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Health Insurance in Illinois for Individuals Under 65

Posted by in on September 2, 2014

Health Insurance in Illinois for Individuals Under 65

Under 65 Health Insurance On or Off Exchange Policies

In the under 65 private market your employer CANNOT purchase a policy on your behalf.  The monthly premium needs to be paid with after tax dollars.

The IRS has issued an FAQ that states that employer reimbursement of individual premiums on a tax-favored basis will trigger this excise tax. All three agencies have issued an additional FAQ that states that reimbursement of premiums for individual coverage on either a pre-tax or an after-tax basis is an impermissible employer payment plan. This prohibition applies whether the payment or reimbursement is through a Section 125 plan, a 105 plan or as compensation.  Click here to read more.

  • Off-exchange Policies
  • On-Exchange Policies
  • Long-Term Policies
  • Short-Term Policies

Off-exchange or non-marketplace policies are health insurance polices that are purchased in the private market that are not subsidized by the Federal government.

On-exchange or marketplace place policies are those subsidized by the federal government.  They include things like cost-sharing that reduces your deductible and advanced premium tax credits that help pay for your monthly premiums.

Long-Term insurance which can be purchased both on or off-exchange typically called comprehensive major medical coverage is a permanent insurance policy that has services like:

  • Guaranteed for 12 months or longer
  • Guaranteed renewable
  • Meets the Affordable Care Act requirements, therefore, you would not have to pay a penalty.
  • Essential Health Benefits include:
    • Emergency Services
    • Hospitalization
    • Preventive Services
    • Mental Health and Substance Abuse
    • Prescription Drugs
    • Labratory services
    • Pediatric dental

Short-term insurance which cannot be purchased on-exchange and must be purchased off-exchange can protect you or your family against unexpected medical cost that could result from accidents or illnesses.

  • Can be purchases for 1 – 11 months
  • Not guaranteed renewable
  • Does not meet Affordable Care Act requirements, therefore, you may have to pay a penalty.

All of the major insurance companies in Illinois including: