In the United States, not having a family health insurance plan can lead to big financial issues down the line, as well as numerous health risks. According to the American Hospital Association , family health insurance coverage is associated with better health outcomes, improved productivity and lower death rates. Family healthcare costs are exorbitantly higher for those without health insurance, as hospitals charge patients who are uninsured up to 4x more than what health insurers typically pay for the same services.

There are many ways to obtain family health insurance in the U.S., ranging from signing up for health insurance at work when an employer offers it, to shopping for it on the federal Affordable Care Act (ACA) marketplace .

There are also more types of private health insurance plans for families . These can be a good option when your work doesn’t provide health insurance coverage, and/or if you want different coverage options than what your work organization provides. In some cases, you can even get better coverage at a lower cost compared to employer-sponsored healthcare .

In this guide, learn more about what private family health insurance offers, when you’re able to get it and how to find affordable private family health insurance in AZ. If you’re ready to compare your options, contact a health insurance broker for expert guidance.

Key Takeaways

For families who don’t qualify for discounts through government-sponsored health insurance, private insurance plans offer an affordable and customizable option for healthcare coverage for families.
Individuals can purchase a private family health insurance plan through a broker, by signing up at work if their employer offers health insurance or through the ACA marketplace.
Often, the best first step to take in securing private health insurance is to talk with an insurance broker. An insurance broker can present all private family health insurance options, including ACA marketplace plans, and help people sign up for insurance immediately, even if it’s outside of an enrollment period with another
plan.

What Is Private Family Health Insurance?

Private family health insurance includes any type of health insurance that’s not government-sponsored. Public health insurance may include insurance from programs such as Medicare , Medicaid and the Children’s Health Insurance Program (CHIP) . These are programs providing health insurance to specific groups, such as senior citizens, those with disabilities and families whose income falls below a certain amount.

Private family health insurance can include employer-sponsored health plans , as well as family plans that are purchased through a private insurance broker. When you purchase family health insurance through a private broker, there may be more choice in how you can customize the plan’s offering and pricing, compared to selecting a private family insurance plan offered through an employer .

When Is Private Family Health Insurance the Right Choice?

There are only a few situations where choosing a public family health insurance plan makes more sense than going with a private family health plan. If your income qualifies you for discounts through a public health insurance program, it might be smart to choose a public plan to take advantage of these discounts.

The ACA also offers potential marketplace premiums , depending on income. For example, in 2024, in Arizona, a family of four with an annual household income below $43,056 would likely qualify for free or low-cost coverage through Medicaid. A family of four in Arizona with an annual household income of $78,000 or less may qualify for a marketplace plan with lower monthly premiums plus extra savings.

For families who don’t qualify for federal program discounts based on income, there are often available private plans that are cheaper than federal plans. For insurance holders who are relatively healthy, the savings can be even greater. The younger and healthier someone is when they need private health insurance for their family, the less expensive rates they can secure for ample health insurance coverage.

What Private Family Health Insurance Options Are Available in Arizona?

In Arizona, there are several ways to find private family health insurance. We recommend you look at different options to compare plan features and costs, so you can select the best plan for your family. An experienced private family health insurance broker can walk you through all your options, including public plan options and ACA plans, so you can also compared those to other private family health insurance options.

Some plans to consider are:

Work insurance coverage : If you start a new job at an employer that offers health insurance , consider that plan in your options comparison.
ACA marketplace plans : You can browse the ACA marketplace like you would an online store, to see plan features and prices. The ACA’s enrollment period is between November 1 through January 15 for health insurance coverage the following month(s). There are special life events, such as divorce or death, that could trigger a special enrollment period outside of these dates.
Private family health insurance broker: An Arizona private family health insurance broker is the easiest place to start, because they’ll do all the legwork for you and can explain your options in clear terms. You can save time researching and reading fine print, by telling a broker exactly what you’re looking for, and having them present you with options. This service is free with AZ Health Insurance Brokers. We offer free consultations so we can help potential clients understand all their options, in case they decide a private family health insurance plan is the best one for their family. With private health insurance, you can get signed up at any point during the year, without having to wait for coverage to kick in, like you would with an ACA plan. You’re not limited to an open enrollment period or work-restricted enrollment period, like you would be with the ACA or with an employer.

If you need family healthcare coverage immediately, the best step to take is to talk to a private health insurance broker in Arizona . You can talk to someone now to start the process for securing health insurance, whether that’s through a private family health plan, through the ACA marketplace, or by taking the step to sign up at work. Expert guidance can help you make the best decision for your family.

Benefits of Private Family Health Insurance

There are a few benefits to be aware of with private family health insurance, in terms of both cost and healthcare services. These include:

Cost savings: With a private plan, you can usually customize a plan exactly how you want, based on the services you want covered. While ACA marketplace plans have set prices you have to choose from, when you talk to a broker, they can find you different private plans that fit your budget and could potentially help you save.
Healthcare coverage: Speaking of covered services, if you have preferred doctors or healthcare providers, a private plan can help ensure you’re still able to see them and get health insurance coverage for your services. ACA marketplace plans and public health insurance plans may restrict the doctors that are in your network. On some plans, you may have to pay out-of-pocket for who you want to see. A private plan can be more customized to your preferences.
Personalized customer service: Another major benefit of working with a private health insurance broker for family insurance is that you have a dedicated account specialist who’s available to quickly help you with questions. With other plans, you’d likely have to call a generic 1-800 customer service number and be routed and placed on hold to speak to an actual representative. With a broker like those at AZ Health Insurance Brokers, we’re always here for our clients. You’ll be able to have the same representative over time, who becomes a trusted advisor for your family’s health insurance needs.

In terms of cost, coverage and customer support, many of our clients prefer a private family health insurance plan because these factors are often better compared to federal or even work-sponsored plans. For most families, health and wellness are one of the biggest priorities. Having a dedicated insurance broker to help you navigate your health insurance coverage can help protect your family.

How to Select a Private Family Health Insurance Plan

When you’re comparing private health insurance plans for a family, consider a few important factors.

Healthcare coverage: Think about the providers you want to continue seeing. If you don’t have strong preferences, you could save with a more general private family health insurance plan. If you do have strong preferences, you’ll want to find a plan that offers health insurance coverage for those providers. Also, consider any prescriptions and current/upcoming health issues that could influence the coverage you need. For example, if someone in your family regularly takes medication, or someone needs an upcoming surgery, that may factor into your choice.
Budget: To ensure your healthcare coverage doesn’t lapse, think about how much you can budget for healthcare coverage. You should also check to see if your income qualifies you for discounts through a marketplace plan. If not, consider if there are ways to save money in your overall budget to add more to your health insurance budget. A healthier family, that uses proactive preventive measures like regular checkups, can save you more money long-term in health expenses. By making regular healthcare a priority, including in your budget, you can protect your finances in the future.
Company reputation: A health insurer’s reputation could impact the quality of service you receive. Some things to consider are: average plan increases year-over-year; customer service quality and response time; and service provider stability. When you’re comparing your options, inquire about factors like these if they’re important to you.

Once you have a plan or plans you’re interested in, you can talk to the plan administrator to get signed up. This might be your human resources representative at work or a private family health insurance broker. If you’re signing up on the ACA marketplace, you can sign up online during open enrollment .

Research Private Family Health Insurance Plans

Every day a family lacks health insurance coverage, they’re at risk of debilitating financial losses due to emergency services and accidents. If someone develops a high-cost disease, such as cancer, without health insurance coverage, that can also lead to serious financial outcomes.

Don’t risk this for your family. Compare private family health insurance coverage now, so you can get coverage that fits your budget and protects your family.

At AZ Health Insurance Brokers, we’re here to help. Contact us by filling out the form online , call 602.617.4107 or email us at quotes@azhealthinsurance.com . We’ll be in touch to show you your options, so you can be confident in selecting the right health insurance plan for your family.

Private Family Health Insurance FAQs

How to Enroll in ACA Marketplace Health Insurance on Your Own

Wed, 02 Oct 2024 21:52:43 GMT

If you need a new health insurance plan or are considering alternatives for your current one, November 1 marks open enrollment for Affordable Care Act (ACA) federal marketplace health insurance enrollment. The last day for open enrollment is January 15, 2025. If you qualify for a special enrollment period, you may enroll in an ACA plan at any time of year.

If you’re considering an ACA plan, it’s simple and easy to enroll in health insurance on your own . AZ Health Insurance Brokers will even facilitate signing you up for free. You get your own personal customer service representative, you can sign up quickly and easily, and you’ll always have someone to help you whenever you need it.

In this blog, learn the simple steps for signing up for ACA health insurance coverage on your own through our simple health insurance form. Get the health insurance coverage you need quickly, so you and your family are protected with a cost-effective plan.

Key Takeaways

Open enrollment for an Affordable Care Act (ACA) federal marketplace health insurance plan is from November 1, 2024, through January 15, 2025. You may also qualify for a special enrollment period that enables you to sign up for ACA health insurance at any time of year, for specific life events, such as divorce or losing previous health insurance coverage.
You can sign up for an ACA health insurance plan in minutes. When you sign up for ACA health insurance through the AZ Health Insurance Brokers form, you get a free personalized customer service representative to help with any questions you have and to ensure fast and simple signup.
ACA health insurance plans are available to legal U.S. residents. Some offer discounts and tax subsidies, based on income.

How to Sign Up for ACA Insurance

Beginning November 1, 2024, you can sign up for ACA insurance for coverage for 2025. If you sign up by December 15, 2024, your ACA health insurance coverage will begin January 1, 2025. After that, if you sign up by January 15, 2025, your coverage will begin February 1, 2025.

If you qualify for a special enrollment period, you can enroll in ACA health insurance at any time of year. Special enrollment period qualifying events include:

Losing health insurance coverage
Moving
Getting married
Having a baby
Adopting a child
Household income falls below a certain amount

To simplify the process, you can use this link from AZ Health Insurance Brokers for free, fast and simple signup. All you need to do is complete the following steps.

Type in your ZIP code.
Type in the age(s) and gender(s) of the insured.
Input your annual income to see if you qualify for a subsidy , which is a discounted rate. If your income is above the income threshold, still input, and continue.
Select a qualifying special enrollment period, if applicable. During open enrollment, you can skip this step.
Type in any doctor(s) you want to continue seeing. Skip this step if you don’t have a preference.
Type in your prescription(s) to see if the plan covers them. This is mostly relevant for expensive prescriptions. Skip this step if it’s not relevant.
See available health insurance options for plans in your area.
Filter or compare to hone in on relevant plans.
Click “Add to cart” to enroll in the ACA health insurance plan that works best for you based on your (and your family’s, if applicable) unique healthcare needs and budget. If you’re having enrollment issues, you can call our office at 602.617.4107, and we can complete your application.

Type in your ZIP code.

Type in the age(s) and gender(s) of the insured.

3.
Input your annual income to see if you qualify for a subsidy , which is a discounted rate. If your income is above the income threshold, still input, and continue.

4 .

Type in any doctor(s) you want to continue seeing. Skip this step if you don’t have a preference.

See available health insurance options for plans in your area.

6.
Click “Add to cart” to enroll in the ACA health insurance plan that works best for you based on your (and your family’s, if applicable) unique healthcare needs and budget. If you’re having enrollment issues, you can call our office at 602.617.4107, and we can complete your application.

You can get coverage right away if you qualify for a special enrollment period, or get it beginning in 2025 if you’re applying during regular open enrollment .

ACA Healthcare Plan Options in AZ

You may see lots of options for ACA healthcare plans in AZ when you sign up for ACA health insurance . Some of the most popular carriers include:

AMBetter : Some advantages of these plans include mental health benefits and no requirements to get a referral in order to see a specialist. AMBetter is contracted with HonorHealth and Banner Health hospitals in the Phoenix/Valley area.
Blue Cross Blue Shield : Blue Cross Blue Shield, also known as BCBS, is one of the largest health insurance carriers in Arizona. If you have or plan to have children, it’s also helpful to know that BCBS is contracted with Phoenix Children’s Hospital.
UnitedHealthcare : UnitedHealthcare, also known as UHC, is a very cost-effective brand, especially in ACA bronze and silver plans. UHC is contracted with HonorHealth and Banner Health hospitals in the Phoenix/Valley area.
Banner|Aetna : Banner|Aetna is also contracted with Banner Health facilities throughout Arizona, as well as with other individual practices. Bronze and silver Banner|Aetna plans are popular options for ACA health insurance in Arizona.
Cigna : Cigna is contracted with Barrow Neurological Institute, Dignity Health, HonorHealth, and KPC Promise Hospital of Phoenix. Cigna has reliable plans, but they are not competitive with pricing compared to other plans here in Arizona.
Oscar : Oscar is contracted with Abrazo Health, Banner Health, HonorHealth and various Valley hospitals.Oscar is a recommended carrier that has an exceptional app for their members to use.
Imperial Health : Imperial Health is contracted with Abrazo Health, HonorHealth, Steward Health Care Arizona and Valleywise Health. Imperial Health debuted in Arizona in 2024, so we haven’t gathered as much feedback on it yet, as compared to other carriers.
Medica : Medica is exiting Arizona in 2025. For people who had Medica previously due to its coverage at Phoenix Children’s Hospital, BCBS is a good alternative.

When you use our form to sign up for one of these plans, it’s completely free to use. You get the added benefit of a personalized customer service agent to guide you through the process and answer any questions you have.

Choosing the Right Metal Tier Options in AZ

With different health insurance tier options to choose from, it can be tricky to decide which option is best. Based on our experience, it really depends on your unique health situation.

For a family that is healthy, for example, an expanded bronze plan is the most popular choice. For someone who will be having a surgery, a health insurance plan with a lower out of pocket maximum can be best. For someone who takes an expensive medication, a gold plan may be best for the lowest out of pocket costs. For someone who qualifies for a cost sharing reduction (CSR), a silver plan can offer a discounted deductible, out of pocket maximum and low copays.

The following are tiers to choose from and how they work.

Catastrophic: All expenses generally apply towards the deductible with a catastrophic plan. Catastrophic plans are only available for people younger than the age of 30.
Bronze : Bronze plans are very similar to catastrophic plans. The price is similar to a catastrophic plan, and you end up with more benefits.
Expanded Bronze : With many of these plans, you should have copays for many common things, such as seeing a primary care physician, seeing a specialist, getting generic prescriptions, getting blood work, going to urgent care and receiving counseling. Most of the other expenses would apply towards your deductible. These plans are one of the most popular tiers to go with.
Silver : These plans are going to cover many of the same things as an expanded bronze plan. The main difference is, you will have lower copays and a lower deductible compared to the expanded bronze plan. Because the out of pocket maximum will be similar, think about if it makes sense to pay the extra money to have a lower deductible and copays.
Gold : With the gold plan, you will have lower deductibles and copays than other plans. Your monthly premiums will be higher, so it’s important to compare your monthly costs in addition to copays and a deductible to see if it makes the most sense. Gold plans can be popular for people who take expensive medications and use their health insurance more frequently.

Don’t leave your healthcare to chance. Let AZ Health Insurance Brokers help you sign up and be a resource for you before, during and after the process.

Use AZ Health Insurance Brokers for ACA Coverage

AZ Health Insurance Brokers is here to help you sign up for the best ACA health insurance plan for you and your family. When you use our site to sign up for ACA health coverage , you get an extra layer of customer service throughout the process to make things even easier. You can rest assured you’ll sign up for the best plan based on your budget and healthcare needs. If there are any issues, you can contact your representative at our office at any time, and we can access your application to fix the problem.

Sign up for ACA health insurance online now. If you have any questions, call 602.617.4107, contact us online or email quotes@azhealthinsurance.com . We’re here to help.

ACA Marketplace Health Insurance Enrollment FAQs

UnitedHealthcare Health Insurance Plans Explained

Fri, 23 Aug 2024 15:45:09 GMT

If you’re thinking about offering health insurance to your employees through a group health insurance plan , you have lots of options of brands to choose from. UnitedHealth Group, which includes UnitedHealthcare group health insurance for businesses , is the fourth-largest health insurance provider in the United States, as of 2024.

As one of the country’s largest healthcare providers, UnitedHealthcare offers unique advantages to businesses in need of health insurance plans for their employees. In this blog, learn more about the pros and cons of UnitedHealthcare for businesses and why your company might consider using it for your employees.

Key Takeaways

UnitedHealthcare is one of the country’s largest work health insurance providers, with an extensive national network of care options that employees may find value in.
Other advantages of UnitedHealthcare plans include access to wellness programs, like smoking cessation and weight loss support, as well as a mobile app and technology that provide high visibility and ease of use for healthcare plans.
Because UnitedHealthcare’s offerings are incredibly diverse and numerous, a potential downside of using this provider is that it requires diligence to stay on top of evolving complexities and plan details.

Pro: Extensive Network

UnitedHealthcare’s extensive national provider network is a significant advantage for employers, ensuring that employees have access to a wide range of doctors, specialists and hospitals. This network flexibility can lead to higher employee satisfaction and better healthcare outcomes, since workers have more control over the providers they see and the care they seek out.

Pro: Very Competitive Products

Like throughout the rest of the country, UnitedHealthcare has a significant presence in Arizona. In 2024, AZ Big Media ranked it as number four out of the top work health insurance companies in Arizona.

Because it has such as strong presence in the state and such a large customer base, UnitedHealthcare is able to offer very competitive products in AZ. Businesses can find some of the lowest prices for group health insurance available from UnitedHealthcare.

Pro: Wellness Programs

UnitedHealthcare offers a variety of wellness programs that help motivate employees to maintain their health. Healthy employees are better for business, as the World Economic Forum reports businesses that invest in their workforce’s health and well-being have a competitive advantage and increased profitability.

Wellness programs provided by UnitedHealthcare include:

Fitness incentives, such as the Rally program that provides rewards for healthy lifestyle actions and UnitedHealthcare Motion , which rewards participants for exercising in the form of out-of-pocket medical expense coverage
Quit for Life smoking cessation program , which includes free nicotine replacement therapy for those who are eligible, 24/7 access to coaches and tools to quit tobacco or nicotine use, and a personalized Quit Plan
Real Appeal online weight loss program , which includes weekly online group sessions led by coaches, a personalized dashboard and tools and resources for weight loss

Employers can promote UnitedHealthcare wellness programs like these to demonstrate a strong investment in employee health. This can help reduce the risk of negative impacts when employees don’t feel like they’re valued. For example, in 2024, “Fast Company” reported that when employees believe their employer doesn’t care about their well-being, 60% are at least somewhat likely to look for a new job in the next 12 months.

Pro: Financial Assistance

UnitedHealthcare also has a feature called UnitedHealthcare Care Cash , which is a preloaded debit card that can be used to pay for specific eligible network healthcare expenses. This feature helps reduce the total cost of care for employees.

Pro: Technology Integration

UnitedHealthcare is known for its user-friendly technology that makes it easier for members to manage their healthcare. For example, using the UnitedHealthcare mobile app and online dashboard, members can:

Find network providers, see pricing and compare ratings and reviews
Check benefits and coverage, including copay and coinsurance amounts, plan spending and how a plan covers different types of services and care
Refill prescriptions, look up drug prices and search for pharmacies
View the status of new and past claims, including the amount billed, what a plan paid and how much is owed
Access plan ID cards and add health plans to an Apple Wallet or Google Wallet
Receive virtual care if a plan includes this benefit

The convenience of the UnitedHealthcare mobile app and technology enables members to gain increased visibility into their plan usage and access resources that can help them maintain or improve their health.

Pro: Surest

Surest is a UnitedHealthcare company that’s unlike anything in the market we’ve ever seen. It’s available to employers with 51+ employees and is offered on a fully insured , self-funded basis. Surest reports employers see an average savings of 11% when using Surest compared to traditional group plans, making this a product worth considering in addition to a traditional group product.

The Surest healthcare product points members to quality and cost-effective care from UnitedHealthcare providers and only requires copays, no deductibles. Surest users can search for medical issues they’re facing, such as “sinus infection”. Surest will then offer a variety of provider options available, such as virtual, in-person and urgent care, along with pricing.

A member can then click through to compare various options and copay costs for whatever type of provider they’re interested in, as well as see a map of providers in their area. Each provider listing includes details like reviews, copay costs, scheduling and what’s included in a visit.

Surest gives employers potentially more control over health insurance budgets for employees and gives employees increased visibility into the choice of their healthcare providers and the services they can get. Since employees can see the most cost-effective care options and compare what’s available, that can potentially curve healthcare utilization among employees in the right direction, as members are driven to the right place to seek care.

Con: Lots to Manage

While UnitedHealthcare is one of the top health insurance offerings available, there are also some potential downsides to choosing this provider. The company has a large number of product offerings, networks and nuances. There’s also a revolving door of adjusting wellness programs. It can be tricky to stay on top of all the details.

If you’re going to deploy a UnitedHealthcare option, you’ll likely want an in-house expert or professional benefits firm partner to help you stay updated on changing developments that can impact your employees and your health insurance budget. There’s a lot of complexity to manage in terms of offerings when you use UnitedHealthcare.

Need Healthcare for Your Employees? Contact Our Team

If you’re interested in providing your employees with affordable healthcare options, the team at AZ Health Insurance Brokers can help. We can work with you to understand your budget and the type of coverage you want to provide, and show you options that fit your needs.

Contact us for a free consultation, by calling 602.617.4107, emailing quotes@azhealthinsuracebrokers.com or filling out the form online . We’ll be in touch.

UnitedHealthcare FAQs

Why You Should Update Your Income on the Healthcare.gov Marketplace & How to Do It

Tue, 20 Aug 2024 14:55:42 GMT

One of the main reasons why someone would choose a Healthcare.gov federal marketplace health insurance plan is that, depending on your income and life situation, you could be eligible for government subsidies that help you save money. While you won’t have to worry much about adjusting your plan if your income and life situation stays the same throughout the term year of your plan, if things do change, it’s important to alert the Healthcare.gov Marketplace so you avoid having to pay back the difference later.

In this blog, learn more about the potential subsidies you can get with a government healthcare plan, how income affects them and how to work with your broker to make changes when needed.

Key Takeaways

If your income significantly changes and puts you over or under the federal poverty limit, you should contact your health insurance broker to alert the Marketplace.gov provider. The earlier you can address how income affects your health insurance premiums and potential subsidies, the easier it is take advantage of Premium Tax Credits and protect your payments on a timely basis.
Not reporting income changes to the federal marketplace could result in having to back-pay the difference in subsidies.
If your income goes down, your broker can help adjust your income reporting so you can potentially pay a lower premium and/or qualify for government subsidies.

First: How Does Income Affect Marketplace.gov Subsidies?

Generally, we recommend Marketplace.gov healthcare plans when individuals and families qualify for government subsidies based on income levels or other conditions that qualify them. Individuals may qualify for Premium Tax Credits on healthcare coverage purchased through the Marketplace when:

They’re a U.S. citizen or lawfully present immigrant with an income that’s at least as high as 100% of the federal poverty level. For an individual, the federal poverty level is an income of at least $14,580 in 2024. For a family of four, the federal poverty level is an income of at least $30,000 in 2024.
They’re a lawfully residing immigrant with an income below 100% of the poverty line, but they’re not eligible for Medicaid because of their immigration status.

Also, to qualify for Premium Tax Credits, individuals must not qualify for public healthcare coverage , including the Children’s Health Insurance Program, Medicaid, military coverage or Medicare .

To qualify for Premium Tax Credits, individuals must also not have access to health insurance through an employer . However, there are some exceptions, such as when an employer healthcare program doesn’t provide a minimum level of coverage, and when the employer healthcare program is unaffordable because the employee share of the premium exceeds 8.39% of the employee’s income in 2024.

Generally, if your income doesn’t meet the federal poverty line standards, you won’t typically qualify for subsidies under Marketplace plans. The size of Premium Tax Credits is based on a sliding scale , so a lower income could result in a larger tax credit to help cover the cost of insurance.

The KFF has a Health Insurance Marketplace Calculator that provides estimates for health insurance premiums and subsidies for health insurance coverage through the Marketplace.

What to Do If Your Income Significantly Changes

If your income significantly increases or decreases, it’s important to immediately reach out to your individual or family health insurance broker. Your insurance broker can help update your income on the federal Marketplace.gov health insurance marketplace and ensure you’re paying what you need to now, so you can either take advantage of subsidies or avoid having to make back payments.

If you’re getting a subsidy, and your income increases, you’ll be liable to pay back the difference in subsidies you were getting, due to the new higher income. Your broker can update your income so that you avoid having to make those back payments.

If your income goes down and qualifies you for a government subsidy, your broker can report it so that your income is adjusted. You may be able to pay a lower premium when your income goes down, so contact your broker whenever there’s a change, even when you’re not sure if your income change will qualify you for a different premium or subsidy.

Interested in Marketplace.gov Insurance, or Getting a Better Plan?

When you want to get health insurance or re-evaluate your current plan, the expert team at AZ Health Insurance Brokers can help. We can help you get a Marketplace.gov plan, adjust your current Marketplace.gov plan, qualify for subsidies based on income or switch from a Marketplace.gov plan to something new.

To talk with an insurance expert now, call 602.617.4107, email quotes@azhealthinsurancebrokers.com or contact us online .

New ParagrapMarketplace.gov Income FAQs

Tips for Medicare Enrollment in Arizona

Thu, 08 Aug 2024 15:29:24 GMT

When you turn 65 years old in the U.S. , you’ll usually become eligible for Medicare , the federal government’s health insurance program for seniors. Some individuals who are younger than age 65 may also qualify for Medicare, such as those who receive Disability benefits and those who have permanent kidney failure.

In this guide, learn more about what Medicare is and the steps to consider if you qualify.

Key Takeaways

Medicare is the federal government’s health insurance plan. Those who are ages 65 and older, as well as those who qualify due to a specific disability or who have end-stage renal disease, may sign up for Medicare.
There are several factors to consider when signing up for Medicare, including getting Part B coverage, deciding which type of Medicare plan makes the most sense for you, and getting a plan that covers your providers, hospitals and prescriptions.
A local health insurance broker can help you navigate the transition to Medicare. If you need help, contact one for a free consultation and to learn about all your options.

1. Activate Medicare Part B

Individuals are automatically enrolled in Medicare Part A coverage when they apply for retirement or disability benefits. If they have worked 40 quarters in their lifetime. Medicare Part A is hospital insurance and provides healthcare coverage for inpatient care from:

In-Patient Hospitalization
Hospice
Skilled nursing facilities

It also covers some outpatient home health care. Medicare Part A is free if you (or your spouse) were employed and paid Medicare taxes for at least 10 years.

In order to get health insurance for coverage for doctor services, outpatient care and things like medical equipment, you must sign up for Medicare Part B. Medicare Part B is medical insurance.

If you’re coming off of employer healthcare coverage past the age of 65, make sure your employer completes the CMS-L564: Request for Employment Information form before you apply for Medicare Part B. This ensures you can continue medical insurance seamlessly after you leave your job, even outside of regular annual Medicare enrollment , during a special enrollment period. And avoids the Late Enrollment Penalty.

If you plan to delay drawing on your Social Security benefits, make sure you sign up for Medicare Part B during your Initial Enrollment Period or during a credible Special Enrollment period. To avoid not having coverage when you need it.

2. Confirm Medicare Part B & D Premium Costs

The Medicare system does a two year look back to determine pricing for the Part B premium, as well as the prescription drug coverage premium (Medicare Part D). If your income is over a certain threshold, there will be an adjustment, known as the Income-Related Monthly Adjustment Amount (IRMAA), that affects your premium costs.

You can check on the Social Security Administration website to see what your premiums would be, based on your past household income.

3. Decide What Type of Medicare Plan You’re Interested In

There are several different types of Medicare plans you can choose from. They include:

Original Medicare: With an Original Medicare plan, you can go to any doctor or hospital in the U.S. that takes Medicare. You usually don’t need a referral to see a specialist. You’ll typically pay a 20% coinsurance rate of the Medicare-approved amount after you meet your deductible. Most people will pay a monthly premium for Part B. There’s no yearly limit on what you pay out-of-pocket. With Original Medicare, you can purchase a Medigap policy.
Medigap: A Medigap policy is a supplement to Original Medicare coverage and can only be purchased when someone has both Part A and Part B of Original Medicare. It only covers one person and must be purchased through a private insurance carrier. Medigap policies are designed to you for out-of-pocket medical costs, including copayments, coinsurance and deductibles. Medigap policies don’t reimburse the member, they pay for the coverages, just like an MAPD or an employer plan.
Medicare Advantage: A Medicare Advantage Plan is called Part C and enables members to receive Original Medicare coverage from private health plans, such as preferred provider organizations (PPOs) and health maintenance organizations (HMOs). Unlike Original Medicare, Medicare Advantage Plans may cover value added services such as vision, hearing, and dental insurance. You can only use providers who are in the plan’s network and service area, and in some cases, you may need a referral to see a specialist. Medicare Advantage plans have a yearly limit on what you pay out of pocket for services Original Medicare covers. With a Medicare Advantage Plan, you’ll pay the monthly Part B premium, as well as potentially the plan’s premium. Many Medicare Advantage Plans also include Part D coverage for prescription drugs. An individual must be enrolled in Medicare Part A and Part B in order to join a Medicare Advantage Plan. You cannot be on both a Medigap policy and a Medicare Advantage plan at the same time.
Drug coverage (Part D): Medicare drug plans , also called Part D, cover a wide range of prescription drugs. All Part D plans generally must cover at least two drugs per prescribed category and class. Individuals can look at the list of drugs covered in a Part D plan, also called a formulary, to find their prescriptions and choose the appropriate plan.

If you’re considering a Medigap policy in Arizona, it’s helpful to know that in this state, they’re guaranteed issue for those who are newly eligible for Medicare Part B insurance. Contact a local insurance broker for more information on the Medigap policies that are available to you in Arizona.

4. Understand the Differences Between HMO, POS & PPO Plan Types

You’ll also want to take into account the type of healthcare coverage you want in terms of HMO, PPO and point-of-service (POS) plans. Some key differences include:

HMO: Under an HMO plan, your primary care physician refers you to specialists in your network. HMOs restrict the availability of physicians covered in-network, so you’ll want to check your preferred providers are covered in an HMO before selecting one.
PPO: With a PPO plan, you have more flexibility in the physicians you see. You also don’t need a referral to see a specialist.
POS: POS plans are similar to HMOs, but you may be able to see a doctor outside of your network, in some cases. Like an HMO, you’ll need to choose an in-network primary care physician who coordinates most of your care.

Before you select a type of healthcare plan, carefully consider how important it is for you to see specific physicians. If you have preferred doctors, you’ll want to either select an HMO or POS that covers their services, or consider a PPO plan that ensures coverage for your physicians of choice.

5. Take Prescriptions Into Account

If you have specific prescriptions, you’ll want to ensure they’re covered in a Part D formulary. Most of the time, even if a specific drug isn’t covered in a formulary, a similar drug will be available in that formulary. There are also different tiers that affect payment, from the most generic prescription drugs, to brand-name prescription drugs.

Before selecting a Part D plan, talk with your doctor to see if there’s an appropriate substitute for your current prescription in the formulary you’re considering. If not, you may be able to ask for an exception.

It’s also important to be aware of prescription drug quantity limits under Part D plans . If your prescriber believes your medical condition requires going over the set quantity limit, you may also be able to contact the plan to ask for an exception.

Another consideration is step therapy under Part D plans. This is the prior authorization to try to a specific less expensive drug on the plan’s formulary before you’re able to “step” to a more expensive drug on your plan. This is another area where a prescriber may ask for an exception to skip step therapy and go directly to a more expensive drug, due to your medical condition.

Part D plans may change their drug availability every year. Your plan coinsurance may also increase if a drug manufacturer raises the price. Take these factors into account when you’re deciding on a Part D selection each year.

6. Look at Plan Ratings

If you’re considering Medicare Advantage and Part D plans, the Centers for Medicare & Medicaid Services (CMS) publishes an annual Star Ratings guide for each plan, which individuals can use as they compare their options. These ratings take into account factors like member satisfaction surveys, healthcare provider offerings and plan details.

The highest rating a plan can get is a score of 5 out of 5, with a score of 1 out of 5 being the lowest. An insurance broker can help guide you through the Star Ratings of the plans you’re considering.

7. Review Value-Added Services

In addition to services from primary care physicians and hospitals, you may also be interested in getting insurance for dental and vision services, as well as potential coverage for specialists like hearing specialists. These services aren’t covered by Original Medicare, but there are health insurance programs that can help you get dental insurance , vision insurance and other wellness coverage, such as those offered through Medicare Advantage Plans.

If you have specific dental and vision providers, consider finding a plan that offers coverage for those. Look for a plan that has a benefit amount that’s adequate for all the services you need. Talk with an insurance broker if you need assistance finding the right plan.

AZ Health Insurance Brokers Can Help You Transition to Medicare

Medicare programs can provide you with essential healthcare coverage for important medical services you need later in life. Navigating this federal program can be challenging, especially when there are diverse plans like Medicare Advantage and Medigap to consider.

The expert team at AZ Health Insurance Brokers is here to help you secure Medicare coverage now and select a cost-effective plan for your healthcare needs. Call 602.617.4017, email quotes@azhealthinsurance.com or contact us online to get a free consultation from one of our representatives.

Medicare FAQs

Need to Sign Up for Health Insurance? Get Health Insurance Sign-Up Tips

Fri, 02 Aug 2024 16:26:33 GMT

If you’re signing up for health insurance , congratulations. Having health insurance is an excellent way to preserve your health, potentially extend your life and stay healthier as you age. With health insurance, you can:

Get annual health screenings that help you identify health issues more quickly and address health problems so they don’t develop into something worse
Use annual check-ups to prevent future health issues
Gain low-cost coverage for hospital stays and emergency treatments, including when accidents happen
Get financial coverage for prescriptions

Your health insurance coverage could also extend to your dependents , like a spouse and/or children. Without health insurance coverage, you could pay thousands or even up to hundreds of thousands of dollars more to cover treatment for everything from a broken toe to cancer treatment.

The decision to get health insurance is a smart first step. But before you select a plan, read this blog for tips on how to choose a health insurance plan with the best coverage, at the best price.

Key Takeaways

Before you get health insurance, you should take an inventory of your (and your family’s) healthcare needs to understand the exact coverage you should look for in a health insurance plan.

If you have preferred doctors, hospitals and pharmacies, it’s more cost-effective to choose a health insurance plan that includes coverage for the providers you want to see.

In addition to monthly premiums, expenses like deductibles, copays and out-of-pocket maximums can affect the true overall price of a health insurance plan. You should compare all these factors when evaluating health insurance coverage.

1. Understand Your Healthcare Needs

Evaluate your and your family’s typical healthcare usage. This includes how often you visit doctors, if you have ongoing treatments and any medications you regularly take. Knowing these details helps in choosing a plan that best matches your healthcare needs .

2. Learn About Different Types of Plans & Components

Familiarize yourself with different types of health insurance plans . These include:

HMOs: HMO stands for health maintenance organization. With an HMO, you’ll be limited in which healthcare providers you can see who are “in-network”, meaning your health insurance will cover costs for their services. HMOs typically have lower monthly premium costs but more limited provider networks.
PPOs: PPO stands for preferred provider organization. With a PPO, you’ll pay less if you go to a provider who’s covered by the PPO, but you can still see out-of-network providers at a higher cost. You also can choose whichever specialists you want to see, without having to get a referral from a primary care physician. PPOs typically have larger networks of covered doctors but may cost more in monthly premiums compared to HMOs.
EPOs: EPO stands for exclusive provider organization. With an EPO, you’ll be limited to using the doctors, specialists and hospitals within the plan’s network if you want to get your healthcare paid for.
POS plans: POS stands for point of service. Like PPOs, POS plans offer coverage for in-network doctors. But while PPO plans don’t require you to choose a primary care physician, a POS plan typically does require you choose a primary care physician in order to get referrals to specialists.

As you evaluate health insurance plans, you’ll likely see an acronym like one of the above attached to the plan. Ask your health insurance broker if you have any questions regarding these types of health insurance plans .

3. Evaluate Network Coverage

Check if your preferred doctors, hospitals and pharmacies are in an insurance plan’s network. Using providers within the network usually costs much less compared to going out-of-network.

If you have preferred doctors, hospitals or other medical providers, you may want to choose a plan whose network covers those providers so you can save more on out-of-pocket costs.

4. Compare Plan Prices Thoroughly

In addition to monthly premium prices, consider other plan costs, including:

Deductibles: A deductible is the amount of money you may have to pay out-of-pocket before more extensive health insurance coverage kicks in.
Coinsurance: Coinsurance is the percentage of a covered healthcare service’s cost you’ll have to pay after the plan’s deductible is met.
Copays: A copay is the cash amount you’ll have to pay out-of-pocket for things like doctors’ visits.
Out-of-pocket maximums: This is the maximum amount you’ll need to pay out-of-pocket before a health insurance plan covers the rest.

These expense categories will affect your overall health insurance cost, depending on how much medical care you use.

5. Evaluate Plan Tiers, If Relevant

Related to pricing, many health insurance plans, including those on the Affordable Care Act (ACA) marketplace , will be broken down into tiers that have varied coverage and prices. Examples include:

Catastrophic: Catastrophic plans may have a high deductible and low premiums. The plan holder will have to pay for expenses out-of-pocket until the deductible is met, and health insurance financial coverage kicks in.
Bronze: Bronze plans may have a relatively high deductible and require plan holders to make copays for primary care physicians and specialists, and to get treatments such as bloodwork and urgent care.
Silver: Silver plans typically have a lower deductible and lower copay cost compared to bronze plans, but monthly premiums may be higher.
Gold: With gold plans, you’ll typically pay the highest monthly premium out of any tier, but costs for deductibles, copays and out-of-pocket maximums will also be the lowest.

Knowing your healthcare needs and how frequently you get services can help you understand your risk and which type of plan may be most cost-effective for you. If you’re really healthy and rarely need to see a doctor outside of an annual checkup, a catastrophic or bronze plan may make more sense for you. If your family has more complex medical needs, you could save overall by selecting a silver or gold tier plan.

6. Review the Benefits

You never know what kind of medical needs may pop up in the future. It’s helpful to make sure the plan covers a broad range of services, including:

Preventative care
Emergency services
Maternity care
Mental health services
Prescription drugs

When you’re anticipating your and your family’s medical needs, think about your future goals, such as having more kids. These can impact your healthcare needs, too.

7. Check for Subsidies

Depending on your family size and your income level, you may qualify for subsidies or government assistance that could help you reduce your overall costs. Public healthcare coverage includes programs like Medicaid and CHIP, for individuals and families with low income levels, disabilities and other types of life situations.

8. Talk With a Health Insurance Broker

Our final tip is to talk with a qualified expert, a health insurance broker who can go over your healthcare needs and budget and present you with a variety of options that meet your requirements. Arizona Health Insurance Brokers offers completely free consultations to help you understand what’s available, so you can select the best plan for you and your family.

Contact us online for a free consultation, email us at quotes@azhealthinsurancebrokers.com or call 602.617.4107 to speak with an Arizona health insurance expert now.

Health Insurance Tips FAQs

Keyman Insurance Essentials: Protecting Your Business's Vital Assets

Tue, 18 Jun 2024 16:48:29 GMT

Keyman insurance is critical for any business that relies on the unique skills and contributions of individual employees to thrive. What is this insurance, and why does your company need it? This article breaks down how keyman insurance protects your business’s operations, finances, and future by offering a safety net when indispensable team members can no longer perform their roles. We’ll guide you through understanding its importance, policy options, and the steps for implementing adequate coverage without overwhelming you with complexity.

Key Takeaways

Keyman insurance is a life insurance policy on key personnel purchased by a company to mitigate financial losses in the event of that individual’s untimely death, with benefits covering recruiting and training replacements, and paying off debts.
It is important to correctly identify key employees whose loss would significantly harm the company, taking into account factors like their skills, contributions to profits, and replacement costs to determine the necessary insurance coverage.
Companies must carefully choose between term and permanent keyman insurance policies based on their specific needs and consider the tax implications, ensuring that the insurance integrates well with existing buy-sell agreements.

Understanding Keyman Insurance

Key man insurance, also called key employee insurance, is a life insurance policy a company purchases on a key individual’s life whose contributions are crucial to the business’s operations. The sudden loss of this key person, also known as a key employee, could significantly affect company operations. Thankfully, key person life insurance offers financial stability and time to implement strategies without immediate financial harm. Considering the key person insurance cost as an investment in the company’s future can help businesses make informed decisions about this type of insurance policy, including the key person insurance cover.

The death benefit from keyman insurance provides a financial cushion to the business, covering costs like:

recruiting
training replacements
paying off debts
closing the business

Additionally, keyman insurance policies can offer living benefits, such as disability coverage, allowing borrowing against the policy if the key individual cannot work due to incapacitation.

Keyman Insurance vs. Personal Life Insurance

While both keyman and personal life insurance provide a financial buffer in the event of an insured individual’s death, they differ significantly in their objectives and beneficiaries. The beneficiary of keyman insurance is the business itself, ensuring financial stability in the event of a key personnel’s untimely demise. These funds help manage business disruption and cover the costs of replacing or training a successor.

On the other hand, personal life insurance is designed to provide financial support to the insured’s beneficiaries after their passing, typically family members or other designated individuals. The benefits from personal life insurance can be used for living expenses, paying off debts, or even education.

Identifying Your Business's Key Personnel

Recognizing the key personnel in your company is pivotal to securing your operations. A key individual can be a partner, executive, or someone with specialized skills whose loss would significantly harm the company. They may possess technical expertise, unique skills or training, leadership ability, high-stakes decision-making responsibilities, and exclusive connections to customers and suppliers.

A practical method to identify key employees is to consider which individuals you would insist on taking with you if you were to leave your business and start a new one.

The need for keyman insurance arises from the company’s reliance on certain individuals whose absence could cause significant financial harm.

Factors to Consider

The monetary value of key personnel is determined by evaluating their contributions to profits, the potential loss of income, and impacts on business objectives in their absence. Factors to consider when calculating the monetary value of a key person include:

Replacement costs
Distinctive skills
Total compensation costs
Possible losses in sales during the transition period

By considering these factors, you can determine the true value of a key person to your business.

When identifying key personnel for insurance purposes, it’s also crucial to consider:

an employee’s involvement in business development
their involvement in client relationship management
their unique, difficult-to-replace skills or reputation.

Policy Options for Keyman Insurance

Choosing the right keyman insurance policy is crucial to safeguard the interests of your business. Keyman insurance policies are predominantly categorized into two main types: term and permanent life insurance. Both these types can include additional coverage options, such as a disability income rider, which generally pays between 40% to 70% of the insured key person’s income if they become disabled.

Term Life Insurance for Keyman Coverage

Term life insurance is typically more affordable than permanent life insurance and offers flexibility in terms, which can be set for a specific number of years or based on a significant date, like the key person’s planned retirement. However, it’s worth noting that once the term life keyman insurance policy expires, there is no death benefit payment.

This type of coverage is ideal for companies seeking cost-effective ways to protect themselves against the potential loss of a key employee. However, the suitable type of keyman insurance will depend on various factors, including the key person’s age, health, and the company’s financial situation.

Permanent Life Insurance for Keyman Coverage

Unlike term life insurance, permanent life insurance policies for keyman coverage offer lifetime protection, ensuring the policy stays in effect for the entire life of the insured if premiums are paid. It accumulates a cash value over time, which can be accessed by the business under certain conditions.

The cash value in a permanent life insurance policy grows on a tax-deferred basis, which can be an advantageous aspect of keyman coverage from a financial planning standpoint. Moreover, a business can generally borrow against the cash value of the permanent life insurance policy without creating a taxable event, providing financial flexibility.

Calculating the Right Amount of Keyman Insurance

Determining the right amount of keyman insurance is crucial to ensure adequate coverage. Coverage is typically recommended to be between eight to 10 times the key employee’s salary or the value they contribute to the company.

When calculating the monetary value of a key person, it’s helpful to consider various valuation methods. These include the Multiples of Income Method, which calculates five to seven times the key employee’s salary and benefits, and the Replacement Cost Method, which focuses on the costs to recruit, hire, and train a replacement.

Another valuation strategy, the Contributions to Earnings Method, assesses the key employee’s contribution to company profits, considering the impact of recruitment and training expenses for a replacement.

Tax Implications of Keyman Insurance

While keyman insurance provides a financial safety net for businesses, it also has certain tax implications. Life insurance premiums, including those for keyman insurance, are usually not eligible for tax deductions. They also cannot be considered as a business expense..

However, on the brighter side, the company will receive the life insurance death benefit from keyman insurance tax-free in most cases, similar to other life insurance death benefits. For tax purposes, companies must be able to document the number of employees with keyman insurance, whether each employee has given consent, and the amount of coverage in place.

Integrating Keyman Insurance with Buy-Sell Agreements

Keyman insurance, also known as business life insurance, can significantly contribute to business continuity when integrated with buy-sell agreements. These agreements play a crucial role in orderly business transitions and can be funded through keyman insurance policies.

The proceeds from a keyman insurance policy can be used to:

Buy out a key person’s share or their heirs’ ownership in the event of their death or disability
Maintain operations and client relationships
Settle financial obligations of the key person’s estate without compromising business stability.

For effective integration, businesses should engage in regular policy and agreement reviews and consult with legal and financial advisors.

Choosing the Right Insurance Provider

Selecting the right insurance provider is as crucial as choosing the right type of keyman insurance. Assess the financial strength and stability of potential life insurance companies by reviewing their ratings from industry-recognized agencies, including AM Best, Standard & Poor’s, and Moody’s.

Investigate an insurer’s reputation for customer service by examining customer satisfaction ratings and complaint indices from the Better Business Bureau, J.D. Power, and the National Association of Insurance Commissioners. Also, analyze and compare different insurance providers’ premiums and payment options.

Lastly, evaluate extra coverage options available from insurance providers, such as disability riders, which can add value to the key person insurance policy and enhance the coverage.

Implementing and Maintaining Keyman Insurance

Implementing keyman insurance involves the company buying a life insurance policy on crucial employees. The premiums are paid by the company, which is also the named beneficiary. The business needs to complete an application, identifying itself as the:

Applicant
Premium payer
Policy owner
Beneficiary

Maintaining keyman insurance necessitates a regular review of the policy to ensure it matches the key person’s current value and the business’s operational needs. If a business no longer requires its keyman insurance, it may either surrender the permanent life policy back to the insurer for cash value or opt to sell the policy.

Summary

Keyman insurance is a crucial financial tool that safeguards businesses from the sudden loss of key personnel. It provides a financial buffer to manage disruption and cover the costs of replacing or training a successor. Choosing the right type of policy, whether term or permanent life insurance, and the right amount of coverage is essential for effective protection. Regular review and adjustments, integration with buy-sell agreements, and choosing the right insurance provider further enhance the benefits of keyman insurance. Remember, a key person’s loss is unpredictable, but your business’s financial stability need not be.

Keyman Insurance Frequently Asked Questions

What Is a Level Funded Health Plan for Business?

Mon, 10 Jun 2024 16:58:54 GMT

As an employer, you’re likely aware of the importance of offering health insurance to employees. According to a survey by the U.S. Chamber of Commerce , 96% of Americans say it’s important that employers offer health insurance . Two-thirds of respondents wouldn’t accept a job offer that doesn’t include health insurance benefits.

You have lots of options for what type of health insurance plan to provide to your staff. Level funded health plans combine elements from fully insured healthcare plans and self-insurance to provide business owners with potentially lower costs, compared to both of those types of plans.

The use of level funded health plans by employers is on the rise, as KFF reports 34% of small firms use a level funded plan, compared to 7% in 2019. In this guide, explore more about level funded health plans to determine if they’d be a fit for your business.

Key Takeaways

Level funded health plans are a type of partially self-funded insurance, where employers pay a fixed cost each month to offer healthcare coverage to employees.
With level funded health plans, employers pay into an insurance claims account, pay for stop-loss insurance for claims that exceed the amount paid for, and pay for health plan administration by the healthcare provider.
Level funded health plans can potentially offer cost savings for small to mid-size businesses whose employees are relatively healthy. They provide an alternative to other types of business health insurance , such as fully insured health plans.

Level Funded Health Plans Explained

Like self-funded healthcare plans, the employer defines liability risk and limits what it pays before stop-loss insurance covers the rest.

Level funded health plans offer some potential cost savings compared to fully insured health plans and self-insured health plans. With fully insured health plans, a business pays a fixed premium, regardless of whether or not employees actually use the benefits.

With self-insured health plans, it’s the employer’s responsibility to pay for all claims unless stop-loss insurance is added for high-cost and catastrophic claims. This means, self-funded health plans carry higher risk with unlimited liability.

Level-funded plans enable employers to pay a set premium and then pay stop-loss insurance for when claims exceed the set amount. Additionally, with level funded plans, employers may be eligible for a refund when the amount they’ve paid hasn’t been used in employee healthcare benefits.

With level funded plans, employers pay a monthly fee that includes maximum claims liability, stop-loss insurance and administrative fees. This provides employers with predictability in terms of costs, as well as potential savings in the form of a refund.

Pros of Level Funded Health Plans

There’s a reason why the adoption of level funded health plans is on the rise. They provide many advantages compared to other types of health plans, especially for small businesses. These include:

Potential savings: Whereas healthcare savings may stay with a health insurer in a fully insured health plan, with level funding, a surplus refund may be applied to the following year’s plan. This means, the healthier your employees are and the less frequently they use healthcare coverage, the more savings your business can potentially achieve.
Focus on workplace health: Level funded health plans often come with employer resources on subjects like employee health and wellness. This could encourage employees to proactively manage their health, which could result in extra savings for your business.
Monthly reports: Level funded health plans may include monthly reporting with insights into how employees are using health services. Using these reports, employers can alert employees about benefits like low-cost generic medications and other potential cost savings, like seeing a primary care doctor virtually. In turn, these savings save the employer money, as well. These reports may not be available in plans like fully insured health plans.

Some level funded health insurers also offer wellness programs and 24/7 virtual care features, as well. These benefits can help you facilitate a healthier workforce and, as a result, lower your health plan costs.

Cons of Level Funded Health Plans

Level funded health plans may not be the best option for your business. It’s important to weigh the pros and cons as you choose business health insurance for your employees. Some level funded health plan disadvantages include:

Expenses to consider: With level funded health plans, stop-loss insurance and administration fees are extra costs to consider. With a fully insured plan, you won’t have to pay for stop-loss insurance, just the full monthly premium you agree to pay.
Potentially higher renewal rates: If the claims your workforce makes exceeds stop-loss coverage, that could result in higher renewal rates.

Plan rigidity: Some health insurers will offer a set amount of plan design options to choose from in level funded health plans. Compared to other types of employee health coverage, you may have less flexibility than you want with a level funded plan, even though these plans typically do offer a variety of options to choose from.

In some cases, you could pay more for a level funded health plan compared to options like self-funded insurance. It’s helpful to talk with a health insurance broker to compare all that’s available, so you make the most cost-effective choice for your business.

Interested in a Level Funded Health Plan?

Level funded health plans have become a popular choice for many small to medium sized businesses today. They could help your business contain costs while you offer a valuable health insurance benefit to your employees.

When you’re considering group health insurance for your business, options like health savings accounts (HSAs) and health reimbursement arrangements (HRAs) , including qualified small employer health reimbursement arrangements (QSEHRAs) and individual coverage health reimbursement arrangements (ICHRAs) , may also be attractive options.

If you want to offer health insurance coverage for your employees , AZ Health Insurance Brokers can help. We’ll learn about your unique business and provide you with options that make sense for both your budget and your employees.

Contact us online for a free consultation on workplace healthcare, call 602.617.4107, or email quotes@azhealthinsurancebrokers.com . We look forward to helping your business.

Level Funded Health Plan FAQs

Exploring the Benefits of a Life Insurance Retirement Plan (LIRP)

Thu, 06 Jun 2024 03:51:15 GMT

Navigating your retirement planning? A life insurance retirement plan (LIRP) could offer a viable option. This unique financial vehicle combines life coverage with the opportunity to build cash value that you could use in retirement. This article strips back the complexities to help you understand LIRPs, contrasting them with standard retirement saving strategies and guiding you through their various characteristics and benefits.

Key Takeaways

Life Insurance Retirement Plans (LIRPs) offer dual benefits of life insurance protection and a potential supplement to retirement income, featuring no contribution limits and the ability to borrow against the policy’s cash value.
LIRPs provide tax advantages, such as tax-deferred growth and the option for tax-free withdrawals, offering a more flexible approach to retirement funding compared to traditional retirement accounts, which have mandatory distribution rules and contribution caps.
While LIRPs may be beneficial, especially for high-income earners seeking tax diversification and long-term growth, they come with varied costs including premium payments, administrative fees, and potential interest on policy loans, necessitating careful financial planning advice.

Understanding Life Insurance Retirement Plans (LIRPs)

Harnessing the power of a permanent life insurance policy, LIRPs stand at the crossroads of necessity and foresight, providing life insurance coverage while doubling as a vehicle to fund retirement. At the heart of a LIRP lies the allure of no contribution limits, a feature that sets it apart from traditional retirement savings vehicles like individual retirement accounts (IRAs). Offering more than just a safety net, LIRPs serve as a financial Swiss Army knife, blending the protective shield of life insurance with the promise of cash value growth.

The premise of a LIRP is straightforward yet compelling: you’re not merely investing in life insurance coverage but cultivating a reservoir of funds to supplement retirement income. It’s a strategic move, allowing the policy’s cash value to be borrowed against, creating a stream of income during those sunset years without the usual constraints of retirement accounts. Think of it as a financial multitool, ready to support you with life insurance retirement benefits while also nurturing your dreams of a comfortable retirement.

Key Components of LIRPs

Nestled within the structure of a LIRP is a cash value account, steadily accumulating funds over the policy’s lifespan. This cash value component can be strategically deployed to offset future premiums or to enhance the policy’s death benefits, offering a level of financial agility that’s particularly attractive.

As the years march on, the landscape of premium allocation within a whole life insurance policy shifts – while the initial years see a larger chunk of your premium nurturing the cash value, this portion gradually gives way, redirecting focus towards insurance costs as you age.

Types of Permanent Life Insurance Policies for LIRPs

Diving into the types of permanent life insurance policies suitable for LIRPs, we encounter a spectrum of choices, each with its unique advantages. Whole life insurance policies are the bedrock of certainty, offering a guaranteed fixed rate of cash value accumulation, a comforting thought for those who value predictability.

For those with an eye on interest rates, universal life insurance policies link cash value growth to the current economic heartbeat, providing a more dynamic approach. Then there’s the indexed universal life insurance, which waltzes with the market, tying cash value accumulation to the performance of a specific index, potentially offering higher growth during prosperous times.

How LIRPs Complement Traditional Retirement Savings

Think of LIRPs as the perfect dance partner to your traditional retirement savings plans; they work in tandem, bringing diversity and depth to your retirement strategy. LIRPs can sidestep onto the retirement savings stage alongside stalwarts like 401(k)s and IRAs, offering a compounded approach to securing your financial future.

While 401(k)s captivate with employer matching and pre-tax contributions, LIRPs pirouette with the potential for cash value growth and life insurance protection – a choreography that enriches your retirement planning with multifaceted benefits.

Tax Benefits of LIRPs

Taxation, including estate taxes, often takes center stage when planning for retirement, and LIRPs command attention with their tax-deferred growth. Like a fine wine maturing untouched, the cash value of your LIRP grows without the immediate burden of taxes, allowing your investment to compound and flourish.

And when the time comes to tap into your LIRP, you can do so with the grace of tax-free withdrawals, provided you navigate within the guidelines and avoid excessive borrowing that could trigger negative tax implications on your taxable income.

Flexibility in Retirement Income

In the realm of retirement income, LIRPs offer a flexibility that’s as refreshing as a breeze in summer. Unlike traditional retirement plans which dictate terms like mandatory minimum distributions and age-related restrictions, LIRPs empower you with the freedom to access your retirement funds on your own terms.

Overfunding your LIRP is akin to an artist adding bold strokes to a canvas, accelerating the growth of your cash value and painting a future where tax-free income streams flow liberally in retirement, making it easier to pay estate taxes.

Assessing the Costs of a Life Insurance Retirement Plan

The journey to a Life Insurance Retirement Plan is lined with considerations of cost, which can vary based on:

age
health
coverage amount
the type of policy you select from a life insurance company

Just like a tailored suit, the final price of your LIRP is a composite of many factors, including the insurance company’s administrative fees and potential additional riders you might choose for enhanced peace of mind, such as long-term care coverage.

Premium Payments and Cash Value Growth

Within the walls of your LIRP, premium payments are diligently assigned to their respective roles:

Some provide for the death benefit
Others for the insurer’s costs and profits
A significant portion to the cash value, which is your ticket to accessing funds during the policy’s term.

As the policy matures and you grow wiser with age, the cash value portion begins to shrink, making way for the rising cost of insurance in your insurance company.

Policy Loan Interest Rates

When you draw on the cash value of your LIRP through policy loans, interest enters the equation. Although typically offered at competitive rates, interest on these loans can vary, from guaranteed rates that offer stability to variable rates that can fluctuate with market conditions. It’s crucial to understand these rates, as they can significantly affect the overall cost and efficiency of your LIRP.

Determining if an LIRP is Right for You

Deciding whether a Life Insurance Retirement Plan aligns with your financial tapestry involves a careful weighing of its advantages against potential drawbacks. It’s a decision not to be taken lightly, contemplating factors such as your income level, tax situation, and the desire for a supplemental retirement income that a traditional plan might not offer.

Identifying Ideal Candidates for LIRPs

LIRPs are particularly appealing to certain voyagers on the retirement planning sea. Affluent individuals seeking to maximize their retirement savings without the restrictions of traditional plans will find LIRPs to be a harbor of opportunity.

Those with a keen understanding of tax diversification and a commitment to long-term investment horizons will appreciate the tax advantages that LIRPs can unfurl.

Working with Financial Professionals

Navigating the LIRP waters can be complex, and the guidance of seasoned financial professionals is invaluable. A financial planner or insurance agent can help chart a course that aligns a LIRP with your financial goals and retirement vision. They are your compass, helping you steer clear of potential tax reefs and ensuring your LIRP augments your retirement strategy effectively.

Alternatives to Life Insurance Retirement Plans

While LIRPs hold a unique position in the retirement savings constellation, there are other stars in the financial heavens that can supplement retirement funds. From structured 401(k)s and IRAs to the Federal Thrift Savings Plan and nonqualified deferred compensation plans, each offers a different blend of benefits and limitations.

Comparing LIRPs with Other Retirement Savings Vehicles

A comparison between LIRPs and other retirement vehicles is like evaluating different breeds of thoroughbreds—each has its strengths and purposes. LIRPs stand out with their life insurance protection and potential for tax-free withdrawals, but they also come with higher fees and complex structures.

In contrast, traditional retirement plans like 401(k)s and IRAs often boast lower costs and fixed returns, though they lack the flexibility that LIRPs offer regarding distributions.

Summary

In the tapestry of retirement planning, LIRPs emerge as a potent tool, offering a blend of life insurance protection and the potential for tax-advantaged growth. We’ve explored their synergistic relationship with traditional retirement savings, their costs, and the factors that make them an attractive option for some. Whether a LIRP becomes part of your financial strategy depends on a myriad of personal factors and should be considered with the guidance of a professional. May your retirement journey be as secure and prosperous as the plans you lay today.

Frequently Asked Questions

Unlocking Funds: A Guide on How to Borrow Against Life Insurance Wisely

Fri, 31 May 2024 14:25:29 GMT

Considering a loan against your life insurance? Understanding how to borrow against life insurance is crucial for making informed financial decisions. Our guide will clarify the eligibility requirements, navigate the steps, and highlight important considerations, providing you with the needed insight to utilize your policy’s cash value effectively.

Key Takeaways

Only permanent life insurance policies with cash value (e.g., whole life, universal life) can be borrowed against, and a mature cash value is necessary before borrowing.
Life insurance policy loans offer flexibility and favorable interest rates compared to other loans, with up to 90% of the policy’s cash value available for borrowing, but risks include reduced benefits or policy termination if the loan isn’t managed well.
Understanding tax implications is critical; while life insurance loans are tax-free if the policy is active, tax liabilities can occur if the policy lapses with an outstanding loan, and beneficiaries could receive reduced benefits as a result.

Eligibility and Types of Policies for Borrowing

To tap into your life insurance policy’s financial potential, it’s crucial to know which policies are eligible for a life insurance loan. Not all policies are created equal in this regard. Only permanent life insurance policies with a cash value component, such as whole life and universal life, are eligible for loans. But patience is key — your policy’s cash value must mature over several years before it becomes substantial enough to borrow against. It’s like nurturing a financial seedling that can eventually grow into a robust tree from which you can harvest the fruits.

Holding a whole life insurance policy, universal life, or indexed universal life policy puts you in a potential position to borrow against it. Keep in mind that the availability of a life insurance policy loan depends on the cash value your policy has accumulated. Essentially, you’re borrowing from yourself, with your policy’s cash value acting as the pledge for the loan. It’s a unique lending scenario that sidesteps many of the hurdles presented by traditional bank loans.

Understanding Life Insurance Loans

A life insurance loan can be seen as unlocking a treasure chest within your policy. When you borrow against life insurance, you’re essentially using the policy’s cash value as collateral. This means that although you have immediate access to funds, the cash value you’ve built up stops contributing to the growth of your policy’s value, leading to potentially lower earnings.

Moreover, if your premium payments fall short, the insurance company might dip into your cash value to cover costs, which could elevate risks for your policy, such as reduced benefits or even termination.

Loan Limits

When you decide to borrow against your life insurance, you might wonder about the amount you can actually take out. It’s not an all-access pass to your entire policy’s value. Typically, policyholders can borrow up to 90% of their policy’s cash value — this is your upper loan limit. Think of it as having a credit line that grows with your policy’s cash; a financial buffer that’s there when you need it, without the need for a credit check or a lengthy approval process.

This capacity to access cash quickly is one of the distinct advantages over other loans, providing a safety net when you need immediate funds.

Interest Rates and Repayment Terms

Competitive interest rates are a notable advantage of life insurance loans. Generally, these loans offer more favorable rates than personal or home equity loans, making them a cost-effective borrowing option. You can choose between fixed interest rates, which are stable over time, or variable rates, which might fluctuate with market trends. As you navigate the sea of borrowing options, these rates can be the favorable winds guiding you towards financial calm.

Unlike other loans that demand a rigid repayment structure, life insurance policy loans float on more flexible currents. There’s no set deadline for loan repayment, allowing you to manage the loan on your terms. Monthly payments can be structured to fit your financial situation, which is a boon for those who value a tailored approach to debt management. However, keep in mind that if the loan remains unpaid, your insurance company may reduce your policy’s death benefit to recover the loan amount plus interest, which could also stir up tax implications.

Initiating a Policy Loan

Starting a policy loan journey involves a straightforward process. Unlike traditional lending scenarios, a life insurance policy loan does not require a credit check or an approval process, making it accessible even if your credit history has seen better days. To initiate a loan, you’ll need to:

Ensure your policy has accumulated sufficient cash value
Reach out to your life insurance company
They will provide you with an in-force policy illustration and guide you through the terms of the loan, paving the way for you to harness your policy’s financial potential.

The process is refreshingly simple: verify your policy’s cash value, contact your insurer, and request a life insurance policy loan. It’s like having a financial lifeline that you can activate with a phone call or a few clicks, bypassing the typical red tape associated with borrowing money. This convenience is a testament to the unique benefits of insurance policy loans, where the policyholders’ needs are met with efficiency and understanding.

Risks and Considerations

However, this venture has its own share of risks and considerations. It’s not just about tapping into a financial resource; it’s also about preserving the integrity of your life insurance policy. Unpaid loans can create a maelstrom that potentially leads to policy termination if the cash value is depleted to zero. Additionally, the looming specter of a reduced death benefit should not be ignored. If you neglect to repay the loan, the outstanding balance and interest could be subtracted from what your beneficiaries receive, diminishing the financial protection you intended for them.

It’s also possible to awaken a tax storm if the policy lapses or is terminated due to an unpaid loan. Therefore, it’s critical to weigh these potential drawbacks before deciding to draw from your policy’s value.

Tax Implications

Exploring life insurance policy loans without considering tax implications can be likened to navigating without a compass. While these loans are tax-free as long as the policy remains active and isn’t a modified endowment contract, things can change if the policy lapses or is terminated. In such cases, you may find yourself owing taxes on the loan amount if it exceeds the total premiums you’ve paid into the policy. It’s like a hidden reef that can jeopardize the financial journey you thought was smooth sailing.

To avoid unexpected tax squalls, it’s crucial to consult a financial advisor. They can help you understand any potential tax liabilities and provide the necessary tax advice to keep your fiscal ship on course. Remember, if your policy’s cash value falls to dangerous levels, you’ll need to infuse premiums to prevent termination and the accompanying tax bill for the loan amount. Tax penalties are the last thing you want when you’re already navigating the complexities of managing a life insurance loan.

Impact on Beneficiaries

Ensure your financial strategy doesn’t adversely affect your beneficiaries, like a storm capsizing a boat. An unpaid life insurance loan can have a significant impact on the death benefit — the very reason you secured the policy in the first place. The loan balance and accumulated interest could be deducted from the full death benefit, leaving your beneficiaries with less than you intended. Over time, unpaid interest can compound, further eroding the death benefit and undermining the financial legacy you hoped to leave behind.

It’s a sobering reminder to ponder your family’s financial needs deeply before you dip into your policy’s reserves, ensuring that the one benefit you aim to provide remains intact.

Strategic Uses for Life Insurance Loans

When used wisely, life insurance loans can become a strategic asset in your financial toolkit. They can serve as a life raft to keep you afloat during high-interest debt storms, offering an attractive alternative with their generally lower interest rates. For those who find themselves shipwrecked by the stringent requirements of standard loans, borrowing against a life insurance policy can be a valuable lifeline. It’s the financial flexibility to meet urgent cash needs quickly, sidestepping the often drawn-out approval process associated with bank loans.

Consider the life insurance loan as a versatile tool for navigating life’s unexpected expenses — be it medical bills, emergency costs, or other significant expenditures. For those quick ‘fast cash’ needs, a policy loan can be a swift and strategic source of funds, especially when repaid promptly to avoid a reduced death benefit. And even as you draw upon the policy’s value, the remaining cash value continues to grow, potentially offsetting some of the impacts of the loan.

Life insurance loans can offer strategic advantages, such as access to funds when turned down for a bank loan, while still allowing your policy’s financial growth to chart its course.

Alternatives to Borrowing From Your Policy

Exploring the broader financial landscape uncovers several alternatives to borrowing from your life insurance policy. Each option carries its unique set of advantages and potential drawbacks, tailored to different financial situations. Some alternatives to borrowing from your life insurance policy include:

Personal loans from banks or credit unions, which can offer competitive rates and a fast application process for those with good to excellent credit.
Fast-tracked online lenders, which cater to a broader credit spectrum.
Credit card borrowing, particularly with 0% APR introductory offers, can be a savvy move if you can clear the balance before the interest-free period ends, though it requires discipline to avoid sinking into more debt.

For individuals looking to borrow money from their future to pay for the present, there are several options to consider:

401(k) loan: offers low interest and no credit score impact
Home equity loan: provides lower rates but with the risk of losing your home if you can’t keep up with payments
Flexible personal lines of credit: allows you to pay interest only on the amount you use
Pawnshop loans: offer immediate funds without credit checks, but beware of high APRs and the risk of losing your collateral items

Weighing these options against the benefits and convenience of a life insurance loan is key to charting the right financial course.

Maintaining Your Policy After a Loan

Securing a life insurance loan doesn’t mark the end of your journey. Sustaining your policy after borrowing is like maintaining your ship after setting sail. You are not bound to a fixed repayment schedule, which offers financial flexibility not typically seen in other loan realms. Some policyholders strategically use their loans to cover their policy’s annual premiums, ensuring their coverage remains active even when direct payment is challenging. You can choose to pay the interest out of pocket annually or add it to the loan balance, though the latter option can lead to a growing debt due to compounded interest.

It’s essential to navigate these waters with a clear map. Here are some steps to follow:

Request an annual in-force illustration from your insurer to assess the loan’s impact on your policy’s performance and sustainability.
Neglecting to manage your loan effectively could lead to the policy’s cash value being depleted, at which point you’d need to inject additional premiums to keep the policy afloat and avoid termination.
Understanding how interest is charged on your loan is also crucial, as it will influence your repayment strategy and ensure you don’t drift into financial trouble.

How to Work With Your Insurer During the Loan Process

Working closely with your insurer throughout the loan process is key to ensuring a smooth financial journey. It’s imperative to grasp the terms and conditions of your loan fully, just as you would understand the rules of navigation before setting sail. Requesting full disclosure of all loan provisions, including loan duration, payment schedules, and consequences of non-payment, is crucial for transparency. Asking your insurance agent to explain the interest rates, how they’re calculated, and when they’re applied will help you steer clear of unexpected costs.

Moreover, inquire about any additional fees or costs that may arise during the loan process, ensuring there are no hidden shoals that could run your financial ship aground. Maintaining open and transparent communication with your insurer is akin to keeping a steady hand on the helm, ensuring that your loan process is manageable and free of surprises. By ensuring full disclosure and understanding, you can confidently navigate the loan process with your insurer as your trusted first mate.

Summary

As we dock at the end of our journey, it’s clear that borrowing against life insurance can be a powerful financial tool when used wisely. Remember that while life insurance loans offer flexibility and ease, they come with risks that can affect your policy’s value and your beneficiaries. Weighing these considerations carefully, maintaining your policy, and exploring alternatives will help you chart a course that maximizes the benefits while minimizing potential drawbacks. May this guide serve as your compass to wise financial decision-making, and may the winds of fortune always fill your sails.

Frequently Asked Questions

Top Burial Insurance Options: Find Your Best Match in 2024

Wed, 29 May 2024 15:05:24 GMT

Preparing for end-of-life expenses? Burial insurance can help. This article breaks down the top burial insurance options in 2024, offering peace of mind without a financial burden on your family.

Key Takeaways

Burial insurance, also known as final expense insurance, is designed to cover funeral costs and associated end-of-life expenses, with coverage typically ranging from $1,000 to $50,000 and does not require a medical exam.
Leading providers such as AARP/New York Life, State Farm, and Mutual of Omaha offer burial insurance with varying policy options, eligibility ages, and coverage amounts, emphasizing the need for consumers to compare providers for the best match.
When choosing burial insurance, it’s important to consider factors like estimated funeral expenses, budget constraints, and policy features such as guaranteed acceptance and cash value accumulation, as well as weighing the pros and cons against other life insurance alternatives.

Understanding Burial Insurance

Burial insurance, also commonly known as final expense insurance, is a specific type of life insurance policy designed to cover end-of-life expenses. These expenses can include funeral costs, outstanding debts, or any other associated expenses. It’s a financial safety net, providing peace of mind that your loved ones won’t be left grappling with these costs in the wake of your passing.

Notably, burial insurance differs from traditional life insurance policies. While traditional life insurance offers a death benefit that can be used for any purpose, burial insurance is specifically designed to cover funeral and burial services. Could burial insurance be the right choice for you? Explore further to understand the intricacies of burial insurance and its operation.

What is Burial Insurance?

Burial insurance, otherwise known as final expense insurance or funeral insurance, is a type of whole life insurance policy that primarily covers expenses associated with an individual’s funeral and final arrangements. This can include costs such as:

the memorial service
casket
urn
burial
cremation
any outstanding debts.

The coverage amount of a burial insurance policy typically ranges from $1,000 to $50,000. This is informed by the average funeral cost, which was approximately $7,848 in 2021, thereby informing typical policy amounts between $7,000 and $10,000. In addition to covering funeral costs, burial insurance can also help manage financial matters such as credit card debt and medical bills left by the deceased.

How Does Burial Insurance Work?

The process of applying for burial insurance is fairly simple. Here are the steps:

Choose your desired coverage amount.
Name your beneficiary.
Apply for burial insurance. In many cases, you can be accepted without the need for a medical exam.
Rates are typically determined based on factors such as your age and gender.

Once a claim is filed and a death certificate is provided, beneficiaries are guaranteed a payout of the higher of the total premiums paid or the original insured amount. Some policies even offer cash value accumulation over time.

There are four distinct types of burial insurance based on underwriting:

Level Benefit
Graded Benefit
Modified Benefit
Guaranteed Issue

Each varies in cost implications and coverage conditions.

Top Burial Insurance Providers

In the selection of a burial insurance policy, considering the array of providers and their offerings is imperative. Leading burial insurance providers include AARP/New York Life, State Farm, and Mutual of Omaha, each offering different policy options and benefits.

Here, we unpack the offerings of these providers, enhancing your understanding of each one’s unique propositions.

AARP/New York Life

AARP, in collaboration with New York Life, offers a Guaranteed Acceptance Life Insurance policy. This policy provides coverage of up to $25,000 and is available to AARP members aged 50 to 80. The eligibility age range in New York has been adjusted to 50 to 75. This change will allow more people to qualify for the program. Notably, eligibility for AARP burial insurance extends to members’ spouses.

AARP’s life insurance policies, including burial insurance, are underwritten by New York Life Insurance, one of the reputable life insurance companies with a strong reputation for customer satisfaction and reliability. It has received fewer complaints than expected for its size over a three-year period, demonstrating its commitment to customer satisfaction.

State Farm

State Farm is another notable provider in the realm of burial insurance. In New York, they provide Guaranteed Issue Final Expense Life Insurance, which is also known as $10,000 Whole Life. This type of insurance is available for purchase. The eligibility age for State Farm’s burial insurance policy ranges from 45 to 80 years old, except in New York where it is 50 to 75 years old.

However, it’s worth noting that State Farm does not offer burial insurance policies to new customers in Massachusetts or Rhode Island. Despite this restriction, State Farm is recognized for its reliable customer service and comprehensive policy offerings.

Mutual of Omaha

Mutual of Omaha offers a burial insurance policy named Guaranteed Whole Life Insurance. Typically, the age range for eligibility for Mutual of Omaha’s burial insurance is 50 to 85 years old, but in New York, this range is narrowed to 50 to 75 years old.

The coverage amounts for Mutual of Omaha’s burial insurance range from $2,000 to $25,000, although in Washington, the minimum coverage amount is slightly higher at $5,000. These varying coverage amounts provide flexibility for individuals with different needs and financial capabilities.

Evaluating Burial Insurance Policies

The selection of a burial insurance policy requires consideration of numerous factors. These include your estimated funeral expenses, budget constraints, and specific policy requirements. Comparing multiple burial insurance providers and their policy propositions, while weighing them against your financial resources, is key.

Engaging the expertise of a licensed insurance agent who specializes in funeral insurance can also prove beneficial. They can provide personalized assistance in selecting suitable policy options, ensuring that you make an informed decision that best suits your needs.

Coverage Amount

The appropriate coverage amount for burial insurance is influenced by numerous factors, including:

The policyholder’s age
Health status
Desired coverage amount
Funeral costs
Outstanding debts

These factors should be taken into consideration when determining the appropriate coverage amount for burial insurance.

The cost of a funeral with a viewing and burial is currently the national median of $7,848, increasing to $9,420 if a vault is included. The cost of a cremation with a cremation casket is typically around $6,970, making it an affordable option for many families. This median amount reflects the average expense for this type of service. These costs inform the typical policy amounts, which generally fall between $7,000 and $10,000.

Different types of burial insurance plans, like Level Benefit, Graded Benefit, and Modified Benefit plans, offer different structures of payouts that can affect the overall benefit received.

Premiums and Payment Options

Factors such as policy type, applicant’s age, gender, and policy size influence the premiums for funeral insurance. Funeral insurance policies often provide fixed premium rates, offering consistent and predictable payment schedules. However, policies without a medical exam typically use age rating, where premiums increase as the policyholder ages. This underscores the financial advantage of securing insurance earlier in life.

Optional stepped premiums, recalculated annually, and capped premiums, which offer a monetary or age limit after which payments cease, are also available for burial insurance payments. Monthly payments are a common form of payment for funeral insurance premiums, catering to budgeting preferences and financial planning needs of policyholders.

Policy Features and Benefits

Various features and benefits come with burial insurance policies, which can make them appealing to potential policyholders. One of these is guaranteed acceptance, ensuring policy issuance without medical exams or health questions – a significant advantage for those with pre-existing conditions.

Whole life insurance policies, including those offered by AARP, come with the following benefits:

Level premiums
A benefit that lasts a lifetime, providing both insurance coverage and peace of mind
Cash value accumulation feature that enables policyholders to have a fund from which they can withdraw or borrow
Tax-deferred growth at a fixed rate, providing a tax-advantaged benefit to the policyholder.

Pros and Cons of Burial Insurance

As with any financial product, burial insurance carries both advantages and disadvantages. Understanding these can help potential policyholders make an informed decision about whether burial insurance is the right fit for their needs.

Benefits of Burial Insurance

One of the key benefits of burial insurance is its simplicity and accessibility. It does not require a medical exam, making it accessible to those with pre-existing conditions. Moreover, these policies can significantly ease the financial burden on families by covering various funeral and burial expenses, ensuring that loved ones are not burdened with these costs.

Another benefit of burial insurance is its cost-effectiveness. It locks in a premium that remains unchanged over time, and getting a plan early can be more affordable as costs increase with age.

Drawbacks of Burial Insurance

However, burial insurance policies also have their drawbacks. For one, these policies typically offer smaller benefit amounts that are specifically tailored for covering final arrangements. They are not designed to address broader financial needs.

Additionally, unlike more comprehensive life insurance policies, burial insurance does not offer income replacement. This could leave beneficiaries without adequate financial support following the policyholder’s death.

Alternatives to Burial Insurance

Although burial insurance may suit some individuals, considering alternatives is worthwhile. Other options include term life insurance, whole life insurance, and pre-need insurance. Each of these offers different levels of coverage and benefits that may better suit your needs.

Term Life Insurance

Term life insurance provides coverage for a specified term, such as 10, 20, or 30 years. This type of insurance can be more affordable than whole life insurance as it only covers a limited period. However, if the policyholder outlives the term, the coverage expires without benefits, potentially leaving no provision for final expenses.

One significant drawback is that should the policyholder seek to renew the term life insurance, the cost may significantly increase with age. On the other hand, policyholders may have the option to convert their term life insurance to a whole life or other permanent plan for extended coverage.

Whole Life Insurance

Whole life insurance, also known as permanent life insurance, provides lifelong coverage as long as premiums are paid. Beneficiaries are assured a fixed benefit, receiving a guaranteed sum of money upon the policyholder’s death. Premiums for whole life insurance are fixed and do not increase over time, offering long-term affordability.

Whole life insurance can provide coverage for:

A family’s lifestyle
Income replacement
Debts
College tuition
Spouse’s retirement
Final expenses

This makes it a more comprehensive solution compared to burial insurance.

Pre-Need Insurance

Pre-need insurance is a type of funeral plan sold by licensed pre-need specialists. Its primary function is to cover funeral costs and final expenses. This type of insurance allows individuals to pay for their funeral services in advance, thereby reducing the financial burden on the family when the time comes.

While pre-need insurance is a viable alternative to burial insurance, it’s crucial to consider the financial stability and reputation of the funeral home offering the plan. This ensures that the services will be available when needed.

Summary

In conclusion, burial insurance is a viable financial planning tool that eases the burden of end-of-life expenses on loved ones. While it comes with its advantages and drawbacks, the key lies in understanding your personal needs and financial circumstances. By comparing various policy options, assessing coverage amounts, evaluating premiums, and considering alternatives, you can ensure a fitting choice that leaves you and your loved ones in a financially secure position.

Frequently Asked Questions

Maximizing Your Legacy: A Strategic Guide to Estate Planning Life Insurance

Wed, 29 May 2024 14:59:19 GMT

When considering estate planning , life insurance emerges as a crucial tool to protect your legacy and provide for your loved ones. How does estate planning life insurance work to ensure your wealth is passed on efficiently and your family is financially secure? In this guide, we tackle the strategic integration of life insurance within your estate plan, shedding light on its role in offering financial stability, shielding your assets from taxes, and ensuring that your beneficiaries are cared for according to your wishes.

Key Takeaways

Life insurance is a foundational element of estate planning, providing immediate liquidity for expenses, ensuring family well-being, and aiding in business succession.
Understanding different types of life insurance policies—term, whole, and universal—is essential to cater to varying estate planning goals, with each offering specific benefits like coverage certainty, cash value growth, or adjustable premiums.
Strategic policy ownership and beneficiary designation, including personal, trust, and business ownership, are critical to ensuring that life insurance benefits are directed and taxed according to the estate owner’s intentions.

The Role of Life Insurance in Estate Planning

Life insurance isn’t merely a financial product; it’s a cornerstone of a well-crafted estate plan, offering solace and support when it’s most needed. Whether it’s providing the funds to cover immediate expenses, ensuring the well-being of family members, or facilitating the transfer of business assets, a life insurance policy is indispensable.

As we dive deeper, we’ll explore how life insurance stands as a bulwark against the uncertainties of the future, making it a powerful ally in estate planning.

Estate liquidity

Imagine the relief in knowing that your estate can meet its financial obligations without delay or distress. Life insurance provides this reassurance, offering immediate liquidity to cover funeral expenses and settle debts. With a life insurance policy, the financial legacy you’ve envisioned remains intact, without the need to liquidate cherished assets or investments under duress.

It’s a clear testament to the power of foresight and the role of life insurance in estate planning.

Providing for family members

The greatest gift we can leave our loved ones is security. Life insurance ensures that your family’s financial needs are met, even when you’re not around to provide for them. It complements other estate planning tools, such as powers of attorney, creating a comprehensive safety net that looks after your family’s welfare.

From the young family to the surviving spouse, a life insurance contract offers a promise of financial support that is both profound and practical, ensuring the availability of insurance proceeds when needed.

Business succession planning

No enterprise should falter at the helm’s change. Life insurance policies provided by a reliable insurance company are instrumental in business succession planning, offering a smooth transition of control and equitable asset distribution. When a business owner’s journey ends, life insurance ensures that the legacy continues, providing financial stability and honoring the original vision for the business.

It’s a strategic tool that preserves the essence of one’s life’s work.

Types of Life Insurance for Estate Planning

The fabric of estate planning is woven with various types of life insurance, each with its distinctive benefits. Whether it’s the simplicity of term life insurance or the enduring value of whole and universal policies, understanding these options is key to selecting the best coverage for your estate planning needs.

Let’s delve into the nuances of these insurance types and how they align with different estate planning objectives.

Term life insurance

Term life insurance is a beacon of hope during life’s most uncertain periods. It provides a death benefit for a specific term, ensuring that your family is protected when liabilities loom large. With term insurance, the premiums you pay are solely for the protection it affords, offering a straightforward and focused approach to securing your legacy within a defined timeframe.

Whole life insurance

Whole life insurance, also known as permanent life insurance, is synonymous with permanence and reliability. It offers not just a guaranteed death benefit, but also a savings component that grows over time, embodying both protection and prosperity.

This policy is a strong foundation for any estate plan, assuring that your financial legacy will endure, even in the face of federal estate tax and potential federal estate taxes.

Universal life insurance

For those who value flexibility, universal life insurance offers a matchless choice. Here are some key features of this policy type:

Allows you to adjust your coverage as your financial needs evolve
Ensures that your estate plan remains as dynamic as the life it represents
Provides long-term financial security
Offers the potential for cash value growth

Universal life insurance is a testament to adaptability, providing you with the flexibility you need for your changing circumstances.

Choosing the Right Policy Ownership Structure

The decision of who owns your life insurance policy can have profound implications for your estate plan. Whether held personally, in trust, or by a business, the ownership structure can impact how the policy’s benefits are realized and taxed.

Let’s explore these ownership options to maximize the strategic potential of your life insurance within your estate plan.

Personal ownership

When you retain personal ownership of your life insurance policy, you wield direct control over its terms and beneficiary designations. This autonomy ensures that the policy serves your estate planning goals precisely as you intend, securing the financial future of those you hold dear.

Trust ownership

Trust ownership of a life insurance policy can be a game-changer for your estate plan. By placing the policy within an irrevocable life insurance trust, you may shield the benefits from estate taxes, ensuring that your legacy reaches your beneficiaries with maximum impact. It’s a sophisticated strategy that requires careful consideration and professional guidance.

Business ownership

For entrepreneurs and business owners looking to purchase life insurance, the ownership of a life insurance policy can be tailored to meet specific business objectives, such as funding a buy-sell agreement or providing liquidity for operational needs. It’s a strategic decision that aligns the protection offered by life insurance with the long-term vision of the business.

Selecting Beneficiaries Wisely

The act of selecting beneficiaries is more than a formality; it’s a deliberate choice that shapes how your legacy is realized. Wise beneficiary designation ensures that your life insurance benefits support your loved ones effectively, without unnecessary tax burdens or legal complications.

Let’s consider the significance of making informed beneficiary choices in estate planning.

Primary and contingent beneficiaries

The designation of primary and contingent beneficiaries ensures that your death benefit proceeds are distributed according to your wishes, even in the event of unforeseen circumstances. This careful planning prevents any interruption in providing for those you care about, securing your legacy as you envision it.

Considerations for naming minor children

When minor children are intended beneficiaries, the nuances of estate planning become particularly critical. Legal protections must be established to ensure that the assets they inherit are managed in their best interest until they come of age. This consideration underscores the importance of involving legal expertise in your estate planning process.

Updating beneficiary designations

Life is in constant flux, and so too should be your beneficiary designations. Regular reviews and updates are essential to align your life insurance with your current intentions, ensuring that the fruits of your labor are bestowed as you desire.

Funding Strategies for Life Insurance Premiums

Navigating the financial aspects of life insurance premiums can be as strategic as the estate planning itself. Whether through annual gift exclusions, loans, or leveraging existing assets, there are numerous pathways to securing the funds for your policy’s premiums.

Let’s explore these strategies to find the most beneficial course for your unique situation.

Annual gift exclusion

The annual gift tax exclusion is a powerful tool for funding life insurance premiums without triggering a tax event. It allows you to contribute tax-free towards the premiums, ensuring that your policy remains active and your estate plan robust. By utilizing the federal estate tax exclusion, you can further protect your assets and secure your financial future.

Loans and interest rates

Loans against the cash value of life insurance policies can provide a source of funds for premium payments, but they must be managed wisely to avoid diminishing the policy’s death benefit. Understanding the terms and interest rates of such loans is crucial for maintaining the integrity of your estate plan.

Leveraging existing assets

Leveraging existing assets to fund life insurance premiums can be a smart move, maximizing the value of your estate while achieving your financial goals. This strategy requires a nuanced understanding of your assets and the foresight to utilize them effectively.

Coordinating Life Insurance with Other Estate Planning Tools

A comprehensive estate plan harmonizes life insurance with other planning tools, ensuring that your legacy is both protected and purposeful. Coordinating policies with wills, trusts, and powers of attorney allows for a seamless integration that reflects your values and intentions.

Let’s look at how this harmonization can fortify your estate planning efforts.

Wills

Your will is a declaration of your final wishes, but it’s the beneficiary designations on your life insurance policy that often take precedence. Aligning these designations with your will is essential to ensure that your assets are distributed exactly as you intend, with due consideration for potential estate tax liabilities.

Trusts

Trusts can elevate your estate planning to new heights, especially when coordinated with life insurance. By placing your policy within a trust, you can effectively manage estate taxes and ensure that your beneficiaries receive the full benefit of your legacy. This strategic pairing can offer significant advantages for the preservation and distribution of your wealth.

Powers of attorney

In the realm of estate planning, powers of attorney are essential for managing affairs and ensuring that your life insurance remains a pillar of your financial strategy. Granting someone the legal authority to act on your behalf can be a prudent measure to maintain the continuity of your estate planning, even in your absence.

Collaborating with Professionals

The complexity of estate planning and life insurance necessitates the collaboration with professionals who can navigate the legal, financial, and tax landscapes. Engaging with estate planning attorneys, financial advisors, and tax professionals is key to crafting a plan that is both comprehensive and tailored to your unique situation.

Let’s examine the roles these experts play in optimizing your estate plan.

Estate planning attorney

Estate planning attorneys are the custodians of your legal wishes, ensuring that your estate plan is compliant with state laws and that your assets are distributed as you desire. Their expertise is invaluable in crafting a plan that stands the test of time and law.

Financial advisor

Financial advisors are your strategic partners in aligning your financial goals with the intricacies of estate planning. They provide insight into the best life insurance policies for your needs and help navigate the funding of premiums within the broader context of your financial plan.

Tax professional

Tax professionals have the acumen to foresee the tax implications of your estate plan, offering strategies to minimize your estate’s tax liabilities for estate tax purposes. Their guidance is crucial in managing the tax aspects of your life insurance policy and ensuring that your estate is preserved for your beneficiaries, including helping you pay estate taxes efficiently.

Summary

We’ve journeyed through the strategic integration of life insurance into estate planning, from understanding its pivotal role to selecting the right policy and beneficiaries. The tapestry of a well-structured estate plan is rich with considerations, and life insurance is its vibrant thread, binding your financial wishes into a legacy of care and security. May this guide inspire you to take a decisive step in shaping a future that reflects your life’s work and love.

Frequently Asked Questions

What Is a Fully Insured Health Plan for Business?

Tue, 28 May 2024 05:23:25 GMT

If you want to attract and retain top employees for your business, consider offering work healthcare coverage . According to a 2024 study by Forbes Advisor :

67% of employees (and 68% of employers) state employer-covered healthcare is the top most-sought-out benefit for workers today.
More than 80% of employees older than age 42 are looking for roles that include employer-covered healthcare .
40% of employers believe workers would leave their jobs to find employment that offers better benefits.

One of the most common forms of employer-sponsored healthcare coverage is fully insured healthcare. In this guide, learn what fully insured health plans are and the pros and cons of choosing them for your business.

Key Takeaways

With fully insured healthcare plans, the employer pays a fixed premium determined by the health insurer for worker healthcare coverage .
Fully insured health plans can offer predictability for employers, since they know exactly how much they’ll owe every month.
Since the health insurer covers employee claims, fully insured plans may offer lower risk compared to plans like self-insured healthcare for businesses.

Fully Insured Health Plans Explained

Fully insured health plans provide peace of mind to employees that their healthcare needs are covered, with you sponsoring their coverage by paying their healthcare premiums. Healthy employees are more productive employees, as the Centers for Disease Control and Prevention reports:

Healthier employees are less likely to use sick or vacation time due to sickness.
That means, companies that support employee health are more likely to have higher numbers of employees at work every day.
A healthier staff reduces employee absenteeism, lowers costs to train replacement employees, and reduces overtime costs to cover absent employees.

Plus, like a study by the University of Oxford finds, happy employees are 13% more productive. Keeping employees happy and healthy is good for business.

With a fully insured healthcare plan, you pay a set amount each month to an insurer, who then takes on responsibility of covering employee healthcare costs that are included in the policy coverage. You know exactly what you’ll pay each month, and that covers everything from preventive care, to major surgeries and accident treatment.

Under fully insured health plans, premiums are typically determined based on the number of employees who are covered in the plan. How are fully insured health plans priced?

For companies that have between 2 and 50 full-time employees, premiums are priced based solely on age and county.
For companies with 51 or more employees, premiums are formulated based on underlying risk.

When the number of employees who are receiving coverage changes, that will also typically impact the monthly premium charge. Workers and their dependents will be required to pay deductibles and co-pays for services, based on the terms outlined in the policy.

Fully insured plans make it easier for employers to plan their budgets related to healthcare coverage, since they know exactly how much they’ll pay to cover each employee. All expenses beyond the monthly premium become the insurer’s responsibility, which means fully insured plans could potentially lower costs for employers.

Pros of Fully Insured Health Plans

There are some advantages to fully insured plans for employers. Consider these benefits to determine if a fully insured health plan is best for your business.

Fewer administrative expenses: With fully insured health plans, the insurer typically manages all administrative tasks related to executing the healthcare plan. This can make it easier for small businesses, especially those with 100 or fewer employees, to manage their healthcare administration and provide a beneficial service to employees with less hassle. Plus, it’s up to the insurance carrier to meet all compliance standards and federal and state legal requirements, which can free up the responsibilities of in-house human resources teams or eliminate the need to work with a professional employer organization (PEO) .
Attractive to employees: Fully insured healthcare plans are the top benefit sought out by employees today. Since employers also value this as the top benefit a business can offer to workers, fully insured health plans can help businesses be more competitive in attracting and retaining top talent.
Reduced risk and improved predictability: Fully insured health plans offer businesses set prices on healthcare costs, which makes it easier for small business owners to manage their budgets and predict healthcare expenses. When employees do experience expensive healthcare needs, employers only have to worry about paying premiums, not full healthcare costs like other health plans might require.

Because of fully insured health plans’ predictability and ease of use, they’re often an attractive option for many small business owners.

Cons of Fully Insured Health Plans

There are also some considerations to keep in mind related to fully insured health plans for businesses. As you compare your health insurance options, keep the following in mind.

Potentially more expensive: Sometimes, a business owner may pay more in premiums compared to what employees actually use in healthcare coverage. For example, an exceptionally healthy team may cost less on another type of health insurance plan, compared to paying full premiums on a fully insured plan.
Less flexibility: While the predictability of a fully insured plan makes it attractive for many business owners, there’s also less flexibility in how a small business can customize health insurance offerings. That means, you may be paying for healthcare coverage that most of your staff doesn’t need, such as pediatric care. You’ll typically need to adhere to the plan options set forth by the insurer and choose the best one for your business.
Cost increases: Every year, the premium prices on a fully insured health plan may go up, so that’s something you’ll need to budget for if you keep that type of plan.

For small business owners who want routine and less risk, fully insured plans may make sense. But if you want more control and potentially more financial savings when offering healthcare coverage to your workforce, options like self-funded or level-funded health plans may make more sense.

Interested in a Fully Insured Health Plan?

If you’re interested in offering a fully insured health plan for your employees , it’s helpful to compare this structure to other types of work health coverage plans, including self-funded health insurance for business, level-funded health plans, health savings accounts (HSAs) and health reimbursement arrangements (HRAs) , like qualified small employer health reimbursement arrangements (QSEHRAs) and individual coverage health reimbursement arrangements (ICHRAs) .

At AZ Health Insurance Brokers, we can help your small business compare all your options, so you can choose the best work healthcare coverage for your employees and your budget. Contact us for a free work healthcare consultation online , or call 602.617.4107 or email quotes@azhealthinsurancebrokers.com , and we’ll be in touch.

Fully Insured Health Plan FAQs

Understanding Whole Life Insurance: A Comprehensive Guide for Lifetime Coverage

Mon, 06 May 2024 15:24:33 GMT

Whole life insurance promises lifelong financial security with a guaranteed payout – but at what cost, and with what benefits? This coverage persists beyond the limits of term life insurance and includes a cash value accumulation that can be used while you’re still alive.

How does whole life insurance compare to other types of life insurance policies ? How does whole life insurance impact your financial planning?

This comprehensive guide to whole life insurance helps you understand the complexities and whether or not whole life insurance can work for your financial planning goals.

Key Takeaways

Whole life insurance provides lifetime coverage, a guaranteed death benefit, fixed premiums, and a unique cash value component that can be borrowed against, which differs from term and other forms of life insurance.
The cash value in whole life insurance policies accumulates over time, is tax-deferred, and can be accessed by policyholders through loans or withdrawals, but such actions can potentially reduce the death benefit and create tax liabilities.
Premiums for whole life insurance are generally higher due to lifelong coverage and the cash value component, with rates affected by factors like age, health, and coverage amount, and there are both participating (dividend-paying) and non-participating policy options.

Demystifying Whole Life Insurance

Whole life insurance is a variation of a permanent life insurance policy that offers coverage for the insured individual’s entire lifetime. Compared to term life insurance, which only covers a specific period, whole life insurance guarantees a payout, no matter when the insured person passes away.

What makes whole life insurance truly unique is its cash value component. Part of each whole life insurance premium payment goes into building this cash value, a feature that isn’t present in term life insurance.

Key features of whole life insurance include:

Coverage for the entire lifetime of the insured individual
Guaranteed payout upon the insured person’s death
Cash value component that grows over time
Premium payments that contribute to the cash value
Ability to borrow against the cash value or surrender the policy for its cash value

Whole life insurance provides lifelong coverage and can be a valuable asset for financial planning and protection. Exploring how this cash value functions, and distinguishing whole life insurance from other types of life insurance, can make it easier to understand how whole life insurance works.

Whole Life Insurance Basics

At its core, whole life insurance is about providing protection. It ensures that your loved ones are financially secure if something were to happen to you. The whole life insurance policy includes a guaranteed death benefit, which means that a predetermined amount will be paid to your beneficiaries upon your death, regardless of when it occurs.

There’s more that differentiates whole life insurance. This type of life insurance policy is unique because of its cash value accumulation feature. It includes a savings element that grows over time and that may even earn dividends. This cash value serves as a fund source during the policyholder’s lifetime, which expands the scope of whole life insurance beyond merely being a death benefit.

How Whole Life Insurance Differs from Other Policies

When you compare whole life insurance with other life insurance types, like term life insurance or universal life insurance, its unique features become clear. The primary differences are in the duration of coverage, the premiums and the cash value elements.

Unlike term life insurance, which only offers coverage for a specific time period, whole life insurance offers lifelong coverage. Moreover, whole life insurance guarantees a death benefit payout at any time during the insured’s life.

While the premiums for term life insurance may increase upon policy renewal, whole life insurance premiums remain level and are guaranteed to not increase over time.

Finally, unlike universal life insurance policies and variable universal life insurance policies, which offer flexibility in premium and death benefit amounts, whole life insurance offers fixed premiums and a set death benefit.

The Ins and Outs of Cash Value

How Whole Life Insurance Builds Cash Value Over Time

The cash value component of a whole life insurance policy has several distinctive features. These include:

A portion of each whole life insurance premium goes towards building the policy’s cash value.
Over time, the cash value of a whole life insurance policy accumulates.
You can contribute to the whole life insurance cash value by making payments larger than the scheduled premium, by purchasing paid-up additions, or by reinvesting whole life insurance policy dividends.
The interest on the accumulated cash value grows on a tax-deferred basis, which increases its value over time.

As a whole life insurance policyholder, you can access this accumulated cash value through loans or withdrawals. This means, a whole life insurance policy provides a flexible source of funds when you need it.

How Whole Life Insurance Builds Cash Value Over Time

In a whole life insurance policy, the cash value expands due to a guaranteed minimum interest rate determined by the insurer. This ensures a consistent accumulation of funds throughout the whole life insurance policy’s duration.

Moreover, whole life insurance policyholders may receive additional cash value growth through dividends. Although dividends aren’t guaranteed, they can significantly contribute to the overall growth of the whole life insurance policy’s cash value if they are reinvested back into the policy.

Over time, as whole life insurance policyholders pay premiums, an increasing proportion of the premium payments goes towards the cash value, which speeds up its growth. This is especially true when whole life insurance policyholders are younger, as the cash value tends to grow more quickly, due to the structure of premium allocation and costs of insurance.

How to Access and Use the Cash Value of a Whole Life Insurance Policy

The cash value of your whole life insurance policy represents more than just figures on paper – it serves as a financial reservoir that you can access in times of need. As a whole life insurance policyholder, you can access your policy’s cash value through direct withdrawals, by taking out a loan, or by using it to cover your monthly premium payments.

A major benefit of whole life insurance is that withdrawals from the cash value are tax-free up to the amount of the premiums paid, which makes a whole life insurance policy a potential source of tax-advantaged funds.

However, it’s important to remember that withdrawals and loans may have negative effects on your whole life insurance policy. These may include:

They can reduce the policy’s cash value.
They can reduce the death benefit if they’re not managed properly.
When withdrawals and loans related to a whole life insurance policy aren’t managed properly, they could result in a policy lapse and/or tax liabilities. Talk with a whole life insurance policy advisor for details on how to avoid these.

Whole Life Insurance Policy Death Benefit: What It Is and How It Works

Every life insurance policy fundamentally includes a death benefit. In the case of whole life insurance, this death benefit is guaranteed, ensuring that your beneficiaries receive financial support upon your passing.

But with whole life insurance, the death benefit isn’t just about providing financial security for your loved ones. It can also serve as an effective estate planning tool . Since the death benefit from whole life insurance is generally income tax-free for the beneficiaries, it can provide a significant financial advantage among other life insurance and financial planning tools.

With a whole life insurance policy, the death benefit isn’t set in stone. As a whole life insurance policyholder, you can increase the death benefit through paid-up additions to your policy, or by reinvesting whole life insurance policy dividends. However, it’s important to be aware that unpaid policy loans can reduce the available death benefit. At the same time, voluntary riders can offer additional coverage within your whole life insurance policy.

How to Change or Increase the Death Benefit in a Whole Life Insurance Policy

As circumstances in your life evolve, so may your life insurance needs. That’s why whole life insurance policies allow for alterations to the death benefit. Whether it’s due to a change in financial circumstances, family size or future plans, you can adjust the amount of the death benefit specified in your policy contract under certain conditions.

For example, you can use dividend payments to:

Acquire additional coverage, effectively increasing the death benefit
Purchase additional riders, or adjust your policy coverage to increase the death benefit
Use the policy’s cash value to cover monthly premium payments, facilitating adjustments to the death benefit

Keep in mind, any alterations must align with the conditions specified in the policy contract to ensure compliance with the terms outlined.

Payout Options for Whole Life Insurance Beneficiaries

When a whole life insurance policyholder passes away, their beneficiaries have multiple options regarding how they receive the death benefit. They can opt for a lump sum payout, which provides them with the entire death benefit amount in one transaction. Alternatively, they may choose for the death benefit to be paid in installments, which allows them to receive the money in a series of payments over time.

Another option for whole life insurance beneficiaries is to convert the death benefit into an annuity. This provides a consistent and predictable income stream, either for a set period or for their lifetime.

Whole Life Insurance Costs and Factors Affecting Premiums

When you’re selecting a whole life insurance policy, it’s important to understand whole life insurance expenses and the elements that influence premium rates. One key feature of whole life insurance is that the premiums are fixed. This means, the payment amount remains the same throughout the life of the policy, which provides financial predictability and stability.

It's important to note whole life insurance premiums are generally higher than those for term life insurance. Whole life insurance includes lifetime coverage and a cash value component, which contribute to higher premiums. These features provide a range of benefits to whole life insurance policyholders.

How Does Whole Life Insurance Compare to Term Life Insurance Costs?

One major difference between whole life insurance and term life insurance is cost. Premiums for whole life insurance are typically higher than those for term life insurance (sometimes up to six times higher), because whole life insurance offers lifetime coverage and a cash value component.

However, higher premiums don’t necessarily make term life insurance the better choice. Term life insurance is generally chosen for temporary coverage due to the policyholder’s financial obligations and is considered more budget-friendly.

Factors That Impact Whole Life Insurance Premium Rates

What factors determine whole life insurance premium costs? Various factors include:

Age: Younger individuals typically pay less for whole life insurance premiums compared to older individuals.
Gender: Women generally pay lower premiums due to their longer life expectancies.
Tobacco use: Tobacco users may find that their life insurance costs are two to three times higher than non-tobacco users.
Health status and mortality risk: These factors are assessed during the underwriting process and can affect your premium rates.

Other factors, such as your occupation, whether you engage in high-risk hobbies and the amount of coverage you want, can also result in higher premium rates. It’s also a good idea to compare rates established by insurance companies, as they may vary widely.

Generally, the younger and healthier you are when you secure a life insurance policy, the lower your rates can be. That’s why getting whole life insurance earlier on in life can help you lower your premiums.

Types and Variations of Whole Life Insurance

There are various types and modifications of whole life insurance policies that can be customized to meet your specific needs. The main types of whole life insurance are participating and non-participating policies. These can be distinguished based on features such as whether or not they share insurer profits with policyholders.

Let’s explore these types and variations to understand their potential impact on your insurance policy.

Participating vs. Non-Participating Whole Life Insurance

Whole life insurance policies can be classified as either participating or non-participating, based on the distribution of excess premiums. If you have a participating whole life insurance policy, you may be eligible to receive dividends. However, dividends aren’t guaranteed. They depend on the insurer’s financial performance.

Conversely, non-participating life insurance policies don’t offer dividends or profit sharing. As a result, these policies often have lower premiums but have a limited growth potential.

Modified Whole Life Insurance

Modified whole life insurance is another variation of whole life insurance. The unique feature of this type of policy is that the premiums start lower and then increase after a predetermined period.

This can make modified whole life insurance more affordable in the beginning, but over the long-term, the premiums become costlier. This can be a suitable option if you anticipate a significant increase in your income in the future, which can allow you to comfortably afford the higher premiums later on.

Whole Life Insurance for Financial Planning

Whole life insurance can offer more than an insurance policy. It also serves as a tool for financial planning.

A whole life insurance policy’s steady cash value growth provides a reliable addition to fixed-income investments within a financial portfolio. Additionally, it can replace “human capital,” in case the insured individual can no longer contribute financially to the family.

Also, if you’re a small business owner, the cash value from whole life insurance policies can serve as a financial resource to support business continuity. It can help fund operational needs that help you grow your business.

Whole Life Insurance as an Investment Tool

The cash value component of whole life insurance can serve as an investment tool, creating a potential source of additional income. This cash value grows over time, accumulating on a tax-deferred structure. This means, you won’t owe taxes on the amount your cash value grows until you take it out, which allows for potentially higher returns.

This makes whole life insurance a useful asset in your investment portfolio. By getting whole life insurance through a reliable life insurance company, you can get financial coverage for your entire life.

Using Whole Life Insurance in Business Planning

For small business owners, whole life insurance can be an essential tool for business planning. It can safeguard against financial loss from the unexpected departure of essential personnel. Additionally, whole life insurance policies can fund buy-sell agreements.

These agreements provide a succession plan to ensure a smooth transition of business ownership. That offers peace of mind and ensures continuity for the business in the future.

Pros and Cons of Whole Life Insurance

Like most financial products, whole life insurance has distinct advantages and some considerations. On the upside, whole life insurance offers lifetime coverage, ensuring you’re insured no matter when you pass away. It also provides a guaranteed death benefit and the potential for cash value accumulation.

One thing to keep in mind is that the premiums for whole life insurance are typically higher than those for term life insurance. Since they also extend throughout the policyholder’s whole life, they may require a longer commitment.

Benefits of Whole Life Insurance

There are many diverse benefits of whole life insurance. First, the death benefit is guaranteed, which provides peace of mind your loved ones will be financially secure upon your passing. The premiums remain constant, which also offers financial predictability and stability.

Additionally, the cash value component of whole life insurance offers a source of tax-advantaged funds you can access through tax-free loans. This offers a financial buffer when you need it most.

Considerations for Whole Life Insurance

You should also keep in mind some of the potential drawbacks of whole life insurance compared to other types of life insurance. These include:

Loans taken against a whole life insurance policy sill accrue interest, which can decrease the overall policy value if they’re not managed carefully.
Withdrawals from the policy’s cash value may be taxable, which could result in a potential financial burden for the policyholder.
The premiums for whole life insurance are typically higher than those for term life insurance, which could be a cost consideration for the policyholder.

What type of life insurance policy works for you will depend on your unique lifestyle and your financial and familial considerations. Talk with a life insurance broker to compare your options.

How to Choose the Best Whole Life Insurance Policy

To select the appropriate whole life insurance policy, you’ll want to consider your unique needs and financial objectives. This involves evaluating your coverage needs, understanding different policy variations, and seeking guidance from a financial professional, if needed.

By taking these steps, you can ensure your whole life insurance policy not only provides financial security, but also meets your long-term financial planning objectives.

Assessing Your Whole Life Insurance Coverage Needs

To determine your whole life insurance coverage needs, it’s critical to evaluate the whole life insurance cost, as well as:

Your potential future earnings
Personal debts
Mortgage and/or other loans
Anticipated educational expenses for your dependents
A financial buffer for each child’s college tuition, which could range between $100,000 and $150,000, to cover future educational costs

By assessing your whole life insurance coverage needs based on your individual circumstances, and by seeking advice from a financial professional if needed, you can ensure your coverage is adequate for all your anticipated financial obligations. For an estimate of how much coverage you may need, use our f ree life insurance calculator .

Benefits of Working With a Financial Professional for Life Insurance

Collaborating with a financial professional can help you simplify your choice of whole life insurance or another life insurance type. A financial advisor can offer comprehensive planning services and offer advice on using life insurance as part of an overall financial strategy. They can also help you understand your life insurance policy options, riders and premium structures, and advise you on the best choices based on your unique needs and financial goals.

It's important to remember that some financial advisors may operate on a fee-only basis or a fee-based model. The latter may include commissions, which could potentially lead to a conflict of interest.

At AZ Health Insurance Brokers, our life insurance experts can consult with you for no fee and no obligation. Contact us for a free whole life insurance consultation .

Get Info on Whole Life Insurance

Whole life insurance coverage offers substantial financial security and flexibility. With features like guaranteed lifetime coverage, a growing cash value and fixed life insurance premiums, whole life insurance not only provides a safety net, but also contributes to your financial strategy and legacy planning.

To fully understand how whole life insurance can fit into your financial landscape, and to explore the best life insurance options tailored for your needs, we encourage you to book a call with one of our knowledgeable life insurance agents. We can provide personalized advice and insights, ensuring you make an informed decision that maximizes your benefits and aligns with your budget and long-term objectives.

Call 602.617.4107, contact us online or email quotes@azhealthinsurancebrokers.com for more information.

Whole Life Insurance Frequently Asked Questions

The Ultimate Guide to Universal Life Insurance: Benefits, Drawbacks, and Strategies

Mon, 06 May 2024 15:17:56 GMT

Life insurance provides a valuable safeguard for your loved ones’ financial future. While term life insurance policies only offer a benefit when the policyholder passes away during the term of the policy, universal life insurance provides unique benefits. Not only does universal life insurance provide protection in case of untimely passing, but it provides a cash value account that serves as an investment option for policyholders while they’re still alive.

Universal life insurance also offers flexibility, in that policyholders can adjust their premium payments to adapt to their unique financial situation. In this guide, learn more about the details of universal life insurance policies and potential benefits of having this type of life insurance .

Key Takeaways

Universal life insurance is a flexible, permanent Iife insurance option with adjustable premiums and a cash value component that grows on a tax-deferred basis.
Universal life insurance policyholders should actively manage their universal life insurance policy to ensure the premiums and cash value remain sufficient to prevent policy lapse while balancing death benefit options and cost.
Universal life insurance offers different management options, including permanent coverage and indexed for growth options. Each management strategy includes distinct features, risks and advantages, designed to meet diverse financial objectives and risk preferences.

Deciphering Universal Life Insurance: A Primer

Universal life insurance is a type of permanent life insurance that stands out with its unique features:

It has a cash value component, which is like a built-in savings account.
The cash value grows over time on a tax-deferred basis, providing a tax-advantaged way to save.
It offers flexible premiums, allowing you to adjust the amount you pay.
It provides a death benefit to your beneficiaries when you pass away.

These features make universal life insurance work as a versatile and attractive option for many individuals.

However, as with anything that offers great benefits, universal life insurance demands an understanding of one’s budget, goals, and risk tolerance. Your ability to adjust premium payments and tap into the policy’s cash value hinges on these factors. If you’re willing to navigate these complexities, a universal life insurance policy may be the financial beacon you need.

The Mechanics of Universal Life Insurance Policies

A closer look at the inner workings of universal life insurance policies reveals the factors that fuel their operation. These policies offer the much-needed ability to adjust premium payments, contributing to their flexibility.

A portion of your premium payment goes into a savings account, building the policy’s cash value over time, while the rest covers the death benefit and administrative fees. But remember, if your premium payments fall short of the minimum required, the policy’s cash value must cover the shortfall to prevent the policy from lapsing.

Premium Flexibility and Adjustments

Universal life insurance policies offer a significant advantage, namely the ability to modify premium payments. As your financial circumstances change, you have the flexibility to adjust your payments within certain limits, either raising or lowering them accordingly. This allows you to better manage your financial obligations. This means that if the policy’s cash value is sufficient, you may even reduce or pause premium payments, using the built-up cash value to cover costs.

However, to maintain coverage, the universal life insurance policy must have a positive cash value. This could mean potentially higher premiums if your financial situation changes or if you choose to increase your death benefit. It’s a balancing act, a test of financial acumen, but the flexibility it offers can be a significant advantage in the long run.

Understanding the Cash Value Growth

It’s key to comprehend another aspect of a universal life policy - the growth of the cash value. This portion of the policy earns interest over time, with the growth rate dependent on the insurance company’s performance and prevailing interest rates.

Some features of universal life insurance policies include:

Minimum performance guarantee to safeguard the cash value against fluctuations in market interest rates
High fees in the initial years that can hinder the accumulation of cash value
Requires patience and prudent financial management for potential substantial rewards

Death Benefit Choices in Universal Life Insurance

When it comes to death benefit options, universal life insurance provides considerable adaptability. Policyholders have the option of a level death benefit, which remains fixed, or an increasing death benefit where the cash value balance is added to the predetermined death benefit amount.

This flexibility allows policyholders to adjust their death benefit as their financial circumstances change. For instance, they can undergo a medical exam to increase the benefit or opt to reduce it to lower premium costs. However, it’s crucial to remember that reducing or stopping premium payments, as well as borrowing against the policy, risks reducing the death benefit and may lead to policy lapse if cash values are depleted.

Universal Life Versus Whole Life: Key Differences

As we further explore the realm of life insurance, it becomes vital to recognize the main contrasts between universal life and whole life insurance. While both are types of permanent life insurance, their features and benefits differ significantly.

Universal life insurance offers policyholders the ability to adjust premiums and death benefits, providing more control than whole life policies which have fixed premiums and a guaranteed death benefit.

Additionally, the cash value in a universal life policy can grow based on current interest rates, presenting potential for higher gains, whereas whole life insurance guarantees a steady increase, regardless of market conditions.

The Financial Implications of Universal Life Policies

While traversing the financial terrain of universal life insurance policies can be intricate, it’s a journey that is undoubtedly worthwhile. It’s crucial to evaluate the potential for cash value accumulation and how premium payments contribute to this growth over time.

Indexed universal life insurance plans are particularly influenced by the performance of the stock market indices, which can lead to a rise or fall of the plan’s cash value. However, policyholders need to be aware of the potential for larger premium payments if the cash value of a universal life policy falls below the required minimum.

Estimating Universal Life Insurance Costs

Calculating the universal life insurance cost is a fundamental step in the decision-making process for a universal life insurance policy. To get an accurate estimate, you need to consider factors such as:

your salary
mortgage
funeral costs
family size

However, bear in mind that premium costs are influenced by several factors, including:

Your age
Your health status
Your lifestyle habits
The desired amount of coverage

Therefore, it’s highly recommended to compare life insurance quotes from various providers to find the best value for your universal life insurance coverage needs.

Example

Lisa, in her early 30s and in excellent health, single-handedly manages a household with two children on an annual income of $160K. She faces a mortgage of $500K, vehicle loans of $60K, and other debts totaling $35K, leading to monthly expenses of $6K. Intent on building a lasting financial legacy, she considers a permanent insurance policy.

The solution: Lisa chooses a $2M death benefit, ensuring not only debt coverage but also providing a financial safety net for her children. Under a preferred rate, a universal life policy would cost her about $650 per month. In contrast, a whole life policy with the same benefits would run approximately $1500 per month.

Comparing Universal Life to Term Life Insurance Premiums

When contrasting universal life with term life insurance premiums, it’s crucial to account for the innate disparities between the two. Term life insurance only lasts for a set number of years and is cheaper, while universal life insurance is permanent and includes a cash value component.

This cash-value component makes universal life insurance more expensive compared to term life insurance. However, while term life insurance rates tend to increase as the policyholder gets older, universal life insurance premiums remain consistent regardless of the policyholder’s age.

Diverse Universal Life Insurance Options

Universal life insurance isn’t a one-size-fits-all solution. It offers various forms, each designed to meet diverse financial goals and risk tolerance levels.

There are two main strategies of universal life insurance: permanent life insurance at a more reasonable cost or indexed universal life tailored for cash-value growth. Each type offers different features and benefits to suit individual needs.

For instance, indexed universal life insurance plans offer flexibility combined with cash value growth potential tied to a stock market index. On the other hand, universal life geared towards having permanent coverage offers stable premiums and a guaranteed death benefit with a limited focus on cash value growth.

Indexed Universal Life Insurance and Market Ties

Indexed universal life insurance could be an appealing choice for those with a higher risk tolerance. These plans are linked to major stock market indices such as the S&P 500, Dow Jones Industrial Average, and Nasdaq, offering potential for higher returns.

However, it’s important to note that despite being tied to the performance of market indices, indexed universal life insurance may have a capped rate of return. This could limit your earnings in a strong market, but it also provides some protection against losses during market downturns.

Permanent Universal Life Insurance: Stability Over Time

At the opposite end of the spectrum lies universal life used as a type of permanent life insurance policy. This policy is often suitable for individuals looking for permanent death benefit coverage at a more reasonable rate than whole life.

Universal life insurance is designed to provide policyholders with stable premiums and a guaranteed death benefit, often compared to a blend of term and whole life insurance. However, compared to other types of universal life insurance, guaranteed universal life policies may offer little to no cash value accumulation.

Enhancing Your Policy with Riders

Universal life insurance policies provide a variety of add-ons, termed riders, which can augment your policy by providing additional protections or adaptability. For instance, family riders enable the policyholder to add coverage for additional family members, such as children, through child term riders.

Other popular riders include the guaranteed insurability rider, which allows policyholders to increase their death benefit at specific life stages without requiring a medical exam or health questionnaire. The waiver of the cost of insurance rider is also worth considering as it ensures that premium payments are paused in case of the policyholder’s disability, maintaining the death benefit as long as the annual amount is paid.

Selecting the Right Life Insurance Company for Your Universal Life Policy

Selecting the appropriate life insurance company for your universal life policy is a pivotal decision. It’s important to assess the company’s financial stability using ratings provided by independent agencies such as AM Best.

Customer service is another important consideration. You can review customer complaint records from organizations like the National Association of Insurance Commissioners (NAIC) and look at customer satisfaction rankings from J.D. Power to gauge the insurer’s reliability and quality of service.

Consulting with a knowledgeable financial advisor or life insurance agent is also recommended when choosing and evaluating complex universal life insurance policies.

Navigating the Complexities of Universal Life Insurance

Universal life insurance, with its assortment of options and adaptable features, can be intricate. It requires active management of premium payments, cash value growth, and investment choices particularly in policies that emphasize cash-value growth.

Policyholders must carefully manage the funding of their universal life insurance policies, as inadequate funding can lead to policy lapse. It’s also essential to keep an eye on the cash value and ensure that it doesn’t fall below the required minimum to prevent policy lapse.

Summary

As you navigate the complexities of universal life insurance, you've discovered it's more than just a policy; it's a strategic financial tool offering flexibility and growth potential through its cash value component and adjustable premiums. Whether you're aiming to secure your family's future, adjust your financial plans with changing circumstances, or optimize your long-term financial strategies, universal life insurance offers a versatile solution.

Ready to Explore More? Connect with one of our expert life insurance agents today to discuss how universal life insurance can be tailored to your unique financial needs and goals. They can guide you through the nuances of different policy options, helping you make an informed decision that aligns with your long-term objectives. Don’t navigate this alone—book a call now and take the first step towards a secure and flexible financial future with universal life insurance.

Universal Life Insurance Frequently Asked Questions

What Is COBRA? An Employee’s Guide to COBRA Insurance

Mon, 22 Apr 2024 23:40:57 GMT

The Consolidated Omnibus Budget Reconciliation Act (COBRA) can impact people when they experience certain life changes, such as losing a job, unemployment, retirement, divorce and death. When you need health insurance, and you’re considering COBRA, reference this guide for what to know about COBRA health insurance.

Key Takeaways

Certain qualifying events may make an individual eligible for COBRA health insurance coverage, for up to 36 months, depending on the circumstance.
In some cases, paying for COBRA insurance coverage can be much more expensive than choosing a private health insurance plan.
To compare your options between COBRA insurance, private health insurance and other plans, it’s best to have a free consultation with an insurance broker who can present all options based on your unique healthcare needs.

Understanding COBRA

The U.S. Congress passed COBRA in 1985 to help Americans who lose their employer-sponsored group health insurance . Under COBRA, an employee who has experienced a qualifying event can continue to carry their employer’s business health insurance for up to 18 or 36 months, depending on the circumstances.

Who’s eligible to continue their work health insurance under COBRA? According to the U.S. Department of Labor:

Employees and former employees
Their spouses/former spouses
Their dependent children

COBRA coverage enables employees and their families to take care of their essential medical needs, which include:

Inpatient hospital care and emergency room visits
Physician care
Surgery and other major medical procedures
Vision and dental care
Prescription drugs

Who Qualifies for COBRA?

COBRA generally applies to all private-sector group health insurance plans maintained by employers that have more than 20 employees for at least 6 months out of the year. The employee must have been covered by their former employer’s group health insurance plan when one of these qualifying events occurs:

A covered employee dies
A covered employee loses their job or receives a reduction in hours for reasons other than gross misconduct
A covered employee becomes entitled to Medicare
A covered employee gets divorced or legally separated
A child loses their dependent status (and coverage) under the employer’s plan

If you experience a qualifying event, your employer must notify you that COBRA is an option. You have 60 days from the time you’re notified to sign up for COBRA continuation coverage. If you reject COBRA and later change your mind, that’s OK – you can still sign up, as long as you’re within the 60-day period.

Please note: COBRA does apply to plans sponsored by state and local governments. It does not apply to health plans sponsored by the federal government, churches and some church-related organizations (more on that below).

How Long Does COBRA Last?

COBRA continuation coverage begins on the date of the qualifying event and extends for 18 or 36 months, depending on the nature of the event.

Termination (for reasons other than gross misconduct) or reduction in hours: The employee, spouse and dependent child(ren) are eligible for 18 months of healthcare coverage. In certain circumstances, such as disability or the occurrence of a second qualifying event, you and/or your spouse and children may be entitled to 18 months of additional continuation coverage, for a total of 36 months.
Employee enrolls in Medicare: The spouse and dependent child(ren) are eligible for 36 months. Some factors affect the actual period of continuation coverage, including whether your Medicare entitlement happened before or after your end of employment or reduction in hours. Contact the U.S. Department of Labor’s Employee Benefits Security Administration for more information.
Divorce or legal separation: The spouse and dependent child(ren) are eligible for 36 months.
Death of employee: The spouse and dependent child(ren) are eligible for 36 months.
Loss of “dependent child” status under the plan: The dependent child is eligible for 36 months.

Does COBRA Cost Extra?

Yes. COBRA health insurance can cost quite a bit more than you were paying previously, depending on how much of your premium your employer paid for you. Your employer will likely require you to pay the full cost of the coverage, plus a 2% administration fee.

Can You Lose COBRA Coverage?

Yes, you can lose COBRA coverage. If your former employer stops offering group health insurance , or if they go out of business, you will lose COBRA coverage. There are other reasons you could lose COBRA coverage, including:

You don’t pay your premiums.
You enroll in a new group health insurance plan with a new employer, and that new plan has no waiting periods, coverage limits or exclusions.
You become eligible for Medicare.

Alternatives to COBRA

As mentioned, employees of the federal government, churches and some church-related organizations do not qualify for COBRA. Federal employees may be able to continue their health benefits through something called Temporary Continuation of Coverage (TCC), which is similar to COBRA. Talk to your human resources representative if you think this applies to you.

If you’re a federal employee who doesn’t qualify for TCC, or if you work at a church or related organization, you will have to find another way to obtain health insurance.

In addition, just because you are entitled to elect COBRA, that doesn’t mean it’s always a good idea to take it. You might find more affordable individual health insurance or family health insurance coverage through any of the following means.

1. Join your spouse’s employer-sponsored plan

Losing your health insurance counts as one of the qualifying events that allows your spouse to add you to their plan outside of the usual enrollment period. If your spouse has their health insurance through their employer and you want to join, they must request special enrollment within 30 days of you losing your previous health insurance.

2. Obtain insurance through the ACA marketplace

You can also explore your available options on the Affordable Care Act (ACA) marketplace (also known as the “ACA exchange”) or your state’s health insurance marketplace, if your state has one. If you’re looking for health insurance in Arizona , know that Arizona doesn’t have a state health insurance marketplace. You’ll need to use the federal ACA marketplace .

The same event that qualified you for COBRA also qualifies you to receive a special enrollment period to obtain a plan on the ACA marketplace.

Health insurance plans purchased through the ACA marketplace may be eligible for two subsidies to defray the cost of insurance:

The premium tax credit health insurance subsidy, which is a tax credit that lowers monthly premiums
The cost-sharing subsidy, which may qualify you for cost-sharing reductions

Important: You cannot use these subsidies to help reduce your COBRA costs. These subsidies are only available on plans purchased through the ACA exchange.

If you want to take advantage of these subsidies, you’ll have to reject COBRA continuation coverage and enroll in an ACA plan during your 60-day special enrollment period. Remember, there are additional income and other requirements to qualify for a subsidy. Learn about these requirements at Healthcare.gov .

3. Purchase a private policy

Another option is to purchase a private policy through a broker or agent. Here’s the good news: when you purchase a private policy through a professional health insurance broker , oftentimes you can get a plan that’s less expensive than COBRA and that’s better tailored to your individual needs. An insurance professional can help you find a plan that saves you money by not overpaying for plan features you probably won’t use.

Tax Credits and Deductions

If you’re looking at other possible ways to reduce the high cost of COBRA, there’s a tax deduction that could help reduce the cost of health insurance, including COBRA continuation coverage. Under current Internal Revenue Service (IRS) regulations, you may be able to claim a deduction on your taxes if total healthcare costs – including COBRA premiums – exceed 7.5% of your adjusted gross income on your federal tax return.

Questions About COBRA? Contact AZ Health Insurance Brokers

If you have any questions about COBRA or health insurance in general, please reach out to the friendly team at AZ Health Insurance Brokers. We’re happy to talk about your specific situation and determine what your options are.

Remember that with private health insurance plans, you can customize the type of coverage you get based on your needs and budget. This means, we can likely get you into a great health insurance plan that’s cheaper than what you’d pay for COBRA.

Work through all this with an insurance professional. The experts at AZ Health Insurance Brokers would love to help you. Contact us online , call 602.617.4107 or email quotes@azhealthinsurancebrokers.com .

COBRA FAQs

What Is a QSEHRA? How Does a QSEHRA Work? A QSEHRA Guide for Small Business Owners

Wed, 17 Apr 2024 03:25:37 GMT

Did you know? There are many ways to offer healthcare coverage to employees , and they’re not limited to traditional group health insurance . For small business owners who want other options, a qualified small employer health reimbursement arrangement (QSEHRA) is an alternative worth considering.

Key Takeaways

2024 QSEHRA Contribution Limits: $6,150 individual / $12,450 family.
A QSEHRA can be a worthwhile alternative for small business owners who want to provide healthcare coverage that’s not traditional group health insurance .
QSEHRAs provide flexibility, in that employers can determine the exact amount of financial support they’d like to provide employees.
QSEHRAs can provide coverage for diverse medical costs, including out-of-pocket healthcare costs, prescription drugs and health, dental and vision insurance premiums.

Is a QSEHRA a good fit for your company’s needs? How do you set up a QSEHRA? What are the QSEHRA limits and rules?

This guide walks you through the most commonly asked questions about QSEHRAs.

What Is QSEHRA?

QSEHRA was signed into law in December 2016, as part of the 21st Century Cures Act . It’s considered a type of health reimbursement arrangement (HRA), which is a broad term that refers to an employer-funded plan that reimburses workers for costs related to qualified medical expenses. The Internal Revenue Service (IRS) outlines the rules for a QSEHRA here.

A QSEHRA isn’t a traditional group health insurance plan. Rather, a QSEHRA allows small employers to offer their workers untaxed reimbursement of specific healthcare costs, including health insurance premiums and coinsurance, provided workers maintain minimum essential coverage.

“Minimum essential coverage” is health insurance that satisfies the Affordable Care Act’s (ACA) list of services that must be covered. Plans that qualify as minimum essential coverage include individual health insurance plans (including plans purchased on the ACA marketplace ), Medicare and most Medicaid plans, among others.

What QSEHRA Qualifications Must a Business Meet?

Non-profits, for-profits and start-ups are all eligible to participate in a QSEHRA for healthcare coverage at work , provided they meet certain requirements. To qualify for a QSEHRA, a small business or non-profit employer must:

Have fewer than 50 full-time employees
Not offer group health insurance to their employees
Provide the QSEHRA using the same terms to all full-time employees

Note: An employer does not have to offer a QSEHRA to the following employees, but they may if they want to:

Part-time and seasonal employees
Employees who have been with the company for less than 90 days
Employees who are younger than the age of 25

How Does a QSEHRA Work?

Employees don’t contribute to a QSEHRA. Only employers contribute to them. Contributions are tax-deductible to the employer, who then uses the money in the fund to pay back employees for certain healthcare expenses.

Essentially, it works like this:

Employers set a monthly allowance, which employees may put toward qualified healthcare expenses. There are contribution limits, which are covered below.
Employees make healthcare purchases based on their needs.
The employer reimburses them up to their allowance amount.

What Are the QSEHRA Limits for 2024?

For 2024 QSEHRA limits , small business employers may offer up to $6,150 per self-only coverage employee and up to $12,450 per employee with family coverage. Provided workers maintain the minimum essential health insurance coverage, employer coverage payments are tax-free.

What Are the QSEHRA Rules of Notification?

If you decide that offering a QSEHRA is a good fit for your company, employers must follow certain QSEHRA rules of notification , as set forth by the IRS. Employers must notify their employees:

That a QSEHRA benefit will be available at least 90 days in advance of the start of a new year, or at the beginning of a new employee’s eligibility
The amount of the annual benefit
That employees need to report their QSEHRA benefit to the marketplace where they apply for premium tax credits
That the employee will have to pay taxes on the benefit for any month in which they did not maintain health coverage

What Expenses Can a QSEHRA Cover?

IRS Publication 502 defines what medical expenses are eligible for reimbursement from a QSEHRA. The list is long, but a sample of eligible expenses includes:

Health, dental and vision insurance premiums
Out-of-pocket healthcare costs
Prescription drugs
Over-the-counter medication
Co-pays and deductibles
Chiropractic care

Note: Employers can limit the list of eligible expenses, if they wish.

What’s the Difference Between an HRA and a QSEHRA?

A QSEHRA is a type of HRA. There are many different types of HRAs, including an individual coverage health reimbursement arrangement, or ICHRA , and they all have various distinctions and eligibility requirements. These differences lie in:

The type of business that can offer the types of HRAs
Which employees can participate in the HRA
How the HRA’s benefit affects the employees’ premium tax credits
Whether the employer may offer the HRA along with group health insurance
The limit on how much untaxed money an employer can offer employees

Are QSEHRA Reimbursements Taxable?

Reimbursements to employees from a QSEHRA are not taxed, with one important qualification: the employee must maintain minimum essential health insurance coverage. Employees will have to pay taxes on their benefit for any month in which they do not maintain minimum essential health insurance coverage.

What Are the Benefits of a QSEHRA?

Your small business might be a good fit for offering a QSEHRA for the following reasons.

A QSEHRA enables small employers to offer healthcare benefits when they may not otherwise be able to. This is important for employee attraction and retention, as the U.S. Chamber of Commerce reports health coverage is the top benefit employees want from a job.
Employers can set the allowance caps in their QSEHRA, which gives them control over their expenses. There are no surprises or hidden costs.
There are no minimum participation requirements. If you have one eligible employee, you can offer a QSEHRA.
There are no geographical restrictions within the U.S. Remote employees and/or employees in other states can participate, as well.

Another potential advantage is that an employee can use their allowance for premium and non-premium expenses. This is not allowed under a group health insurance plan.

How Do I Set Up a QSEHRA?

The general process to set up a QSEHRA entails the following steps.

Decide if you will self-administer the plan or if you will use a third party. At AZ Health Insurance Brokers , we have the knowledge and experience to help you devise a solution that fits your needs and budget.
Choose a start date. If you offer a group health insurance policy , you must cancel it before the QSEHRA can take effect.
Decide who among your employees will be eligible to participate. Remember, while you must offer the benefit to full-time employees, you may include part-timers, as well.
Set your allowances. You may offer up to $6,150 per self-only coverage employee and up to $12,450 per employee with family coverage.
Get all your plan documents and compliance policies in order.
Notify employees about the QSEHRA (see the notification requirements above).
Meet all deadlines.
Stay compliant. If you fail to do so, the IRS could determine your QSEHRA to be invalid, and you (and potentially your employees) could get taxed on all of your reimbursements. Check out IRS Notice 2017-67 for more on this.

Want to Set Up a QSEHRA for Your Business? Contact AZ Health Insurance Brokers

Setting up a QSEHRA can be tricky on your own. We at AZ Health Insurance Brokers are experienced health insurance professionals. We can help you better understand QSEHRAs, answer additional questions you may have and help you determine if a QSEHRA is the best fit for your small business.

Contact us online today to set up a no-cost, no-obligation meeting to discuss your needs. Or, call us at 602.617.4107, or email quotes@azhealthinsurancebrokers.com .

Dental Insurance: Pros & Cons for Employers, Individuals, Families

Thu, 04 Apr 2024 17:00:41 GMT

Oral health is an important part of overall health. The Centers for Disease Control and Prevention (CDC) reports poor oral health is linked to chronic diseases, including heart disease and diabetes.

Despite health associations like these, many people neglect going to the dentist. The CDC reports fewer than two-thirds of adults ages 18-64 had a dental visit in the past year. Out of children ages 2-17 years old , nearly 15% of kids didn’t go to the dentist in the past year.

Dental insurance typically covers basic procedures, like extractions and fillings, as well as major procedures, like crowns and bridges. Cosmetic care is typically not included in dental plan coverage. Some plans will cover orthodontics.

Dental plans are considered more of a benefit, rather than traditional insurance, since plan holders will have to pay for work done beyond the out of pocket annual maximum. But like the National Association of Dental Plans (NADP) reports , only around 5% of people reach their annual maximum for in-network services. If you’re like the vast majority of Americans, you can get all your dental needs covered with a low-cost dental plan.

Is dental insurance worth it?

In most cases, dental insurance is a major benefit for employees, individuals and families. At Arizona Health Insurance Brokers, we typically break down the benefits using this equation.

Annualized cost for dental insurance: On the higher end of the expense scale, this would be around $35/month x 12= $420/year; however, dental insurance can be as low as $15/month x 12 = $180/year, depending on a variety of factors
Cost of 2 preventive checkups: The average dental cleaning and exam costs around $175 out of pocket. The cost per year for preventive care, then, would be around $350/year out of pocket.
Other dental work average costs out of pocket:

X-rays: $146
Tooth extraction: $200
Dental crown: $1,288
Dental filling: $147

As you can see, dental insurance costs make it manageable to pay for preventive care on a monthly plan. Plus, you’re covered for dental maintenance, like cavities.

Not to mention, prevention helps you avoid more time-consuming (and sometimes painful!) dental work. If you’re offered dental insurance through your employer, you may even be able to get part or all of your dental insurance covered for free.

Benefits of an Employer Dental Plan

If you’re an employer, offering dental insurance can be a major selling point for attracting talented candidates and retaining staff. According to the NADP, workers say dental coverage is the top benefit they want, following general health insurance . Employers can set up dental plans at no cost, so doing so is an instant advantage. Since only 41% of employees working in private industries in the U.S. in 2023 had an employer-sponsored dental plan , businesses can stand out by offering this valuable benefit.

Employers can offer dental plans to employees as voluntary benefits, which means the employee can choose a plan if they want, at no cost to the employer. Employers also have the option to contribute to employee dental plans, in which case the rates are typically a little better overall.

Another advantage for health insurance for employees is dental coverage can be installed as a pre-tax benefit.

Employer dental plans are very customizable. Depending on the group size, employers may be able to offer more than one dental plan, such as one with orthodontics coverage and one without. That variety can also be attractive for employees.

Also, typically with employer health insurance plans , there may not be waiting periods for major dental work. While an employer dental plan may be a bit more expensive for small groups, being able to get the dental work you need done right away makes it worth it for employees.

Considerations for Employer Dental Plans

For both employees and individuals who have a dental plan, it’s important to be aware that dental coverage carriers have a maximum liability. Carriers won’t pay beyond that maximum amount. Ultimately, this is one of the main reasons for the cost difference between medical and dental insurance.

However, since dental coverage has such a lower monthly cost, on average, compared to medical plans, they’re easier for employers to contribute to and for employees to manage.

If you do pay for dental health insurance coverage for your employees and they don’t use it, you won’t be refunded for any unused coverage. Dental plan compensation can be a major benefit for employees who are looking for that from employers, but when people don’t use the benefit, it loses its value.

Employers should be aware there are a lot of different dental carriers and options. It can be overwhelming to navigate. It’s helpful to work with a dental insurance broker , because you’ll know exactly what to look for in the best dental plan for your employees.

Benefits of an Individual / Family Dental Plan

If your employer doesn’t offer insurance , you’re aging out of your parents’ health insurance coverage, or you’re self-employed and need insurance , you may be considering your own dental private insurance plan . For individuals and families who are looking for dental plans on their own, it’s helpful to revisit the equations above.

With dental plan costs, you’ll be almost breaking even for going in for routine teeth cleanings and exams twice a year, which is recommended for optimal oral health. If you do have to have periodic work done, like a filling for a cavity, you’ll typically save money.

Dental insurance can give you peace of mind that most dental costs for you and your family will be covered. Preventive care that’s covered by a dental plan can also help you identify problems early, which could save you time and money in future treatment.

A dentist also helps educate you and your family about proper oral health, which can lead to improved overall health. Dentist visits are an important part of protecting your and your family’s well-being.

Considerations for an Individual / Family Dental Plan

When you get a dental plan, you’ll immediately have coverage for preventive dental teeth cleanings and exams. If major work needs to be done, there are generally waiting periods, depending on the plan you choose. If you need immediate dental care, for your health, you may want to get it now and pay out of pocket, depending on your dentist’s recommendations.

It's important to consider the waiting period now because, should major dental needs come up in the future, you won’t be able to get immediate coverage for care unless you’re already insured. By getting low-cost dental insurance now, you can have peace of mind that you won’t have to choose being waiting and paying higher costs for dental care you need.

For dental orthodontics for a child, there’s generally a maximum amount the plan will pay after the waiting period has been met. Group dental plan coverage is typically a better option if it’s possible to wait. If not, sometimes cash or a payment plan may be the better option.

Contact Arizona Health Insurance Brokers for Dental Insurance Info

Ultimately, whether or not you can benefit from dental insurance will depend on your unique needs as an individual, family or employer. The professionals at Arizona Health Insurance Brokers are here to help, whether you need health insurance for yourself, or you want to offer group health insurance to employees.

We’re experienced in providing employer group insurance plans , dental insurance for individuals and dental plans for families . Contact us to see what dental plan makes sense for you.

Dental Insurance FAQs

Everything Employers Should Know About Health Savings Accounts (HSA)

Sat, 16 Mar 2024 21:26:38 GMT

As a business owner, you’re probably familiar with retirement investment accounts like 401(k) accounts, which you may currently offer to your employees. Another way to provide your staff with financial security options is to provide a health savings account (HSA) plan.

HSA plans provide flexibility for healthcare coverage. As employees (and potentially you, their employer) contribute to their HSA plans, they accumulate dollars that can go towards covering future healthcare costs.

HSA plans offer some unique benefits your employees may be interested in, as well as potential advantages for your business. Here’s what business owners should be aware of with HSA plans.

First: What Is an HSA?

An HSA is a similar to a flexible savings account (FSA), only it’s used for healthcare costs. HSA participants add money to their account and can use those contributions to pay medical expenses tax-free now or in the future. Balances roll over year-over-year, so participants always retain control of and never lose their HSA contributions.

HSAs were created to pair with high deductible health plans (HDHPs), to help offset HDHP costs. A benefit of offering an HDHP is that there are typically lower monthly premiums compared to lower-deductible group health insurance plans. That can lower the cost-sharing for employers. In order to offer HSA plans to your employees, you must also offer an HDHP for your business health insurance .

Compared to a traditional copay plan, the biggest differentiator with an HDHP-designated plan is that there are no copays. Members pay 100% of the “contracted rate” for each service, assuming it’s in network, until the deductible is met.

On a traditional copay plan, copays only apply towards the out-of-pocket maximum (OPM). On an HDHP, everything hits the deductible. Once the deductible is met on an HDHP, then the plan starts payout more aggressively.

It’s important for employers to be aware that not all HDHPs are HSA-eligible. Just because an HDHP deductible is above a certain amount doesn’t mean a plan-holder can contribute towards an HSA.

Generally, HSA-eligible plans state “HSA” in the plan title. In order to be able to contribute towards an HSA, the HDHP plan has to be HSA-qualified.

Another note is that employees cannot be eligible for an HSA if they’re a dependent or if they’re listed on another person’s tax returns. They also can’t have any other health insurance coverage .

How Can Employers Use HSA Plans & Deploy Them?

Benefits of HSA Plans

A major benefit of an HSA plan is that the contributions to that plan always stay with that employee. Anyone can contribute to an HSA plan to maximize contributions to it, including a spouse or relative. An HSA plan can provide health security and peace of mind, which current and prospective employees may be interested in.

HSA plans are a very good tax-sheltering vehicle for your employees. An HSA is the only vehicle in which money can be contributed tax-free, can grow tax-free and can be taken out tax-free.

Contributed tax-free: When an employer offers an HSA, contributions are deducted from a paycheck before tax. The employee won’t have to pay taxes on that income that goes toward an HSA, which can lower their overall taxes. Plus, employers don’t have to pay for payroll taxes on the pre-tax contributions of employees.
Grow tax-free: If a member has more than $2,000 in their HSA, it can be invested and earn tax-free interest. Interest on HSA contributions or any returns from investing HSA assets in a mutual fund are never taxed.
Taken out tax-free : As long as the money is spent on qualified HSA procedures and prescriptions, HSA participants don’t have to pay taxes on those dollars.

HSA plans can be especially beneficial for long-term healthcare costs. HSA funds can pay for Medicare premiums , including Part A, B, C and D, once participants turn 65 years old.

In that way, an HSA plan can serve as a retirement asset for your employees, since healthcare costs typically increase with age. The Fidelity Retiree Health Care Cost Estimate reported the average retired couple ages 65 years old in 2023 needed $315,000 saved (after tax) for healthcare expenses.

Participants who are older than 65 years old can also use their HSA funds to cover non-medical expenses without having to pay a penalty. For reasons like these, offering an HSA plan may help you stand out as an employer and can boost your recruitment efforts.

Another financial benefit of HSAs for employers is that any contributions you make to employee HSAs can be used as a small business income tax deduction.

What Can HSA Funds Be Used For?

Eligible HSA expenses have continually expanded , as HDHP expenses now include healthcare such as telehealth appointments, over-the-counter drugs and feminine care products. The Internal Revenue Service (IRS) defines medical and dental expenses here .

Qualified medical expenses for HSAs may include:

Health plan deductibles
Dental and vision care expenses
Prescription drugs
Counseling
Copays

If your current employees become unemployed in the future and receive unemployment compensation, they’ll also be able to use HSA funds to pay Consolidated Omnibus Budget Reconciliation Act ( COBRA ) premiums, healthcare coverage premiums and long-term insurance premiums.

The IRS announced in 2024, the max annual contribution for HSA plans is $4,150 for individuals with self-only HDHP coverage (up from $3,850 in 2023) and $8,300 for individuals with family HDHP coverage (up from $7,750 in 2023). As you can see, the max general contribution generally increases each year.

Things to Consider With HSA Plans for Employers

Since HSA plans are paired with HDHPs, they likely don’t make sense for employees who frequently visit the doctor or who take a relatively expensive medication on a recurring basis. The employee will have to pay 100% of their healthcare costs until they meet the HDHP deductible.

With a copay group health insurance plan , employees would typically pay less if they’re using healthcare services more frequently. For example, if someone just had a baby and they need biweekly checkups, a traditional copay health insurance plan may make more sense. Paying 100% for a specialist visit on an HSA plan may cost an employee hundreds of dollars per visit, whereas a more traditional copay health insurance plan would typically cost less.

Also, healthcare expenses and illness can be unpredictable. That can make it difficult to accurately budget and save the appropriate amount of funds in an HSA for future medical expenses.

For these reasons, some current and potential employees may not want an HSA plan compared to a more traditional copay healthcare plan .

Also, not all procedures are eligible for HSA coverage. Like various other types of healthcare plans, voluntary and elective treatments generally aren’t covered by HSAs.

As an employer, know that whatever HSA funds an employee has accrued will always belong to that employee. If you contribute to an employee’s HSA plan, those financial contributions will stay with the employee, whether they remain at your company or leave.

However, since that’s something that benefits employees, that could make your company an attractive employer if you offer HSA contributions to employees.

HSAs also reward proactive health management. People who focus on staying active and maintaining a balanced lifestyle often benefit the most from these plans. Partnering with professionals who specialize in fitness and long-term wellness, such as Anastasii fitness , a Phoenix-based personal training company that helps clients achieve sustainable weight-loss and health goals can help employees reduce preventable healthcare costs and make the most of their HSA funds over time.

When Does an HSA Make Sense for an Employer?

You might choose to offer an HSA if you offer an HDHP and your employees are interested in growing their health savings. The OPM is typically slightly less compared to more traditional, similar copay plans, which can also benefit you and your employees with cost savings.

HSA plans also make a lot of sense for employees who know they’ll meet their OPM, due to the tax liability assistance. If you offer a HDHP to employees, an HSA can supplement that insurance plan for employees and provide your business with tax benefits.

There’s an abundance of health insurance options for employers to choose for their employees, including options like a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) and an Individual Coverage Health Reimbursement Arrangement (ICHRA) .

Reach out to Arizona Health Insurance Brokers to see if an HSA employer-based plan is the best choice for your workforce. Call 602.617.4107, email quotes@azhealthinsurancebrokers.com or contact us online for Arizona employer health insurance options .

Health Savings Account (HSA) FAQs

3 Mistakes to Avoid When Buying Insurance

Sat, 20 Jan 2024 17:39:35 GMT

In the U.S., having health insurance is essential to avoid high out-of-pocket costs for medical treatment. According to the Kaiser Family Foundation , some reasons to get health insurance include:

Uninsured patients are typically charged up to 4 times for hospital service, compared to what health insurers and public programs actually pay.
One-third of uninsured adults are asked to pay for the full cost of medical care before they can see a doctor, which typically results in credit card charges, negotiating payment schedules and/or having to source cash to cover the charges. Otherwise, patients may be turned away if they can’t pay.
Uninsured adults were more than 2 times as likely as those with insurance to have difficult paying medical bills.

Health insurance helps cover your medical costs and can cover preventive care that keeps you healthy. It also provides peace of mind that whatever medical expenses you have, you have a plan in place to support those payments.

Whether you currently have a health insurance plan in place for yourself through an individual plan and/or your loved ones through a family health insurance plan , or you’re new to purchasing insurance altogether, there are a few considerations we recommend keeping in mind when buying health insurance.

The following are the most common mistakes we see when people buy health insurance. Avoid these so that you can ensure you get the best plan that works for your needs.

1. Buying Based on the Name of the Insurance Company

The first common mistake we see when purchasing health insurance is choosing a provider based on name recognition, without comparing all available options. Even if you’ve had health insurance through a specific provider in the past, that provider may not necessarily be the best choice for where you currently are in life.

If you’re used to having a group plan based on your employer or your previous business, and you switch to an individual or family plan through the HealthCare.gov Marketplace or a private carrier, many times, what the networks offer for business health insurance versus individual insurance is different. For example, the plans Blue Cross Blue Shield and United Healthcare offer through an employer may be significantly different than what Blue Cross Blue Shield and United Healthcare offer for individual and family plans.

You might purchase a plan with the same insurer you had at a previous employer, but you may no longer be in network with your preferred doctor on an individual or family plan. In this case, in order to keep your preferred doctor, you’d need to repurchase a new plan, or switch doctors altogether.

That’s why, when you’re buying insurance for yourself, you need to make sure to verify the network for the plan you’re going to be purchasing. It’s helpful to research the plan’s terms and doctors that are in-network, or work with a health insurance broker to do so, so you understand what new terms are available in the plans you’re considering.

2. Not Taking Frequency of Use Into Account

Another mistake we see when people purchase health insurance is not taking their medical needs and frequency of use into account. Depending on how often you (and your family, if applicable) need medical services, that will influence what the best health insurance choice would be.

For example, let’s say a family doesn’t go to the doctor too often, and they want low-cost medical coverage. In that case, a health savings account (HSA) where the policyholder contributes money to use for medical expenses tax-free may make sense. However, if the family ends up having to visit the doctor several times in a year due to sickness or needs to go to urgent care for a medical emergency, the family may have to pay out-of-pocket until they meet the deductible. An HSA may not make financial sense in this case.

If someone knows they’re going to meet their out-of-pocket maximum (for example, they have an upcoming surgery), they can purchase an insurance plan that saves them the most money across the board related to premiums and out-of-pocket maximums. Frequency of use should always be a consideration when individuals and families are considering health insurance plans.

3. Underestimating Your Income

Income should be another health insurance consideration when you’re purchasing insurance. Income impacts your ability to pay certain premiums, as well as to pay for out-of-pocket expenses to get the medical care you need.

Income should be a consideration especially when you’re considering HealthCare.gov Marketplace plans. That’s because for Marketplace policies, individuals may qualify for discounts based on income. However, if you underestimate your income, and it ends up being higher by the end of the year, you’ll have to back-pay the difference when you pay your taxes.

For self-employed people, it can be difficult to estimate the difference in estimated income and actual income. That’s why, even if you think you qualify for health insurance discounts now, what you owe could change by the end of the year.

Knowing all your options, including different options based on estimated income, can help you make the most informed choice. For underemployed, unemployed and self-employed people, it makes sense to consult with a health insurance broker who can analyze all your available options to find you the most cost-effective choice.

Need Help With Health Insurance?

If you need health insurance for the first time, or you’re not sure your current plan is the best for yourself and your family, talk to the AZ Health Insurance Brokers team. We can help you understand how your current plan is working for you, and present you with other options to consider that could lower what you’re paying and/or provide better healthcare coverage for your and your family’s needs.

We provide free consultations and are here to help. Contact us online , call 602.617.4107 or email quotes@azhealthinsurancebrokers.com , and we’ll be in touch.

Life Insurance Examples: How Life Insurance Can Help Your Family

Wed, 21 Jun 2023 17:50:31 GMT

Life insurance is an essential policy for most individuals and families. But with lots of different options to consider, selecting a policy can be challenging.

According to a recent study by IBM , 46% of Millennials were confused about life insurance policy specifics. There’s also the question of whether or not you need life insurance at all, especially if you don’t have dependents.

Whether you’re married with children, or you’re single and independent, life insurance can help financially protect your loved ones when you pass on. Expenses like funeral costs and outstanding debts can add up. Life insurance puts financial protection in place to give you peace of mind now that outstanding expenses will be covered.

There are lots of different life insurance policies to consider, depending on your unique financial situation and what you want to provide your loved ones, should you pass away. The following are some unique examples of how life insurance can help individuals and families secure financial protection now and in the future.

1. Married Parents with Adult Kids

Tom and Julie are 59 and 46 years old, respectively. Tom is the breadwinner of the family. He owns a small business and makes an annual income of $175K a year.

The couple’s home is paid off, and their kids are grown up. Tom wants to make sure he’s paying into a life insurance policy that will not expire and guarantee his wife receives a death benefit when he passes away. He plans to retire at 65 years old and wants to make sure his policy will remain viable beyond his having to make a monthly insurance payment.

The solution: Tom applies for an indexed universal life insurance policy with a death benefit of $100K. Tom overfunds the policy at $500 per month for the first year, then increases his payment to $700 per month from ages 60 to 64 years old. By the time Tom’s 65 years old, he has paid enough into the policy to ensure coverage will last up to age 120, without him having to continue to pay premiums.

2. Policies to Supplement Work Life Insurance

Nancy and Richard are in their 40s and have two teenaged children. They have $120K left on their mortgage and owe $20K in miscellaneous debt.

Both parents work full-time and have $100K life insurance plans through their employers, but their coverage will end if they leave their employers. They want a private life insurance policy, attached directly to them, to ensure they’ll still have insurance if they switch or lose their jobs.

The solution: Richard and Nancy apply for $500K 30-year term life insurance policies, with living benefits attached. The living benefits will pay a portion of the death benefit early, in the event of a critical, disabling or terminal illness. Their private policy will provide enough coverage to cover the cost of their home, remaining debt and outstanding expenses, if one of them were to pass away.

3. Building Retirement Income with Life Insurance

Ming and Marcus are in their mid-30s. Marcus is the breadwinner, while Ming works inside the home, taking care of their young children. Marcus doesn’t have life insurance yet and wants a substantial death benefit, as well as a policy that builds retirement income as he pays premiums.

The solution: Marcus applies for an indexed universal life insurance policy with a death benefit of $900K. To build out the cash value portion of the policy to supplement his retirement income, he considers a $100K initial out-of-pocket premium payment, also called a premium outlay. To keep the initial cost of insurance low, he opts to split that into $50K for year one and $50K for year two. Then, he will pay $24K per year until the age of 65 to optimize the cash value growth.

Assuming Marcus is relatively healthy and is approved for a standard rate, conservative estimates show he’d be able to take out $150K per year from the policy from the ages of 65 to 100 years old.

4. Term Life Insurance Policies to Cover Debt & More

Isaiah and Ava have three young kids. Isaiah is the main provider for the family, while Ava works inside the home taking care of the kids. Isaiah has an income of $100K per year. The couple owes $350K on their house, $35K on vehicles and $15K in miscellaneous debt.

The solution(s): Isaiah and Ava have several term life insurance policy solutions to choose from.

Isaiah can purchase a term life insurance policy with a death benefit of $400K to pay off outstanding debts.
Isaiah can purchase a term life insurance policy with a death benefit of $500K to pay off outstanding debts and cover burial and miscellaneous expenses.
Isaiah can purchase a term life insurance policy with a death benefit of $1.5M to pay off outstanding debts and offer replacement income, so Ava doesn’t have to worry about getting a job immediately.
Ava can get a term life insurance policy with a death benefit of $500K to help with end-of-life expenses and get extra financial help to pay for someone to take care of the kids while Isaiah continues to work.

5. Term Life Insurance for Peace of Mind

Liam and Sarah have three children who live at home. They each make $100K, totaling a household income of $200K. Their debt includes $600K on their house, $70K on vehicles and $30K in miscellaneous debt. They’re both 35 years old and are in good health.

The solution(s): Liam and Sarah have different low-cost term life insurance options that ensure their family’s covered.

Liam and Sarah can both purchase a term life insurance policy each with a death benefit of $700K to pay off debt in case one of them passes away. A 10-year term life insurance policy would roughly cost them each $50 per month.
Liam and Sarah can both purchase a term life insurance policy each with a death benefit of $2M to pay off debt and offer income replacement in case one of them passes away. This option offers the family more insulation and would roughly cost them each $100 per month.

6. Disability & End-of-Life Insurance Coverage

Tim is a 40-year-old single man with no debt. He’s very active and relatively healthy, but he wants to ensure his family doesn’t have to pay for his end-of-life expenses, like a funeral and burial costs, should he pass away.

The solution(s): From term life insurance to whole life insurance that builds up cash value, Tim has several options.

Tim can purchase a $100K term life insurance policy with a 10-year term. He would pay roughly $30 per month during the term.
Tim can purchase a $100K whole life insurance policy that doesn’t expire and that builds up cash value as Tim pays his premiums. At his age, in his good health condition, Tim would pay roughly $100 a month. His payments will accrue cash value Tim may be able to access later in life.
Tim can purchase a $300K universal life insurance policy that includes disability and long-term care coverage. This helps ensure Tim is covered in case he experiences a disability-causing accident, as he’ll be able to supplement his lost income with the policy. Tim would pay roughly $200 a month.

7. Long-Term Care Coverage

Delores and John are both 50, are both in good health and are closing in on retirement. They’ve paid off all their debts, but they’ve witnessed a relative who needed long-term care and saw how expensive it was. They want to ensure they’re covered in case they need long-term care in the future, too.

The solution(s): Since long-term care life insurance policies can take different forms, here are a couple sample options.

Delores and John purchase a long-term care life insurance policy that would cover each of them up to $8K per month for 5 years in a nursing home. At their age, in their health conditions, the monthly premiums would be around $400 per policy.
Delores and John purchase a universal life insurance policy with a $400K death benefit, and attach a long-term care rider that would also cover each of them up to $8K per month for 4 years in a nursing home. At their age, in their health conditions, the monthly premiums would be around $400 per policy.

Consult a Life Insurance Professional to Explore Your Options

The above scenarios are just a few ways life insurance can over financial protection for diverse individuals and families. You can learn more about different life insurance options in our post on how to choose the right life insurance policy .

We recommend talking with a life insurance agent about the most cost-effective options that provide you and your family with adequate coverage. Life insurance can give you peace of mind now that no matter what happens, your loved ones are financially protected.

Contact us online to get a free life insurance quote , or call 602.617.4107 to talk with one of our licensed life insurance brokers.

Health Insurance Examples: Which Coverage Works for Various Situations

Wed, 21 Jun 2023 17:38:05 GMT

When you live life without health insurance, you risk high costs when medical issues arise. According to the U.S. federal government, the average cost of various types of medical care include:

$7,500 to fix a broken leg
$30,000 for a 3-day hospital stay
$100,000+ for comprehensive cancer care

If you don’t currently have health insurance coverage, or you’re wondering about other options, it’s helpful to understand what’s available. That way, you can make a cost-effective decision that works for your finances and ensures you have the health insurance coverage you need.

Let’s explore some ways to get health insurance coverage. We’ll use Jack and Jill Smith as an example. The couple has two kids, lives in Arizona and needs family health insurance . The following scenarios illustrate when they might choose each plan.

1. Healthcare.gov Marketplace

How the Healthcare.gov Marketplace Works

The Healthcare.gov federal insurance Marketplace offers American citizens the ability to compare and shop for various health insurance plans online through the website. A health insurance broker can also browse plans for you, and present ones that include coverage for the doctors and terms you prefer.

These plans are primarily health maintenance organization (HMO) plans, which means only certain doctors are covered within each plan. Keep in mind, if you choose insurance through the Marketplace, it’s important to filter plans based on the ones that offer coverage for your preferred doctor(s). Otherwise, you may not be able to get health insurance coverage with your current provider when you choose various Marketplace plans.

Getting insurance through the Marketplace is generally best for people who qualify for discounts based on their income, or for those who have pre-existing conditions, as the Marketplace plans cover those.

You can use the Marketplace’s income levels and savings calculator to see if you might qualify for health insurance savings through the Marketplace. You may be able to qualify for a premium tax credit that lowers the monthly premium.

When a Healthcare.gov Marketplace Plan Makes Sense

One reason Jack and Jill would look into a Marketplace health insurance plan is when Jack has a recurring back issue and sees the doctor regularly. Because of his pre-existing condition, he might work with a health insurance broker to look into a Marketplace plan that covers his existing back issues.

Another scenario where the couple might consider a Marketplace plan is when they have a relatively low income. Let’s say their combined household income is $60,000 per year. Based on that income, they may qualify for a government subsidy when obtaining health insurance. It may be the most cost-effective for the couple to choose a Marketplace plan, based on the subsidy they can get.

2. Private Health Insurance Plan

How the Private Health Insurance Works

With private health insurance, like that offered through Arizona Health Insurance Brokers , a person seeking health insurance contacts a health insurance broker to facilitate health insurance coverage for them. The health insurance broker works on behalf of a health insurance company or companies, and helps individuals and families navigate various health insurance choices to choose the best plan.

Private health insurance provides flexibility, as you can compare more options and customize a plan based on your needs with the expert help of a broker. Sometimes, private insurance plans offer lower prices compared to Marketplace policies, especially for people who are relatively healthy and who don’t qualify for Marketplace discounts based on their income.

Private health insurance provides a convenient way to get health insurance coverage, especially when you don’t have options through your employer. As the number of full-time independent workers in the U.S. has drastically increased in the past 6 years, private health insurance also helps solopreneurs and independent contractors get health insurance coverage when they’re their own boss.

When Private Health Insurance Makes Sense

Let’s say Jack and Jill are both relatively healthy, but their household income is too high to qualify for Marketplace subsidies. They research their Marketplace options, but after talking to a private health insurance broker , they learn a private plan is cheaper and more flexible.

Going with a private health insurance plan makes sense in this scenario, since it offers cost-effective health insurance coverage for their family.

3. COBRA Health Insurance Plan

How COBRA Health Insurance Works

COBRA stands for the Consolidated Omnibus Budget Reconciliation Act. When someone loses their job, that individual (and potentially their family members) can continue receiving the group healthcare benefits they previously had at their former job. COBRA offers continued healthcare coverage for limited periods of time for circumstances including:

Involuntary or voluntary job loss
Reduced work hours
Transition between jobs
Death
Divorce

If you or a loved one has gone through significant life events that impact health insurance coverage, like those above, you may qualify for COBRA coverage to continue your healthcare plan, uninterrupted.

COBRA health insurance may make sense depending on factors like cost and how much an individual/family has paid into a deductible. Because COBRA health insurance coverage can be more expensive than a plan through a private insurance broker, it may make sense only in certain situations, including:

Someone is taking expensive medication that was covered in a former group plan.
Someone needs to see specific doctors who aren’t in-network with other insurance plans.
Someone has specific health issues and has already met their health insurance deductible.

In some instances, when someone has been a part of a large group health insurance plan, the cost of COBRA is similar to what Marketplace or private health insurance quotes would be. Before choosing COBRA coverage, you can speak with a health insurance broker to see if you could save money with a different plan, or if it makes sense to choose COBRA coverage.

When COBRA Health Insurance Makes Sense

Using Jack and Jill as an example, let’s say Jack has switched jobs. Jill recently had surgery, so the couple has already met their deductible. Jill has surgery follow-up appointments with several doctors she prefers.

In this case, it may make sense for Jack and Jill to choose a COBRA plan. This way, Jill can see the doctors she prefers, and the plan could potentially be a cost-effective option, since the couple has already met their deductible.

4. Group Health Insurance Plan

How Group Health Insurance Works

Group health insurance refers to health insurance coverage offered through a business. When someone works for a company, the business may offer health insurance coverage. Business owners can look into offering group health insurance to their employees, as a way to attract talent and increase retention among their staff.

Group health insurance can be a convenient option for professionals, as coverage may also extend to a spouse and dependents. You can get coverage when you start working at a place group insurance is offered, but if you leave your job, you’ll need to explore COBRA coverage or another health insurance option for coverage.

When Group Health Insurance Makes Sense

For Jack and Jill, they may be interested in group health insurance plans if they’re offered by their employer(s). If one person works for a company and the other person works from home, there may be options to get health insurance coverage for the entire family through a group health insurance plan.

Jack and Jill can compare pricing and coverage with other types of plans before they decide to sign up for group health insurance. In some cases, private health insurance may be the less expensive and more comprehensive option.

If Jack and Jill own their own business, it may make sense for them to secure group health insurance coverage for themselves and their employees. There are diverse health insurance plans business owners can choose from, including health reimbursement arrangements (HRA) like an individual coverage health reimbursement arrangement (ICHRA) and a qualified small employer health reimbursement arrangement (QSEHRA) . Business owners can also look into health savings account (HSA) arrangements for their workers.

Get Help Comparing Health Insurance Plans

There are lots of ways to get health insurance coverage so you and your loved ones are protected when medical issues arise. Health insurance coverage can help you save money when you get annual check-ups and need treatment for whatever happens.

At AZ Health Insurance Brokers, we can help you compare private plan coverage, get group health insurance coverage for a business or explore other health insurance options. We’re here to help you learn about what’s available, so you can make the most cost-effective decision for yourself and your family.

Set up a free consultation online , give us a call at 602.617.4107 or email quotes@azhealthinsurancebrokers.com . We’ll be in touch to help you walk through your options.

Options for Group Health Insurance & Alternatives for Businesses

Wed, 17 May 2023 17:01:27 GMT

Group Health Insurance Options & Alternatives

Health insurance coverage continues to be a top sought-out benefit for employees in the U.S. According to a February 2023 survey by Forbes Advisor , the number one benefit employees want from employers is “employer-covered healthcare,” cited by 67% of employees, followed by life insurance . Healthcare coverage is so important to workers, 40% of employers believe workers leave their jobs to find a role that offers better employee benefits.

By offering healthcare to employees, you can increase retention and improve your recruitment efforts. Whatever size business you own, from five employees to 5,000, you have options. Consider the following choices when you’re evaluating business health insurance for your company.

Traditional Group Health Insurance

There’s a wide variety in healthcare plans for traditional group insurance. To be eligible for group health insurance , a business must have 50% of employees participating. Group insurance options include the following.

Fully Insured

With fully insured plans, the employer (and potentially the individual employee) pay an insurance premium to the insurance carrier. While on the plan, the insurance carrier is responsible to pay for medical claims that are covered in the policy’s contract, including any expenses that go beyond what the individual is responsible for in the deductible.

Fully insured plans are the most common type of insurance plans people think of when it comes to health insurance. A business owner has the ability to choose what type of coverage they want to offer, and employees have the option to enroll. Plans are based on age and county, so employees’ health conditions don’t impact premiums.

Self-Funded Insurance

With self-funded insurance, in essence, the employer becomes the insurer who is then responsible for paying for covered claims. This type of insurance may cost less up-front than fully insured plans, but it also places more risk on employers who will have to pay for claims.

For employers to protect themselves from claims that are more expensive than the insurance coverage pool they have to cover employees, the employer typically has "stop-loss” insurance in place. Stop-loss insurance covers an employer when claims exceed the pool. The employer pays a premium to obtain this insurance.

Level-Funded Insurance

Level-funded insurance is a type of self-funded insurance for small businesses that has a lower threshold for stop-loss coverage. This type of insurance can be cost-effective for small businesses with healthy employees, which can be determined by requiring employees to fill out health questionnaires before securing coverage.

With level-funded plans, if total claims costs are higher or lower than expected, the carrier may offer a premium increase on stop-loss insurance renewal, or a refund to the employer. Level-funded plans can be a way for employers to move toward self-funded insurance, with less risk.

How to Get Traditional Group Health Insurance

Business owners have several ways to get a traditional group health insurance plan for their employees. These include:

Health insurance broker: A health insurance broker works on behalf of a health insurance company or companies and helps their clients determine the best group health insurance plan for their unique business. A broker can help a business owner save money, by identifying the most cost-effective plan that provides the coverage employees need.
Professional employer organization: A professional employer organization (PEO) sponsors health insurance for various companies and acts as a “co-employer” when it comes to health insurance. A company may use a PEO for other functions, like human resources.
Small Business Health Options Program (SHOP): The Small Business Health Options Program (SHOP) is a federal program for small employers who want to provide health insurance to employees. Small business owners can customize what they offer and work with a SHOP-registered agent or broker to determine coverage.

With any type of traditional group plan, employers have a wide variety of plans to choose from. You can offer as comprehensive or as basic coverage as you want, from health maintenance organizations (HMOs) to preferred provider organizations (PPOs). You can add new employees any time to a traditional group plan, which means all your employees can get coverage as soon as they begin working for you.

With traditional group insurance plans, employers need to pay at least 50% of each enrolled employee’s health insurance premium. This is a great benefit for employees, but it can also get expensive for employers, especially when spouses and children are added on to plan coverage.

One way to offset costs is to take advantage of the Health Insurance Premium Tax Credit , which is available to:

Small businesses that have existed in Arizona for at least 1 year and
Haven’t provided health insurance to employees for at least 6 months prior to submitting an application and
Had at least 2 but no more than 25 employees during the most recent calendar year

When an eligible company enrolls in a business health insurance plan, the health insurer gets a credit that it passes on to the small business in the form of reduced premiums. The tax credit amounts to $1,000 per year for each enrolled individual and $3,000 per year for family coverage, or 50% of the annual premium, whatever costs less. A company can apply for renewal for subsequent years.

If your business wants options beyond traditional group insurance, there are even more options for health insurance for business available.

Individual Health Insurance for Employees

With individual health insurance, employees can choose their own plans. This can be a great route for businesses that don’t meet the 50% participation requirements of having a group plan. Individual plans can also be more cost-effective for relatively healthy employees and their families.

One popular individual health insurance plan is a health reimbursement arrangement (HRA). An HRA enables an employer to provide tax-free healthcare reimbursement to employees. HRAs may take the following forms.

Individual Coverage Health Reimbursement Arrangement (ICHRA)

With an Individual Coverage Health Reimbursement Arrangement (ICHRA), an employer sets a monthly allowance limit for healthcare reimbursement for employees. The employee can purchase individual-market insurance and get reimbursed for health insurance premiums and/or qualified medical expenses.

All reimbursements are tax-free, so employees don’t have to pay premiums with after-tax dollars. An ICHRA gives an employer the ability to choose what’s reimbursed. Employees can enroll if they want, but there’s no mandatory participation requirement.

Employers can offer an ICHRA in addition to a traditional group insurance plan. There’s no limit on how many employees may be eligible for an ICHRA.

Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)

A Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) is available only to employers that have fewer than 50 full-time employees and that don’t offer a group insurance policy. All full-time employees and families are automatically eligible for a QSEHRA under the same terms.

The QSEHRA has annual allowance caps determined each year by the Internal Revenue Service. In 2023, the limits were $5,850 for individuals and $11,800 for family coverage.

Other Options for Individual Health Insurance for Employees

In addition to ICHRA and QSEHRA plans under the HRA umbrella, there are also various health savings account (HSA) options employers can provide to employees. With an HSA, employees contribute money from their paychecks into the account, which they can use tax-free for qualified healthcare coverage. Employees can also contribute to an HSA, sort of like 401(k) matching.

Money in an HSA rolls over each year, so healthy employees can save their money and use it when they need it. HSA plans must be offered with an HSA-qualified high-deductible health plan (HDHP), which requires an individual to meet a deductible before additional healthcare coverage pays out.

HSA plans, as well as ICHRA and QSEHRA plans, give employers more choice in what to offer employees that makes financial sense for their business. You’re not limited to offering traditional group health insurance for employees. With alternative options available, you can evolve your health insurance offerings as your business grows.

Talk with a Health Insurance Broker to Find the Best Option

Health insurance plays a big role in retaining employees, which impacts business growth. If you want to attract leading candidates to work for your company, and keep them there, health insurance coverage is essential for today’s workforce.

You have lots of choices available. The team at AZ Health Insurance Brokers is here to learn about your unique business and provide you with all the options available to you. We’ll help you choose the most cost-effective solution for your business needs that serves your employees.

Call 602.617.4107 to talk with one of our team members. Or, email quotes@AZHealthInsuranceBrokers.com or fill out this form , and we’ll contact you.

How Does Life Insurance Impact Estate Planning?

Sun, 16 Apr 2023 18:10:22 GMT

When loved ones rely on you today , you may want to consider estate planning and life insurance to help protect them in the future. Life insurance provides financial coverage to a policyholder’s beneficiary or beneficiaries should they pass on. This coverage can help the surviving beneficiaries:

Pay outstanding debts
Cover funeral costs and other end-of-life expenses
Continue to retain the same quality of life they had while the policyholder was alive

Estate planning can bring you peace of mind that whatever happens in the future, your loved ones are taken care of. Here’s how life insurance factors into estate planning, so you can consider it as part of the process.

Key Takeaways

Life insurance plays a crucial role in estate planning by providing financial protection for loved ones, helping to cover outstanding debts, funeral costs, and maintaining their quality of life.
Life insurance benefits can be passed on to beneficiaries without going through probate, saving time, money, and potential tax burdens.
By including life insurance in an estate plan, you can safeguard assets, provide liquidity, and maintain control over the distribution of funds to your beneficiaries.
When setting up a life insurance policy, it's essential to avoid common mistakes such as purchasing insufficient coverage, naming the wrong beneficiary, and delaying securing a policy.

1. Life Insurance Helps You Leave a Legacy

If you have goals for your family, like sending a kid off to college one day, life insurance gives you a way to provide a meaningful inheritance for those who depend on you. Life insurance beneficiaries get access to the death benefit without having to go through court, also called probate when related to estate planning. That saves time, money and hassle during what’s often already an emotionally charged time.

Plus, with life insurance, the proceeds typically aren’t taxable as income. You may be able to pass on finances without making your beneficiaries pay taxes on them, as long as the benefit amount doesn’t exceed federal or state exemptions.

2. Life Insurance Offers Protection for Debt & Expenses

Many people carry some form of debt, whether it’s a mortgage, car loan, student loan or credit card debt. The amount of consumer debt in the U.S. increased to $16.38 trillion in 2022, according to Experian , up from $15.31 trillion in 2021.

If you have any outstanding debts, a life insurance payment gives your beneficiaries the means needed to cover any debt, tax obligations and ongoing expenses you had, without having to use their own finances.

Again, when assets are tied up in probate court, that could force survivors to accumulate their own debt in the meantime to cover expenses while they’re waiting for court to play out. A beneficiary can file a life insurance claim and receive funds in as little as a few weeks.

3. Life Insurance Safeguards Assets

In a scenario where life insurance isn’t part of the estate planning process, loved ones may feel pressured to sell off assets to get the money needed to pay outstanding debts and bills, or even to cover taxes on assets in an estate. This could result in situations like letting go of a beloved family home, selling a treasured family heirloom or putting up an inherited asset for sale in order to make ends meet.

Life insurance helps protect other assets that may be included in an estate plan, like a house, vehicle, jewelry or other valuable object. These assets may carry important sentimental value, as well, which you can protect for your loved ones with a life insurance policy.

4. Life Insurance Provides Liquidity

A beneficiary can spend the money from life insurance benefits however they’d like. That means, a policy provides liquidity for whatever expenses come up.

That can give your family peace of mind that there will be money available to cover anything that’s needed. You can’t predict the exact future, but you can ensure there are funds available to pay for whatever’s needed.

5. Life Insurance Helps You Control Distribution

Back to probate. Even when family and loved one situations are calm and peaceful now, when a loved one dies and court is involved, things can get ugly. Fighting over family finances in court can tear families apart, unfortunately. Strategic estate planning and life insurance gives you more control over your finances and helps prevent problems.

With your life insurance policy, you’re in control of how funds are distributed. You can tell your family members as soon as you set up a policy what will happen, so there are no surprises and everyone has clear expectations.

This can help alleviate unnecessary stress and conflict. If you love your family and want to protect their relationships, deciding what will happen with your estate now can help avoid future issues.

Avoid These Mistakes When Setting Up a Life Insurance Policy

Getting a life insurance policy makes sense for many people. If you have anyone in your life you want to protect financially in the future, including a spouse or kids, we highly recommend securing a life insurance policy now. If you have debt, life insurance also helps protect your loved ones with the financial means to cover outstanding expenses.

The earlier you apply for a life insurance policy, the more likely you can secure a lower monthly premium. As you go through the process, some things to avoid are:

Getting a policy with too little coverage: Some life insurance coverage is better than none, but the point of life insurance is to provide the coverage your loved ones will need. Your life insurance broker will help you calculate life insurance coverage . You’ll want to factor in monthly expenses, outstanding debt and the financial legacy you want to leave to find an accurate total coverage amount.
]Naming the wrong beneficiary: You’ll want to ensure your life insurance benefits go to the right person(s). Your desired beneficiary may change over time (for example, if you get divorced), so make sure you revisit your policy and update it as necessary every year.
]Delaying securing a policy: For some life insurance policies, the younger you are and the better health you’re in, the less expensive your policy will be. That’s why it can be more cost-effective to secure a policy as early as possible, since you can lock in lower rates now and avoid higher rates as you age or your health condition changes.

Finally, a major mistake people make is choosing the wrong type of life insurance policy. There are lots of options to choose from, including one that will make the most sense for your unique needs. A life insurance broker will explain various types of policies and recommend a selection that’s cost-effective, while providing the coverage you need.

Talk with a Life Insurance Broker to Learn About Your Options

If you already have an estate plan but no life insurance, or you’re new to estate planning, make sure life insurance is part of your plan. You can provide tax-free financial benefits to your loved ones, so they can cover outstanding costs and get the financial support they need.

Our team is ready to help you. Contact us for a free consultation by filling out the form online , calling 602.617.4107 or emailing quotes@azhealthinsurancebrokers.com for information.

Life Insurance and Estate Planning FAQs

How to Select a Life Insurance Plan | AZ Life Insurance Brokers

Wed, 08 Mar 2023 22:19:15 GMT

How to Choose the Right Life Insurance Policy

If you’re a financial provider for your spouse, kids or other family members, it’s helpful to get a life insurance policy that protects them should you pass away. Life insurance provides financial payment to the policyholder’s named beneficiary or beneficiaries if the policyholder dies. A life insurance policy can help ensure surviving family members can continue living the lifestyle they’re accustomed to, even when the policyholder’s income is no longer available.

Some reasons you may want to get a life insurance policy include:

Your beneficiaries would face financial challenges without your income.
You have debt that would be difficult for your loved ones to pay off if you pass away.
You want to provide financial coverage for final expenses, such as a funeral and end-of-life expenses.
You want to ensure a financial legacy to pay for expenses like your kids’ college tuition or your spouse’s retirement.

When you decide to get life insurance, you have a few options available depending on your and your family’s unique financial needs. Here’s what to consider when you want to get a life insurance policy.

1. Understand the Types of Life Insurance

First, it’s helpful to understand what types of life insurance you can choose from, to make the right decision based on your budget and your potential financial needs. Life insurance options include:

Term life insurance: Term life insurance lasts a set number of years and typically has a lower monthly cost compared to another type of life insurance, permanent life insurance. With term life insurance, you set the “term,” or number of years the life insurance policy will be active for. Typically, term life insurance policies last 10, 15, 20 or 30 years. Once the policy’s term length ends, the payout possibility ends, as well. Term life insurance can be helpful when you know you’ll want coverage for a specific amount of time, such as until all your kids reach adult age, for example.
Permanent life insurance: Permanent life insurance provides coverage for your whole life. With a permanent life insurance plan, your premium payments will also accumulate cash value. You may be able to access this cash value while you’re still alive. There are several types of permanent life insurance, including:
Whole life insurance: Whole life insurance provides lifetime coverage and builds up cash value as you pay your premiums.
Universal life insurance: Universal life insurance is similar to whole life insurance, but the cash value earns interest. There may also be options to adjust your premium amounts over time.
Variable life insurance: Variable life insurance is similar to universal life insurance, with the additional option to invest cash value from the life insurance policy into a different account.
Final expense life insurance: Final expense life insurance, also sometimes called burial life insurance, provides coverage for end-of-life expenses like a funeral and burial. According to World Population Review , the average funeral cost is around $9,000 in the United States, but final expenses can increase, especially if the deceased has outstanding debts. This type of life insurance provides coverage of around up to $35,000 for end-of-life expenses.
Survivorship life insurance: Survivorship life insurance, also called joint life insurance, provides life insurance benefits to two people on a single policy.
Mortgage payoff life insurance: This life insurance policy helps cover mortgage expenses, with coverage terms aligning with an outstanding mortgage balance.

Regardless of what type of life insurance policy you get, some coverage is better than no coverage. Life insurance can help your spouse and/or your kids stay financially stable if you pass away. It provides peace of mind that your family will receive financial support to help with everyday and outstanding expenses, depending on what policy you choose.

2. Consider Your Family’s Financial Situation

Your current budget and your financial needs will likely impact your life insurance policy choice. You’ll want to take into account family expenses and financial planning including:

Current monthly expenses, like a mortgage, bills and childcare expenses
Current debt
Small business expenses, if someone in your family owns a business
College tuition expenses for children

Generally, term life insurance is less expensive than permanent life insurance. The coverage timeline will be shorter with term life insurance, and the policy won’t accumulate cash value.

Term life insurance is an affordable option to keep you covered for your desired amount of time. You can also typically lower your expenses the younger and healthier you are when you apply for a term life insurance policy.

If you have a bigger budget for life insurance, you might be interested in permanent life insurance. A benefit with permanent life insurance is that you may be able to access the cash value and even invest it to increase your savings.

Another benefit of permanent life insurance is that you’ll always have the same policy terms throughout the life insurance policy. With a term life insurance policy, if you decide to renew it or get a new policy later on, costs will likely go up as you age and your health conditions change.

If you have a limited budget, you can look into lower coverage options like final expense life insurance and mortgage payoff life insurance options. These will still help ensure you have some type of life insurance coverage, making them a good minimal option when you’re exploring life insurance policies.

3. Consult with a Life Insurance Broker

Since there are lots of different life insurance policies to choose from, it’s really helpful to talk with a life insurance expert about what option works best for you, your family and your budget. If you currently have a lot of expenses, it may make more sense to get more coverage so your family is covered when they need to be. If you have a smaller budget, a broker can walk you through affordable options that provide coverage for your unique financial situation.

Talk with a life insurance agent to discuss your and your family’s current income situation, current financial expenses and future financial needs. An agent can walk you through your options so that you get the exact coverage you need, with premiums that fit your current budget.

To learn more about your options for life insurance in Arizona , contact us online , call 602.617.4107 or email quotes@azhealthinsurancebrokers.com . We’ll be in touch with a free consultation.

Medicare Open Enrollment 2023: Everything You Should Know

Thu, 13 Oct 2022 19:29:27 GMT

What You Should Know About Medicare 2023 Open Enrollment

If you currently have a Medicare plan and you want to change or drop yours, this fall is the time to do so. Every year, there’s a Medicare Annual Enrollment Period (AEP). From October 15 through December 7, those who are eligible can:

Join a Medicare plan
Switch a Medicare plan
Drop a Medicare plan

As long as you put in your request during the AEP and submit it by December 7, your new plan coverage will begin January 1, 2023.

Here’s everything you need to know about the Medicare AEP so you can ensure you get the coverage you’re interested in.

What Is Medicare?

Medicare is the federal government’s health insurance plan for those who fall into one of the following categories.

People who are ages 65 and older
People who are outside of that age group but who qualify due to a specific disability
People who have end-stage renal disease, otherwise known as ESRD, which indicates permanent kidney failure that requires a transplant or dialysis

Medicare comes in different coverage parts, each of which covers specific services. These include:

Medicare Part A (Hospital Insurance): Medicare Part A provides coverage for inpatient hospital treatment, skilled nursing facility treatment, some at-home healthcare services and hospice care.
Medicare Part B (Medical Insurance): Medicare Part B provides coverage for specific doctors’ services, preventive services, medical supplies and outpatient care.
Medicare Part D (prescription drug coverage): Medicare Part D provides coverage for the cost of prescriptions drugs, including many recommended vaccines and shots.

What about Medicare Part C ? Medicare Part C is considered a Medicare Advantage Plan. It works similarly to a PPO or HMO, where you can choose a Medicare plan from a private insurance company that’s approved by Medicare.

These plans will provide coverage that’s typically included in Part A and Part B plans. Many also offer Part D prescription drug coverage. Medicare Part C plans may also offer extra coverage, for programs like vision, dental, hearing and wellness programs. Many people prefer Medicare Advantage Plans because they offer customization and control over the types of services you can get and from which providers.

Medicare Supplement Insurance (Medigap):

Medigap is Medicare Supplement Insurance that helps fill "gaps" in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like: Copayments, Coinsurance & Deductibles. A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.

Medicare Terminology

You may see some abbreviations that relate to Medicare plans. One common one is MAPD vs PDP.

A PDP refers to a Medicare Part D plan, which only covers prescription drugs, which you can add to a Medicare Part A and Part B plan. MAPD refers to a Medicare Advantage Plan that includes prescription drug coverage, as well as Medicare Part A and Part B coverage. You can’t have both a PDP and a MAPD simultaneously.

Another common Medicare abbreviation is ANOC. This stands for Annual Notice of Change. Before the AEP, you should receive an ANOC from your current Medicare plan. provider, if you have one. The ANOC will cover any changes in cost and/or coverage that will go into effect in January.

Look closely at the ANOC, because you may determine that these changes cause you to want to also change your plan. For example, if you currently have Medicare Part A, B and D plans, but costs are going up or your preferred doctor will no longer be covered, you may want to talk with an insurance broker about a Medicare Advantage Plan that gives you the exact coverage you want.

What Changes Can You Make During the AEP?

You’ll want to consider your Medicare coverage every year, because the kind of coverage you’re interested in may be on a different carrier. For example, if you want to change a medication or use a new prescription drug, there may be drug and formulary tier changes with every AEP.

During the AEP, you can make the following changes to your Medicare coverage.

Change from Original Medicare to a Medicare Advantage Plan.
Transition from a Medicare Advantage Plan to Original Medicare.
Change from one Medicare Advantage Plan to a different Medicare Advantage Plan.
Get a Medicare Advantage Plan that provides prescription drug coverage.
Change to a Medicare Advantage Plan that doesn’t provide prescription drug coverage.
Join a Medicare Part D plan.
Change from one Medicare Part D plan to a different Medicare Part D plan.
Drop your Medicare Part D plan.

You can make as many changes as you want before the deadline. If you make a change during the AEP, you can also expect to get new Medicare ID cards that you can use once your new coverage goes into effect.

What If You Don’t Make the Medicare Deadline?

You may have other options to enroll in or change your Medicare coverage after the December 7 deadline, or before the AEP, depending on when you turn 65. You can apply for Medicare 3 months before and 3 months after the month of your 65 ^th birthday, as well as during the month of your 65 ^th birthday – so for a 7-month period altogether.

There are also qualifying life events that may enable you to sign up for or change your Medicare outside of the AEP. These include change in residence, involuntary loss of creditable drug coverage, gaining or losing Medicaid, losing employer coverage and etc. You normally have up to 3 months from the special enrollment period to elect a plan.

Learn More About Your Medicare Options

Health insurance is essential, especially during senior years. There’s a lot to consider and various deadlines to keep track of. Any time of year, you can connect with the AZ Health Insurance Brokers team to stay ahead of your Medicare enrolment deadlines and get answers to any health insurance questions you have.

You can also visit the Medicare.gov website to explore Medicare coverage options online and add your drug and pharmacy information to get personalized cost details. You can also read over the official U.S. government Medicare handbook , which has more than 125 pages of Medicare information.

Or, call AZ Health Insurance Brokers at 602.617.4107 any time you want a quick answer to one of your Medicare or health insurance questions. We’re here to help you get the coverage you need to ensure your health is protected.

How to Choose Health Insurance at Work

Thu, 13 Oct 2022 03:07:12 GMT

How to Pick the Best Group Insurance Plan Through Your Employer

If your employer offers group health insurance coverage, congratulations! Health insurance typically ranks among the most-desired benefits from job candidates. Jobvite’s 2021 Recruiter Nation Report found 51% of HR recruiters and professionals said medical and dental coverage is the most effective benefit for attracting new candidates.

Whether you’re just starting at a job, or you’re employed but you’re thinking about a change to your health insurance, you may be wondering what the best health insurance plan through work is. Our guide explains what to consider so you can save more money while getting the coverage you need.

Estimate Your and Your Family Members’ Health Needs

Your employer’s health insurance plan may offer coverage for both you and your dependents and/or your spouse. If you’re interested in coverage for both yourself and your family member(s), consider what your own health needs are and what the health needs of those you also want coverage for are.

Some things to consider:

Does anyone take medication?
How often do you attend doctors’ visits?
How many specialists do you see, and how frequently?
Is anyone going to have a surgery coming up in the next year?
Is anyone undergoing an expensive procedure?
Is someone pregnant, or do you want to plan a family?

Your goal with health insurance is to reduce the amount of money you’ll pay out of pocket while you’re covered for the benefits you’re interested in. Your total out-of-pocket expenses include:

Your health insurance premium
Co-pays and fees you’ll pay for doctors’ visits and prescriptions
Medical expenses you’ll need to cover when you factor in the deductible

With an estimate, you can compare plans to see which one will enable you to spend the least, when you factor in both your monthly health insurance and medical costs and the out-of-pocket maximum you’ll pay based on the deductible.

Also, consider that health insurance premiums are usually deducted from your income before any taxes are withheld. When that’s the case, that means getting on an employer health insurance plan can lower your overall taxable income for your income and payroll taxes.

As long as you have an estimate of your expected medical expenses for those who will be covered under your plan, you can compare plans to choose the least expensive plan.

What If You Can’t Estimate Your Health Expenses?

It’s common for employees to not have a clear idea of what their upcoming medical expenses will be. You may not be able to anticipate a broken bone or a hospital stay. Even if you’re had perfect health for most of your life, health issues can pop up unexpectedly.

When you don’t have a way to predict your upcoming expenses, it may make the most sense to choose the least expensive plan. That way, you’ll pay less on health insurance premiums. If you have a relatively stable health condition, you’ll likely pay less out of pocket.

If you choose this method, you can set aside what you’re saving in a rainy day fund. That way, if something does come up, you can use that fund’s money toward your deductible. If you don’t experience major health issues, you’ll have the money saved for other expenses or to roll over for the next year.

It may not make sense to buy a really rich employer group health insurance plan “just in case,” when that money could be wasted if no major expenses occur. Ultimately, your health insurance plan choice is up to you. Some people want the peace of mind of more expensive coverage. Others like to save the extra cash and use it for what they want.

Other Group Health Insurance Considerations for Employees

There are some other factors that may influence your choice of a group health insurance plan. One is the type of network that’s available, from a health maintenance organization (HMO) to a preferred provider organization (PPO). You’ll want to understand the terms of the types of plans available to ensure they fit your needs.

Depending on your preferred healthcare provider(s), you may want to pay for a more expensive plan that includes coverage for those providers. If you don’t care who you see, a less expensive plan may be just fine for your needs.

Some plans will also require a primary care physician referral in order to see a specialist. Getting one can take extra time, so consider how much freedom and flexibility you want out of your healthcare plan.

Some people also choose to decline employer-based health insurance coverage altogether because the coverage that’s offered doesn’t match their desires or needs. You’re not obligated to agree to employer health insurance just because it’s offered. You can always seek out non-employer health coverage if there’s a better option for you and your family.

When your employer does offer coverage, it’s helpful to read through the benefits materials and talk with your human resources department to get all your questions answered. Pay attention to enrollment deadlines. If you miss an enrollment deadline , but you want health insurance through your employer, check to see if your situation may meet a special exception.

If your employer doesn’t offer traditional group plan coverage, you may be interested in contributing to a health savings account , if one’s available. These work similarly to flexible savings accounts, where participants can add money to the account and use the contributions to pay medical and dental expenses tax-free. As an employee, you’ll never lose your health savings account contributions.

Ask your employer about what they offer. Health coverage options at work may change every year, so stay up-to-date on your options to ensure they still work for you and your family.

What If Your Employer Doesn’t Offer Health Insurance?

Unfortunately, there are still many employers who don’t provide their staff with health insurance coverage . If your employer falls into this category, you can still get health insurance through a private broker.

Health insurance coverage matters for you and your family, because health conditions can change in an instant. Accidents happen, and having coverage in place can help protect you from tens (or hundreds) of thousands of dollars in medical bills.

If you lack health insurance but you want coverage, talk with AZ Health Insurance Brokers . We help everyone from self-employed professionals to workers without employer health insurance options get coverage.

We can help you get the coverage you need, while keeping costs low. Call us at 602.617.4107 or contact us online .

What You Need to Know About Health Insurance Open Enrollment 2022

Sat, 30 Oct 2021 14:26:51 GMT

Health Insurance Open Enrollment 2022: Everything You Need to Know

Your health is your most precious asset. You can protect it with health insurance coverage that meets your unique needs.

During open enrollment, you have the opportunity to obtain or change your Marketplace Health Insurance plan , without penalties. These plans were created under the provision of the Affordable Care Act (ACA), also known as “Obamacare.”

This year, open enrollment is from November 1, 2021, through January 15, 2022. If you want your new health insurance coverage to start on January 1, 2022, you need to enroll by December 15, 2021.

This guide explains what you need to know about the open enrollment period.

What Is Open Enrollment?

Open enrollment is an annual time frame in which the United States federal government allows people to enroll in a health insurance plan for the next calendar year, either as individuals or as part of a family plan. During the open enrollment period, you can also opt to keep or change your existing plan.

Note: For small business owners who want to apply for health insurance for their employees, you can do this any time of year. If your employer offers health insurance, the open enrollment period listed above also doesn’t necessarily apply to you. Your employer may have a different open enrollment period in which you can apply – within 60 days of being hired, for example.

Actions you can take for your individual or family insurance during open enrollment include:

Enroll in Marketplace Health Insurance benefits for the first time
Change your current plans
Change your coverage amounts
Drop coverage completely

When you take one of the actions above, you are typically bound to that option for the next year, until the next open enrollment period.

What Happens If You Miss the Open Enrollment Time Period?

If you miss the open enrollment time frame, you may still qualify to enroll in a government health insurance plan if you’re eligible for a Special Enrollment Period . To qualify, you have to experience a certain Qualifying Life Event , like:

You get married or divorced.
You have a baby or adopt a child.
There’s a death in the family.
You lose other health insurance coverage.
You move to a different ZIP code or county.
You have changes in your income that affect the coverage you qualify for.
You become a U.S. citizen.
You leave incarceration.

There are also special exceptions that can be made if you miss the open enrollment period. You can research what you qualify for and get information on filing an appeal for a Special Enrollment Period .

Also, know that you can apply and enroll in the Children’s Health Insurance Program (CHIP) or Medicaid at any time of year, including outside of the open enrollment period.

Who’s Eligible for Marketplace Health Insurance?

To qualify for the open enrollment period, you must:

Live in the U.S.
Be a U.S. citizen or national
Not be incarcerated

If you already have Medicare coverage, you cannot use the Marketplace to buy a health or dental plan. Rather, you’d need to get that coverage through a Medicare plan.

Read what to expect during the Medicare Annual Enrollment Period , which lasts through December 7, 2021.

What’s Covered in a Marketplace Health Insurance Plan?

All Marketplace Health Insurance plans cover at least 10 essential health coverage benefits. These include:

Ambulatory patient services
Emergency care and services
Hospitalization
Laboratory services
Substance use disorder and mental health services
Pediatric services, including oral and vision care
Pregnancy, maternity and newborn care
Prescription drugs
Preventive and wellness services
Rehabilitative and habilitative services and devices

While all these services are covered, who you can receive treatment from will depend on the plan. Each plan has limits on the primary care and specialty doctors who are in-network. If you have a doctor you want to continue to see, you may want to keep your existing plan or find one that provides coverage for that doctor.

What Do You Need to Apply for Open Enrollment Health Insurance Coverage?

HealthCare.gov shares the information you’ll need to successfully enroll in healthcare coverage . This includes:

Name and date of birth

Information about your household

Mailing addresses

Information about individuals applying for coverage

Social Security numbers

Employer and income information

Plan for around 20 minutes to an hour to apply for health insurance coverage online, especially if you want to research plans and see which doctors are covered in each one.

Can You Get Reduced or Free Healthcare Coverage Through Marketplace Health Insurance?

Yes, you may be able to get Marketplace Health Insurance at a reduced cost or even for free. This coverage may include Medicaid and CHIP.

Typically, subsidized coverage for health insurance with premium tax credits is also available to individuals whose incomes are below certain levels. To qualify for a premium tax credit:

Your household income must be between 100% and 400% of the federal poverty level (FPL) .
Your household income must be below 138% of the FPL in states that have expanded Medicaid coverage.

If your income is above 400% FPL, you may still qualify for Marketplace Health Insurance plan savings. You can apply for a quote to see what you qualify for.

What If I Don’t Want Government Health Insurance?

If you don’t want a Marketplace Health Insurance plan, you have other options. You can contact an Arizona health insurance broker to get a private insurance plan that’s perfectly tailored to meet your needs.

Note: If you choose to go with a private insurance plan, you will not be eligible for government subsidies like those listed above.

One of the benefits of going the route of private health insurance is that you can talk with your Arizona health insurance agent and explain your exact health situation and what type of coverage you want for you and/or your family members. In some cases, you may want different health insurance plans for different members of your family. An agent can walk you through all your options.

Also, since network coverage is more limited with government health insurance plans, a private plan can enable you to see the exact doctors you want, with coverage.

You can get a private insurance plan for your family or yourself any time of year. If you miss the open enrollment period for a federal plan and aren’t eligible for a Special Enrollment Period, contact a private health insurance plan provider to get coverage.

How to Determine What’s Best for You: Marketplace Health Insurance or a Private Plan?

During this open enrollment period, you may be considering your options: a federal Marketplace Health Insurance plan, or private insurance. Answering these questions can help you decide.

Which doctors do I want to see? You’ll want a plan that enables you to visit the doctors you trust and are comfortable with.
Am I eligible for government subsidies? If you are, the only way you can get these is to apply for a Marketplace Health Insurance plan.
What kind of relationship do I want with my health insurance provider? When you work with a private agent, you typically have them as a single point of contact you can get in touch with whenever you have questions. With a federal plan, you may have to call in to national help hotlines and talk with different customer service representatives each time. Some people find this to be a hassle and want the level of comfort and ease that comes with working with a private broker.
How comfortable am I navigating my health insurance coverage options? Depending on the complexity of your family’s healthcare needs, you may be able to save time and money, and get better coverage, by working with a private broker. When you work with an expert, they’ll be able to provide you with the most cost-effective healthcare recommendations for everyone in your family. Attempting to get coverage on your own in the Marketplace can be more difficult and complicated.

There are also cost considerations. You may be able to save money going with one type of provider over the other.

An advantage of working with a private insurance broker is that your needs are their priority. It’s a broker’s job to provide you with the top health insurance coverage options and walk you through what’s available, so you’re comfortable with your choice and get all your healthcare needs met.

At AZ Health Insurance Brokers, we always offer free consultations so you can research your options. Call us at 602.617.4107 to talk with a representative. Or contact us online and we’ll be in touch.

What to Expect During Medicare Annual Enrollment Period (AEP)

Fri, 22 Oct 2021 21:03:43 GMT

Medicare Annual Enrollment Period: What You Should Know

More than 63 million Americans are eligible for the federal government’s health insurance program, Medicare . These include:

People who are age 65 or older
Certain younger people who have permanent disabilities
People who have End-Stage Renal Disease

While you can initially enroll in Medicare within 3 months before or after the month of your 65th birthday, the fall Medicare Annual Enrollment Period (AEP) may enable you to make changes to your current Medicare plan. Medicare’s fall enrollment period began October 15 and lasts through December 7, 2021.

During this time, you may be contemplating your current Medicare healthcare coverage and whether or not you should adjust it. Here’s what to consider during the Medicare AEP.

What Is Medicare AEP?

AEP is a 7-week time frame where Medicare plan holders can make changes to their existing plan without a penalty. First, it helps to understand Medicare basics so you know what’s available with Medicare.

Medicare Basics

There are two main ways to get Medicare coverage: through Original Medicare or through Medicare Advantage. Original Medicare includes both Medicare Part A and Medicare Part B, explained further below.

Medicare coverage falls into several different categories. These include:

Medicare Part A : Part A is hospital insurance. You typically aren’t billed a monthly premium for your Part A coverage if you or your spouse contributed Medicare taxes while employed for a specific amount of time. If you aren’t eligible for premium-free Part A coverage, you can purchase it. Part A covers:

o Inpatient hospital stays

o Care in a skilled nursing facility

o Hospice care

o Some home healthcare

Medicare Part B : Part B is medical insurance. Most people pay a monthly premium for Part B, which covers:

o Certain doctors’ services

o Outpatient care

o Medical supplies

o Preventive services

Medicare Part D : Part D is prescription drug coverage offered by private insurers, sometimes called a prescription drug plan (PDP). You can also get a Part D plan as part of a Medicare bundle through a Medicare Advantage Plan (called a MAPD), or purchase it as a separate plan with Original Medicare coverage with Part A and Part B. Part D helps cover the cost of:

o Prescription drugs

o Various recommended shots

o Various recommended vaccines

Finally, a Medicare Part C plan is also known as a Medicare Advantage Plan. Medicare Advantage Plans function similarly to a health maintenance organization (HMO) or preferred provider organization (PPO). It’s a Medicare health plan choice that’s offered by private companies Medicare has approved.

Medicare Advantage Plans include all Part A and Part B coverage and typically include Part D coverage, too. These plans may also provide extra coverage for healthcare needs like:

Vision
Hearing
Dental
Health and wellness

While Medicare will pay a fixed amount for care to the company you get a Medicare Advantage Plan from, you typically will need to pay certain out-of-pocket costs for the extra coverage. There may also be different rules regarding the services you can get and which providers you can get them from.

What Medicare Changes Can You Make During AEP?

During AEP, you can add or change coverage related to your Medicare Advantage Plan or your Medicare Part D plan. You can add, drop or switch those parts of your coverage. Comparing your options could help you save money or help you get better preventive coverage that helps protect your health.

It’s helpful to do research on plan changes, since you may be using a new prescription drug or you may be interested in changing medications. Typically, formulary and drug tiers may change with carriers every AEP.

During the AEP, you can make as many of the following changes to your plan as you’d like before the December 7 deadline, as many times as you want. Whatever changes you end up with will go into effect on January 1, 2022. The changes you’re able to make during the AEP include:

Change your Medicare Advantage Plan to a different one
Drop a Medicare Advantage Plan and return to Original Medicare
Change your Original Medicare plan to a Medicare Advantage Plan
Change a Medicare Part D plan to a different one
Cancel a Medicare Part D plan
Add a Medicare Part D plan if you don’t currently have one

If you’re new to Medicare altogether, and your eligibility period comes up during the AEP period, don’t feel rushed by the December 7 deadline. You’re eligible to apply for Medicare 3 months before the month of your 65th birthday, during the month of your 65th birthday and within 3 months after the month you turn age 65.

Also, if you never signed up for Medicare when you were eligible or during a special enrollment period, there’s a general enrollment period for Medicare from January 1 through March 31. Your Medicare Part B benefits will not begin until July 1.

With the various deadlines to keep track of, it may help to talk with an Arizona Medicare insurance agent so you know what you’re eligible for and when your deadlines are. If you’re perfectly happy with your current plan, you don’t have to do anything to keep it into 2022 and beyond.

What Should You Expect from Your Current Carrier?

If you’re currently enrolled in a Medicare Advantage Plan or a Part D plan, your carrier should send you a packet, called an annual notice of change (ANOC), explaining Medicare changes in costs and coverage for the upcoming year. You should have received this information by September 30.

If you didn’t, contact your carrier to obtain this information. It should include:

Adjustments to monthly premiums
Changes to copays and deductibles
Information on coinsurance or maximum out-of-pocket limit changes
Adjustments to drug coverage

If you do decide to change your coverage, add Part D coverage, etc., you may also have changes to your Medicare card. You may get a new type of plan card if you add Part D coverage or supplemental coverage, which you’ll want to carry with you or keep in a safe place.

Reasons to Change a Medicare Plan

If you currently have Medicare, use the AEP to consider your options. You may benefit from making a change to your plan if:

Your prescriptions are no longer on your plan’s formulary or they’ve become more expensive.
Your preferred doctors are no longer in-network.
You could save money on a different plan, based on your health needs.
You may be able to get extra benefits you need, like dental, hearing or vision coverage.

You have the AEP to research your options and make changes penalty-free. Talk with your carrier or other Medicare brokers to compare your options and find the best Medicare plan.

Helpful Medicare Resources

Whether you’re new to Medicare or you’re thinking about making a change to your plan during the AEP, there are resources that can help.

Every year, the U.S. government publishes a Medicare handbook. You can download the Medicare & You 2022 handbook here . You can also access it by logging into your Medicare account.

The handbook has lots of helpful information that explains which type of Medicare plan may work best for you. You can also preview 2022 health and prescription drug plans online . This tool enables you to create or access a list of your drugs if you have a Medicare account.

It’s also valuable to get a free Medicare consultation with an Arizona health insurance broker . On the phone, it’s easy to explain your unique health needs and get recommendations for the most cost-effective Medicare plan that protects your health.

Contact AZ Health Insurance Brokers online or at 602.617.4107 for a free Medicare consultation . You can learn about your Medicare Advantage Plan and Part D plan options.

Special Enrollment Period for ACA Health Insurance Kicks off Feb.15

Wed, 10 Feb 2021 03:01:31 GMT

Special Enrollment Period for ACA Health Insurance Kicks off Feb.15

Pres. Biden signed an executive order on Jan. 28 that opens up a “special enrollment period” for Americans who need access to health insurance. This special enrollment period runs Feb. 15 to May 15, 2021.

The move is in response to the ongoing COVID-19 pandemic, in which millions of people have lost their jobs and health insurance. In fact, according to the Economic Policy Institute , an estimated 12 million people lost their employer-sponsored health insurance due to the pandemic.

What does this special enrollment period mean for me?

If you are one of the millions of Americans who are uninsured or underinsured, this is an opportunity to gain affordable health coverage.

Open enrollment in the Affordable Care Act Marketplace usually runs Nov. 1 through Dec. 15 every year. If you miss the deadline, you have to wait until the following Nov. 1 to enroll (unless you have a life event that qualifies you for a special enrollment period).

This new open enrollment period gives you another opportunity and more time to find and enroll in a health insurance plan through the ACA marketplace.

Two important things to note:

If you had health insurance from your employer and lost it during the pandemic, you may be eligible for financial assistance with premiums on plans purchased through the marketplace
This special enrollment period is only open to those living in the 36 states that use the federal ACA marketplace found on HealthCare.gov . Arizona is one of those states.

What should I do next?

If you are interested in purchasing health insurance from the ACA marketplace during this special period, visit HealthCare.gov . Start looking around at your options and see if you are eligible for any government subsidies. There are numerous resources to guide you through the process, including a robust “Help” section .

You have 30 days after you submit your application to choose a plan, and your coverage will begin the first of the month after you select a plan, according to the U.S. Centers for Medicare & Medicaid Services .

Or, contact an insurance broker to help you

You can also purchase a private policy through a broker or agent. In many cases, the policies purchased through a broker cost the same or even less than a comparable plan on the marketplace.

A reputable agent will learn what’s important to you and what kind of budget you’re working with. Remember: It doesn’t cost you anything to use a reputable agent or broker. They are paid commissions from the health insurance companies; they don’t charge clients for their services.

>>Learn More: New to Arizona? A Guide to Health Insurance in AZ

Questions? Reach out to AZ Health Insurance Brokers

Don’t hesitate to call us at 602.617.4107 or send us a message today . We are happy to answer any questions and see if we can come up with a health plan that meets the needs of you and your family.

New to Arizona? A Guide to Health Insurance in AZ

Wed, 17 Jun 2020 15:54:10 GMT

Welcome to Arizona! There’s a lot going on in the Grand Canyon State that makes it a great place to live.

If you’re new to the state, we think you’ve made a good move. We’re glad you’re here.

Now it’s time to talk about health insurance in Arizona.

AZ Health Insurance Brokers can help you with all your health insurance needs, but first it’s important to understand what’s out there. This guide to health insurance in Arizona explains what your options are for your particular situation.

For Individuals: ACA Options or Private Insurance Plans

Individual health insurance is for those who aren’t covered by a group plan through their employer or through some other way, such as the VA. In some cases, people aren’t happy with the plans offered through their employer, and they want to find their own policy.

There are two ways to purchase individual health insurance in Arizona: You can buy one through the Affordable Care Act (ACA) exchange (or marketplace), or you can purchase a private policy through a broker or agent.

Buying through the ACA exchange

The ACA (sometimes referred to as “Obamacare”) passed in 2010. Insurance purchased from the ACA exchange is considered “government” insurance, and you may also hear it referred to as “on-exchange.”

The ACA’s aim is to make health insurance available to everyone, and the law requires everyone to have health insurance or pay a tax penalty. All ACA plans cover preexisting conditions as well as a list of essential health benefits. Based on your household size and income, you may be eligible to receive a government subsidy that reduces your monthly premium for an ACA plan.

Important to note: To get ACA coverage in Arizona for 2020, you had to buy your plan during the open enrollment period in 2019 (which was Nov. 1 to Dec. 15). The next open enrollment period for plans effective in 2021 will begin Nov. 1, 2020.

There is an exception; if you had any of the following “qualifying events” happen in your life, you receive a special enrollment period that lasts 60 days. According to the ACA site , these qualifying events are:

Getting married
Getting legally separated or divorced and losing health insurance as a result
Having a baby, adopting a child or placing a child for adoption or foster care
Moving
Becoming a U.S. citizen
Leaving incarceration
Losing other health coverage
Losing eligibility for Medicaid or the Children’s Health Insurance Program (CHIP)

If you need health insurance in Arizona in 2020 but you haven’t had any of the above qualifying events happen in your life, consult with a broker or agent to see what you're eligible to sign up for.

Who should buy an individual health insurance plan through the ACA exchange?

The ACA marketplace is a good idea for those who:

Qualify for a government subsidy. There are several factors that go into this determination, but the main one is that you have to earn between 100% and 400% of the federal poverty level.
Are willing to accept a narrow in-network list of doctors. According to Forbes , 72% of plans in the ACA marketplace have narrow networks, which limits choice for consumers. If this is OK with you, a plan purchased through the ACA may be a good fit.

Buying private insurance through a broker or agent

Private health insurance purchased through a broker or agent offers most of the essential health benefits as their ACA counterparts.

Who should buy a private individual health insurance plan through a broker or agent?

Go this route if you:

Make too much money to qualify for a government subsidy. If you’re not able to take advantage of the government subsidy that accompanies the ACA, then you may want to consider a private plan.
Your doctor doesn't accept any of the ACA plans. If you have a favorite doctor that you see often enough, it could make sense to go with a private plan that covers those visits.
You want personal attention and guidance. Let’s face it — insurance policies are confusing, the laws change frequently, and professional insight and advice are very welcome things. A broker can provide you with guidance and insight as to which plan makes the most sense.

For Families: Government (ACA) Options or Private Insurance Plans

The same principles that guide buying insurance for an individual apply to buying insurance for a family. Read the above section if you haven’t already, and then note:

You also have two options

you can purchase a family plan through the ACA marketplace, or you can get a private family plan through a broker or agent.

Expert guidance is suggested

Working with an experienced professional becomes even more important when shopping for insurance for an entire family. You must consider the individual needs of every family member. It’s possible, for example, for each of your children to have different insurance plans based on their individual conditions. The same applies for a spouse. This becomes very difficult to maneuver when you’re shopping solo via the ACA exchange. An insurance professional can get a customized plan for your family.

Couples should compare individual vs. family plans

If you’re looking for health insurance for you and your spouse, get quotes for yourselves separately (individual plans) and together (family plan). Based on your age difference and health needs, you may save money by going one route or the other.

For Businesses: Group Health Insurance

The ACA has requirements for business owners when it comes to offering health insurance to employees. In 2020, if your company employs 50 or more full-time employees, you are required to provide a certain percentage of them with minimum essential coverage — or face penalties.

Employers with fewer than 50 full-time employees are not required to provide group health insurance coverage. However, these businesses may be eligible for a tax credit if they do offer coverage, which makes the purchase of group health insurance more affordable. If you’re a small business owner in Arizona, you can usually qualify for the tax credit if you meet the following conditions:

You employ 25 or fewer full-time employees
The average salary of your employees in 2019 was $54,200 or less
Your business pays at least 50% of employee premiums

Even if your business isn’t required to offer health insurance to employees, it’s still a worthwhile thing to do. You’ll attract and retain top talent and be known as an employer of choice who cares about their employees.

It can be tough for business owners to keep up with the changing rules regarding health insurance. Working with an insurance professional ensures you understand what your responsibilities and options are.

Medicare Switch

Arizona is second on the list of states where senior citizens move to the most, according to SmartAsset (Florida holds the number one spot). If you’re a senior who’s making Arizona home, you may wonder what you need to do regarding your Medicare.

The answer depends on the type of Medicare you have. If you’re enrolled in Original Medicare, Part A and Part B, you don’t need to do anything — your plan will transfer beautifully to Arizona. You simply need to find a new doctor who accepts Medicare.

If you have any other type of Medicare coverage, you will need to enroll in an Arizona plan. First, contact Social Security to update your mailing address. Then, notify your Medicare plan provider so you can enroll in a new plan ( moving counts as a special circumstance in which you can switch plans).

You may wish to consult an insurance professional to help you with the process. We can help you understand Medicare coverage and the health care plans that supplement Medicare.

AZ Health Insurance Brokers Is Here for You

Please reach out to us to discuss your health insurance needs. Before we recommend anything, we’ll get an idea of your current situation, so we can find the best solution for your circumstances. It’s always our goal to help you find the answers to your insurance questions and get the right insurance plan for your needs.

And if you need referrals for other services, let us know. We can give sound recommendations regarding financial advisors, home and auto insurance, real estate agents and more.

We’re here to help! Contact us today.

Why Is My COBRA So Expensive?!

Wed, 11 Mar 2020 18:04:08 GMT

So, things have changed with your employer...

Maybe they’ve cut your hours and you're no longer eligible for their health insurance benefits, or maybe you’ve been laid off, or maybe you’re retiring !

No matter what the reason, all you know is that you no longer qualify for your company’s health insurance plan. Now you’re on the COBRA program--and it’s expensive.

We’re going to reveal why COBRA is so expensive, and what your options are if you’re looking to spend less and still get great health insurance coverage.

How COBRA Works

So, COBRA stands for Consolidated Omnibus Budget Reconciliation Act. COBRA is an Act that gives employees and their families the right to continue their current employer-based insurance plan in the event that they lose the health benefits they qualify for through the company.

COBRA eligibility only applies in certain situations to certain workers. For instance, COBRA is only available to you if your existing health plan is covered by COBRA. Your company’s Human Resources department can answer that question.

Also, in order to qualify for COBRA coverage, you need to have experienced what’s termed a “qualifying event”. Qualifying events include situations such as:

Involuntary job loss such as a layoff or firing (except for gross misconduct, which makes a person ineligible for COBRA)
Voluntary job loss such as retirement
A reduction in work hours that makes a person ineligible for health insurance benefits

And other types of qualifying events. If you qualify for COBRA, you can elect to continue the health care coverage you had before the qualifying event. You’ll have the same plan and the same benefits you had before your change in job status. However, there are a few caveats to the right to continue that coverage under COBRA.

COBRA is Temporary

The first caveat is that COBRA coverage has term limits. Typically, most people can use COBRA benefits for a maximum of 18 months. After you’ve used COBRA for 18 months, you are required to find another health insurance option.

In some cases, you may be able to continue COBRA coverage for up to 36 months. Those exceptions include scenarios such as if you or a family member is disabled, or if you experience a subsequent/second qualifying event.

See the Department of Labor’s COBRA page for more information on qualifying for COBRA. Again, just keep in mind that most people are only eligible to receive COBRA benefits for a maximum of 18 months.

Why COBRA Costs More (Why It’s So Expensive)

COBRA coverage will cost you more money than the insurance plan you had before your qualifying event--even though you carry the same insurance plan.

This is because, in most cases, your employer was contributing to the payment of your insurance plan’s monthly premium. After your qualifying event, your employer no longer contributes to the payment of your monthly insurance plan premium.

This means you are left to pay the entire monthly premium out of your own pocket--and that can be very expensive.

Luckily, you don’t have to use COBRA coverage to ensure you have good health insurance for yourself and/or your family. You do have other options.

What Are Some Alternatives to COBRA?

Government ACA (Affordable Care Act) Plans

As you likely know, the Affordable Care Act provides health insurance plans for citizens through the federal government. If you are within the Open Enrollment Period for the ACA (typically the beginning of November through mid-December) you can see the ACA website page for plan information.

The ACA also allows for Special Enrollment access to their health care plans in some situations. Typically, if you’ve experienced a job layoff or other qualifying event, you may be able to purchase an ACA health care plan during a Special Enrollment Period.

The government ACA program has a variety of available plans for you to choose from. Just be sure to read the fine print before purchasing, as some ACA plans can be quite costly.

Or Private Health Insurance Plans

We strongly encourage that you also take a look at private health insurance plans as an alternative to COBRA. Private health insurance plans offer a large variety of health insurance options with a wide selection of coverage options--and cost options.

With private health insurance plans, you can customize the type of coverage you have based on your medical needs, budget and more.

For instance, maybe you just want a short-term health insurance plan that carries you over until you find different employment or until you reach the open enrollment period.

Or, you may want a high-deductible plan to minimize premium costs. Maybe you just want to go with the cheapest health insurance you can find.

You and your family members have individual health needs and wants. You have doctors, clinics and hospitals you prefer.

There may be medical conditions you need to have covered. Private health insurance plans are so vast that you can find one to cover just about any health insurance preference or need you may have.

However, because your options are so vast, you’ll want help in finding the right health insurance plan for you. Don’t try to wade through the hundreds of health insurance options you have on your own. Get help from independent, experienced health insurance professionals that can help you find the best plan for your situation.

Summary

Whether you want to continue COBRA coverage, look at ACA plans or seek out a private health insurance plan, we can show you which health insurance options best fit your wants and needs.

Contact our expert team at AZ Health Insurance Brokers by calling us today at (602)617-4107 to get more information about which COBRA alternatives are available to you.

A Notice to Our Valued Clients and Current Associates

Mon, 10 Feb 2020 18:25:17 GMT

Why the rebrand and name change?

AZ Health Insurance Brokers is the new branded name for Ethan J. Pickner’s services to the Arizona community! (Formerly branded online as “Ethan J. Pickner - US Health Advisors”)

Ethan and his team have undergone significant transformations in the last few years in terms of expanding his and their network to better advise Arizonans on their health insurance options. Originally he was branded as a one-man show, advising folks as a licensed agent. However, because of the professional expansion and ability to serve greater, we believed it was an important time for an official rebranding.

Ethan J. Pickner is still your licensed agent and remains associated with US Health Advisors, but has expanded his personal licensed network in a greater effort to meet the demands of locals seeking advice and coverage. Meet AZ Health Insurance Brokers.

Does the name change affect my health coverage or premium plans already in place?

No. There will be no changes to the service we provide, and no action is needed by any persons.

This new name better aligns with our mission to help all Arizonans, every day, navigate the complicated arena of health care options.

This name change does NOT involve ANY modifications to the nature of the company, nor will it in any way affect existing relations with customers, medical providers, financial departments, contracts, associated network partners or contracts.

A thank you to all our friends and clients who have entrusted us with your personal situations over the years. Let us continue to help more individuals and hard-working families in Arizona. Our new brand has been designed to satisfy all the expectations of what a health insurance advisor can do for you.

And finally, we hope this goes without saying, but AZ Health Insurance Brokers will still never give out or sell your information to any other companies. We look forward to working together as we move forward!

I Missed Open Enrollment! Now What?

Tue, 31 Dec 2019 21:35:07 GMT

Getting Insurance After You’ve Missed Open Enrollment: Alternative Options

Just because you’ve missed open enrollment, that doesn’t mean you have to go without health care coverage. Here are some options you can check into to see which choice best suits your individual situation regarding your health insurance needs.

Check to See if You’re Eligible for a Special Enrollment Period

A Special Enrollment Period (SEP) is a time outside of the designated annual enrollment period when you can sign up for health insurance. In order to be eligible for a Special Enrollment Period, you need to have experienced what’s called a Qualifying Life Event.

Qualifying Life Events include events or situations such as:

Changes in Your Family

Getting married
Getting divorced
Having a baby
Adopting a child
Gaining custody of a child
Experiencing a death in the family

Changes in Residence

Moving to a different state, zip code or county
A student moving to or from the place they attend school
Moving to or from transitional housing, such as a shelter

Loss of Current Health Care Coverage

Ageing out of your parents’ health care plan
Losing health care coverage due to job changes, etc.
Losing eligibility for government assistance health programs such as Medicaid or Medicare

Other Life Circumstance Changes

Ending an incarceration period
Becoming a U.S. citizen
Starting or ending your services as an AmeriCorps member

There are other events that may qualify you for a Special Enrollment Period as well. For instance, if you can show that you were incapacitated or the victim of a natural disaster, you may qualify for Special Enrollment Period status. See this government webpage on Qualifying Life Events for more information.

If it turns out you do qualify for a Special Enrollment Period, you can contact the call center for the ACA insurance plans, and they’ll show you how to apply for the right insurance plan from there. Getting approved may involve having to show supporting documentation of the change that qualifies you for the Special Enrollment Period.

Note that if you’re eligible for an SEP due to a Qualifying Life Event, you have just 60 days after the occurrence of said event to enroll in a health plan under a Special Enrollment Period.

After that 60 day period ends, you’ve got to look at other alternative options. Whether you’ve missed the 60-day window or simply want to look at other health insurance choices, here are some other options for you.

Getting Coverage Through Medicaid or the Children’s Health Insurance Program

If you don’t have a Qualifying Life Event that allows you to enroll in a health care plan, you may be eligible for Medicaid or for the Children’s Health Insurance Program (CHIP).

These types of plans are available through the government and are income-based health plans. You can get Medicaid and CHIP anytime throughout the year, if you’re eligible for it.

Eligibility for Medicaid and CHIP are based on your income levels. However, families with income levels too high to qualify for Medicaid may still be eligible for CHIP.

Medicaid and the Children’s Health Insurance Program can be great options for you if you’ve missed enrollment and still need health care. Each state has different rules regarding eligibility criteria. Contact your state’s Medicaid agency for more information about Medicaid and CHIP eligibility.

Getting Coverage Through a Private Health Insurance Plan

Another option you have for getting health insurance if you missed open enrollment is to get coverage via a private health insurance plan. Luckily, there are short-term private health insurance plan options that could cover you until the next open enrollment period.

Short term plans and other types of private, individual or family health insurance plans can be great options when you’ve missed open enrollment and don’t qualify for Medicaid or other government sponsored health care programs.

With private health insurance plans, you have an abundance of options to cover all of you and your family’s insurance needs and your budget. There are plans to meet the needs of all budgets and health scenarios:

High deductible plans with lower monthly premiums
Lower deductible plans
Specific plans for ensuring your desired doctors, clinics and hospitals can be used

And more. Even though you’ll likely only need a private insurance plan until open enrollment time starts up again, you’ll want to make sure you have the right insurance plan for you and your family’s needs.

Since there are so many health insurance plans out there, you’re certain to find one that can meet your health care needs. In fact, you may even like your private health care plan so much that you’ll want to make it a permanent solution for your health insurance needs.

Related: What’s the Cheapest Health Care Plan?

Missing Open Enrollment Doesn’t Have to Leave You Uninsured

Whether you missed open enrollment for Affordable Health Care plans, for your employer, or if your employer doesn’t offer health care coverage anymore, you don’t have to worry about being without health care coverage to protect yourself and your family. Call the team at AZ Health Insurance Brokers today.

We’ll walk you through all of your health care options so you can choose the right solution to help ensure all of your health care needs are taken care of. You can reach us at 602.617.4107 .

What’s the Cheapest Insurance Plan?

Wed, 06 Nov 2019 16:42:45 GMT

Finding the “Why” Behind the Cheapest Insurance in the Phoenix Area

It’s smart to take your budget into account when shopping for individual health insurance . However, be sure you know the details behind the lower cost insurance plans before you sign on the dotted line.

Choosing the cheapest insurance plan could end up costing you thousands of dollars more in deductibles, copays or other costs. Before you choose the cheapest insurance plan, ask the plan provider or your insurance broker questions like the ones we’ve listed here.

Are There Missing Coverage Components in the Plan?

Sometimes insurance plans are cheaper because they’re missing key coverage components. For instance, the plan might not cover maternity care or psychiatric care.

Or, it might exclude dental or vision care. Look into the coverage details of the plans you’re considering before making a purchase decision. If a plan excludes a coverage component you may end up needing, it’s probably not worth the risk.

Is There a Maximum Amount the Plan Would Pay Out?

Some insurance plans include maximum payouts per benefit. For instance, you might have a limit or cap on a specific surgery. Or, there may be a calendar year maximum or lifetime maximum on certain policies.

Although the Affordable Care Act has eliminated annual and lifetime limits on the government health plans, there can still be some limits on some of the private plans.

You can call our customer service line at 602.617.4107 for more information on coverage limits.

What Kind of Network is the Plan Part of?

Insurance plans must be a part of a network, but there are several networks to choose from such as:

PPO (Preferred Provider Organization)
EPO (Exclusive Provider Organization)
HMO (Health Maintenance Organization)
POS (Point of Service)
HDHP (High Deductible Health Plan)

There are many differences between the varying networks, and each includes benefits (and detriments) that are too numerous to explain here.

However, the type of plan you choose is important and could impact you financially. For instance, PPO plans typically offer a broader coverage arena while POS plans are typically more limited.

And HDHPs typically require a large out-of-pocket deductible before benefits kick in. You’ll want to know what type of plan best suits your individual situation before choosing an insurance plan.

Our knowledgeable client representatives can help you understand the various types of health insurance networks, so that you can choose the right network plan for your needs.

Does the Plan Have a Term Limit?

Some of the cheapest health insurance plans are short-term health plans. These types of plans differ from the more common “major medical” plans that provide broader, long-term health care coverage.

In most cases, short-term health insurance plans are only a good option if you’re in between major medical plan options, such as if you’re moving from one job to another.

Short-term plans are often sold in 3, 6, 9 or 12-month terms. However, these types of insurance plans also carry limits that could neglect vital health care coverage for you and your family.

We can tell you whether a short-term insurance plan is a good option for you, or whether you’d be more safely covered with a major medical plan.

Does the Plan Exclude Pre-Existing Conditions?

Another potential downfall of cheaper health insurance plans in Arizona is that they often exclude pre-existing conditions.

It’s important to view and understand a health care plan’s Exclusions section before you purchase insurance under the plan.

Believe it or not, the term “pre-existing conditions” doesn’t only apply to major medical conditions such as Diabetes. Insurance companies can count seemingly minor health issues such as acne, asthma or obesity as a pre-existing condition too.

Also, psychiatric ailments such as anxiety and depression often count as pre-existing conditions.

Do you or a family member have any type of pre-existing condition? If so, you may find yourself short on coverage for important necessities if you choose an insurance plan based on cost alone.

This could result in massive out-of-pocket costs for you and your family. Be sure to do your research on what health issues in your family might be listed as pre-existing conditions.

Our broker representatives can help you determine whether health issues your family suffers from would be counted as a pre-existing condition.

Summary

While saving money on your health insurance plan is important, it shouldn’t be your main source of consideration when you shop for health insurance in Arizona.

The most important consideration should be finding the plan that best fits you and your family’s insurance needs. Where health insurance is concerned, being an informed consumer is paramount to saving money.

In addition, the money you’ll save in the long run by choosing the insurance plan with the best coverage for your needs will likely be a much bigger number than what you’ll save by going with the cheapest plan. This is why knowing the details on each plan is so important.

Our health insurance experts will give you a free consultation that will help you determine what the best insurance coverage plan is for you. Call AZ Health Insurance Brokers today at 602.617.4107 for more information on the various health insurance plans.

We’ll help you find the cheapest health insurance in Phoenix and surrounding areas, while working to ensure you get the right coverage for all of your health needs.

ew Paragraph

I’m Changing Jobs and My New Employer Doesn’t Offer Insurance Coverage.

Wed, 06 Nov 2019 14:45:47 GMT

Are you in the process of switching jobs and your new employer doesn’t offer insurance? Or are you thinking about working for an employer that doesn’t offer insurance?

Maybe you are considering leaving your job to start your own business. As a start-up business, you likely won’t be in a financial situation to offer insurance plans right out of the gate.

That can be a scary thought. Going without insurance is an option. The new mandates for the Affordable Care Act (ACA) reduced the non-insured penalty to $0. However, going without health insurance can be risky from a financial standpoint.

What if you encounter a major medical issue or have an accident? But do the risks of going without insurance mean you should avoid taking a job with an employer that doesn’t offer health insurance?

Not necessarily. Some great employers don’t offer health insurance plans--and you may not want to pass up a good job opportunity. So, what are your options?

Photo by Austin Distel on Unsplash

Finding Independent Health Insurance

Luckily, there are many companies that can offer to insure you independent of your employer. Independent health insurance policies are a popular choice. However, it can be daunting trying to find the right independent health insurance policy for your needs.

Here are some factors to consider as you contemplate a new employment situation and shop for individual health insurance.

What Will Your New Pay Rate Be?

Money is an important consideration when switching to an employer that doesn’t offer health care coverage. Most employers that offer health insurance contribute at least something toward insurance premium costs for employees.

If your employer isn’t offering health insurance, you may be left paying insurance premiums out of your own pocket. Therefore, the pay rate you’ll get at your new job is important.

If your new job pays more than your previous job, you’ll have extra money to use for independent insurance coverage costs. If your new job pays the same rate or less than your previous job, your insurance coverage costs may have a significant impact on your budget.

If that’s the case, you may want to talk with your new or potential employer about negotiating a pay increase.

Does Your New Employer Give You Money Toward Independent Health Insurance Costs?

Some employers that don’t offer health insurance coverage options will participate in a Defined Contribution Plan. A Defined Contribution Plan is a health insurance alternative employers have that allows them to not offer insurance coverage directly.

With a Defined Contribution Plan, your employer gives you a set amount of money each month via payroll. You, as the employee, can withdraw the money in your plan to use toward the purchase of an individual health insurance policy.

If your new employer doesn’t offer direct health insurance options, ask if they offer a Defined Contribution Plan.

How is Your Health?

Your current health picture--and the health picture of your dependents--is another important factor to consider. If you’re in a situation where you need to purchase independent health insurance, you’ll want to assess all of your options.

It’s not a good idea to simply go with the cheapest insurance plan you can find. Instead, you’ll want to consider the type of independent health insurance plan that’s best for your situation.

Are you relatively healthy and don’t take any prescription medications? If so, a cheaper health insurance policy with a higher deductible could make sense for you. The same goes if you don’t have any dependents that count on you for health care coverage.

However, what if you do have prescription medications you need? Or if you have a pre-existing condition or impending health procedures to consider?

What if you have a spouse and kids that depend on you for health care coverage? In cases like these, you may be better off choosing a more all-inclusive health care plan.

Finding a plan with lower deductibles and copays for office visits and prescriptions will likely benefit you more in these situations than a high deductible plan will. Even though the monthly premiums will be higher, the lower deductibles and out-of-pocket expenses will typically offset the higher premium amounts.

What Are All of Your Health Insurance Options?

If you choose to work for an employer that doesn’t offer health coverage, you do have options. Here is a summary of some of those options.

Get or Continue COBRA Coverage

COBRA insurance coverage is part of the Consolidated Omnibus Reconciliation Act of 1985. This act provides insurance coverage for people who are left without insurance due to job loss, divorce or other qualifying events.

You may already be using COBRA if you were laid off from your previous job. Or, you may qualify to start COBRA coverage. You can learn more about COBRA coverage here.

Use a Government Health Plan Offered Through the ACA

With the implementation of the Affordable Care Act, the government created government-based health plans for consumers. You do have the option to enroll in one of those plans.

You can find more information on government-based health plans through the ACA here.

Find a Private Health Insurance Plan

Another option is to find a private health insurance plan that fits your needs. The insurance experts here at AZ Health Insurance Brokers can help find you the right individual insurance plan for your needs.

We work with top-rated local insurance companies throughout Arizona in cities such as Phoenix, Flagstaff, Scottsdale, Kingman and more. Simply call us at 602.617.4107, and we’ll help you find the best insurance policy for your needs--at the right price.

Summary

If an employer doesn’t offer health insurance, that doesn’t mean you shouldn’t take the job. As a whole, it can be a phenomenal opportunity to work with an employer for the right combination of compensation and opportunity.

Just remember to take all things into consideration--including your health insurance needs. Whether you’re on the healthier side or facing medical issues, it’s important to explore all of your health insurance options.

In today’s world, independent health insurance policies are giving people like you more flexibility in where they choose to work.

How Can I Make the Insurance Sales Calls Stop?

Wed, 06 Nov 2019 14:34:06 GMT

It all started with such an innocent thought. Things are changing--or going to be changing--in your life. And you need to know how those changes will affect your ability to get (and afford) health care coverage.

You have perfectly logical questions such as:

What would my insurance costs be if I switched to an employer that doesn’t offer coverage? (<insert link to other blog post)
I’m retiring soon. Can you tell me what my insurance options are in retirement? (<insert link to medicare page)
I’m thinking about (or going to be) becoming self-employed. How do I get health care coverage?

You start getting curious and do an internet search to see if you can find some online health insurance quotes.

You go to a couple of websites, click “get a quote” and suddenly your phone starts ringing off the hook! Repeated third party calls with people trying to sell you insurance coverage are inundating your phone.

How can you make the calls stop?

Photo by Josh Appel on Unsplash

How Can I Make the Insurance Sales Calls Stop?

The calls go on for weeks, and you start to get that sick feeling in your stomach every time the phone rings. WHAT have I done? I just wanted a couple of quotes!

Thankfully you do have a couple of options to get the information you need AND stop the phone from ringing off the hook with unwanted calls. Here are some suggestions.

Get a Couple of Quotes

It won’t hurt to get a couple of quotes in order to get a better idea on some pricing and options. That way if you do end up needing coverage, you’ll know where you stand from a financial perspective.

And it’s always good to know how your new insurance situation might compare to your current health insurance premiums and out-of-pocket costs.

Just make sure you’re getting the full details of the plan they’re offering, coverage details and prices for the policies the companies are quoting you.

Get Your Insurance Quotes in Writing

Whenever you get a price quote from an online insurance broker, it’s important to ask for an email with the proposed coverage--and the costs associated with the coverage. Some companies will quote you “too good to be true” information over the phone.

Then you’ll get the policy in writing only to find out it is missing important components or has high out-of-pocket costs.

A trustworthy broker will gladly email you a summary of costs for the proposed coverage. If someone says they’re unable to provide you with a written quote--or if they say you have to sign up before you can get actual numbers--this is a red flag you shouldn’t ignore.

Use Your “Blocked Number” Feature on Your Phone

If you’re getting calls from the same number over and over again, you can always put the number on your Blocked Number list on your phone.

At the very least, this will stop some calls and texts from coming in. However, it’s important to note that some companies use multiple phone numbers to call from. If so, that could make using your Blocked Number feature a fruitless and/or tedious process.

Don’t Ignore the Calls

Likely the worst thing you can do is to ignore the calls, and ignoring them probably won’t make them go away. A lot of the companies you’ll find online are third party companies that will sell your information to different agents and brokers across the country.

They’ll work hard to get your business as any smart business will do.

Instead of ignoring the calls, answer the calls. Tell them you want a quote, or tell them to place you on their Do Not Call list. The Federal Trade Commission has a national Do Not Call list too, where you can add your phone number.

However, the national Do Not Call list won’t help you if you’ve contacted a company on your own to look for a quote.

Don’t Sign On the Dotted Line Until You’re Sure of What You’re Getting

It might be tempting to just sign up for a policy in order to make the phone calls stop. However, that move could put you in a precarious situation.

Finding health insurance coverage outside of your employer coverage can be overwhelming. You have so many options. And then there’s the fine print.

What if you sign up for a plan only to find out the deductibles and copays are much higher than what you can afford to pay? Or, what if you sign up for a plan that doesn’t cover important components you need, such as maternity care or pre-existing conditions?

Going with the cheapest insurance plan (<insert link to “cheap” article) isn’t the best money-saving plan if the cheap policy doesn’t provide the coverage you need.

Instead, you need a policy that will consider your budget and your insurance coverage needs. For that reason, it’s important not to sign up for a policy just to make the phone calls stop.

You need to be sure of what you’re being offered in terms of coverage and costs.

Call AZ Health Insurance Brokers

It’s frustrating to get barraged with calls from health insurance sales sites, but there is a better way. Instead of using a random online quote site that will often lead to your information being sold to dozens of agents or companies, call AZ Health Insurance Brokers.

We’re happy to give you a hassle-free quote or health insurance assessment. Call us at 602.617.4107 or click the “Quote” button below.

We will never sell or share your information with anyone. Instead, we’ll share some important insurance insights with you and give you the information you need--without the hassle.

Prevent the hassle of having to do damage control from the dozens of calls you’ll get if you unintentionally partner with a company that sells your personal information. We have a strict no sell/no share policy here at AZ Health Insurance Brokers.

And, we partner with local insurance companies in nearly every city in Arizona. This means we can help you find insurance whether you live in Phoenix, Kingman, Scottsdale, Tempe, Peoria, Tucson, Chandler, Mesa, Glendale or anywhere else in Arizona.

Call us today to get your free quote and to get the scoop on all of your health insurance options.