At look at – What is going on in the way we receive health care services?

I want to share some points from a report – Considering Healthcare’s Transformation. It was created following a gathering in January 2015 of healthcare executives. Specific comments made by individuals are shown in quotes. I added bold to emphasize some points I see as important to individuals.

● Much is being done to transition to value based care, which gets you and I as consumers involved in our health. About 1/3 of the providers – hospitals – physician groups indicate their concern in implementing this was “uncertainty about revenue streams”.

● The transition going on in information technology (IT) to store data in cloud based systems results in physicians thinking individuals electronic medical records (EMR) will be connected to all aspects of care.

● Consumers will be more involved in the way care is going to be managed and will “take more responsibility for health decisions".

● Surveys indicate “nearly half of consumers and 79% of physicians believe using mobile devices can help clinician’s better coordinate care”.

● Consumers are demanding more eVisits and done when they want.

● The chief medical officer at a North Carolina health system indicated – “The consumer wants to be more in the driver’s seat and less in the it’s-being-done-to-them seat as we move forward”.

● An individual from one health insurance company stated – “We work - - to move to population health in a new world order where payment structures will transition from fee-for- service healthcare to instead reward outcomes and value”.

● An MD who is a principal in the consulting firm PriceWaterhouseCooper (PwC) Health Industries Advisory service indicated – “We are now focusing on the 80% of people who are healthy, who we never paid attention to before. In the past, nobody cared if a member is healthy because as long as there is no cost and he is not sick, it’s not important. But now, because we are going to be accountable for the total cost of our population, we want to keep these folks healthy, which means we can attack the obesity problem to prevent people from getting sick and getting diabetics. That’s important”.

● The PwC MD also indicated – “My hope with the population health management approach is that we are able to bring the cost down so the financial burden is not significant on the consumer. Because otherwise we can be doing everything good but the patient is not willing to comply”.

Connecting to what the MD states, in the above comment about responsibility for treatment expenses, individuals in today's medical insurance have a larger cost share. Plans no longer just have visit co-pays. Now, to meet health reform requirements, plans use more cost sharing and a deductible. In some cases it is a deductible followed by cost sharing.

FYI - Traditional plans in CT include a provision in 2015, which limits a person's expenses during a plan year to a Maximum Out of Pocket (MOP) of up to $6,600. Health Savings Account plans follow IRS regulations and have have a MOP of $6,450.

Questions - Call my Google Voice - we can talk about things going on in CT. (860) 451-9793.

How will medical insurance plans change for the 2015 plan year?

Some details on the 2015 plans were made available in the last couple weeks which I want to share.

First some background. Federal health reform required a change in the design of medical insurance plans. IOW the deductible, co-pays, and cost sharing amounts are used in a different way. These changes began January 1, 2014.

Medical insurance plans, whether purchased in the Individual or Small Group market, have to meet certain requirements. The basics of these changes are:

● Plans must cover 10 Essential Health Benefits (EHB). Two are new to Conn. Pediatric dental coverage (for age 19 and under) and what is called habilitative services. Rehabilitative services help an individual recuperate for example following hip surgery. This coverage stops when the person is no longer improving. Habilitative coverage helps a person who is no longer improving but their condition would decline if certain services were to stop. It’s only available for certain conditions.

● Each health insurance company must use a complex calculation to determine how much of a person’s medical treatment expenses the company pays and how much an individual will pay. This calculation results in what is called the plans Actuarial Value (AV).

There are four AV levels. Platinum, which has to cover 90% of the required EHBs. Gold covers 80%, Silver is 70%, and Bronze is 60%.

A person might think when looking, for example, at a Silver plan – oh my if I have $100,000 in medical expenses I will have to pay $30,000. The answer is NO. A person’s expenses, if a major treatment situation were to occur, are limited each plan year by the maximum out of pocket (MOP) provision. This limit is adjusted each year.


Second let’s look at the highlights of a person’s coverage during 2014, who is enrolled in the Standard Silver Individual plan through Access Health CT:
● No cost for a variety of preventive exams and tests.
● A $30 co-pay for a primary care doctor visit and $45 to see a specialist
● Other medical treatment is covered after a $3,000 deductible.
● A $400 deductible on prescriptions and then a $10 co-pay for Generics, $25 for preferred brands, $40 for non-preferred brands, and 40% cost sharing for specialty medications.
● A $75 co-pay for Urgent care and a $150 co-pay for an emergency room visit.
● A $500 co-pay for outpatient surgery
● A $500 per day co-pay for hospitalization up to $2,000 is applied after the medical deductible has been met.
● A MOP of $6,350 for Single coverage. The MOP is doubled when a person enrolls one or more dependents on their plan.

Third let’s look at the highlights of Access Health CT plans for the Standard Silver Individual plan in 2015:
● No cost for a variety of preventive exams and tests.
● A $40 co-pay for up to three primary care doctor visit and $50 to see a specialist.
● Other medical treatment is covered after a $2,600 deductible.
● Generic medications will have $5 co-pays, Preferred brands at $30, and non-preferred brands at $55 with no deductible. Specialty medications will have a $60 co-pay after a $25 deductible.
● A $75 co-pay for Urgent care, after the deductible, and a $150 co-pay for an emergency room visit.
● A $500 co-pay for outpatient surgery
● A $500 per day co-pay up to $2,000, for hospitalization after the medical deductible has been met
● A MOP of $6,600 for Single coverage. The MOP is doubled when a person enrolls one or more dependents on their plan.

There may be some variation in this coverage between the health insurance companies offering these plans effective January 1, 2015.

What companies will be available for 2015? It is anticipated additional companies will apply to offer plans through Access Health CT in 2015.

How much higher will the premiums be in 2015? A BIG unknown. The Access Health CT consultants indicated the 2015 plan changes should not result in much of an increase. Of course the big unknown is what impact the every increasing cost of medical treatment will have.

Questions - send a note to - LearnMore@JohnParker.agency

The best way to review options and select medical insurance!

The media provided lots of coverage about signing up for medical insurance in the months leading up to January 2014. That coverage continues but what is being found – many people looking at their options do not understand the terms used to describe the new coverage!

I want to share a post which mentions a recent Atlantic article, It included some points about this lack of understanding and the impact it is having. It brings out:

● “- - - more than 77 million people have difficulty with common health-related reading tasks.”

● “Not only is it more difficult for individuals to understand and take action in their own health, but it contributes to higher healthcare costs.”


Many people have enrolled but others may still be thinking about this important kind of “medical treatment expense protection”.

If you want to look and gain a clear understanding of how the various options work the most effective approach is to contact a health insurance professional.

How to contact a professional: The Connecticut Chapter of the National Association of Health Underwriters has a feature on their web site, which takes you to the national association’s Find an Agent page. Using this resource is easy - just enter your zipcode.

Doing this means you can find a health insurance professional in your area to work with to fully understand this important coverage. They will simplify the language and complexities and be sure you select a plan, which will meet your interest and budget. There is no cost for this professional help and you gain on going help through-out the year for any questions, which come up.

Federal health reform requirements effective in 2014

Federal health reform became law in March 2010 followed by the issuing of numerous regulations on details on how the new legislation will all be implemented. These requirements apply to plans at the end of their current policy year in 2014. Some of the new requirements are highlighted here:

● The new Advance Premium Tax Credit (APTC) for those who qualified based on their income and who enrolled for coverage through Access Health CT. The way this works:
+ the person pays a certain amount for their share of the premium, which is based on a percent of their income.
+ The APTC is the amount after the persons share of the premium is subtracted from the actual premium which is based on their age.
+ The APTC amount is sent each month to the health insurance company the person selected. They then bill the person each month for their share.

● Penalty for not having medical insurance: Individuals who do not enroll in a qualified individual or employer plan will have to pay a penalty at the end of 2014. It equals 1% of their income. It will increase to 2.5% in a couple years.

● Plan design requirements: Medical insurance plans can no longer have a lifetime limit and the maximum out of pocket expenses now follow the health savings account annual limits.

● How premiums are determined: The premium for a 62 year old can be no more than three times the rate for a 22 year old. Rate bands have been eliminated. The premium now goes up for each age. Rates for males and females are the same when the age is the same. The rate for a child from birth to age 20 is now .635 of the age 21 rates for the plan.

● MedicAID expansion: Connecticut has been very generous in providing medical coverage for children through the state’s Husky program. Adults whose income was around 70% of the federal poverty level (FPL) were also eligible for MedicAID coverage. Health reform increased the eligibility for adults to 138% of FPL.

● Small Business Tax Credit: Certain small businesses can quality for this tax credit if the coverage is purchased through the employer part of Access Health CT. The credit increases to 50% of the premium for 2014. An employer can qualify for the maximum credit if they have 10 or fewer employees, excluding the owner, and average salary for these employees is $25,000 or lower. Employers with up to 25 employees and whose average salary is $50,000 or lower can qualify for a lesser credit. The amount does not slope down from 25k to 50k but falls off rapidly. Many employers will not qualify for the max credit because they do not offer medical insurance.

● Taxes on medical insurance: When an person receives a quote for an individual medical plan three taxes, included in the premium are shown. A Health Insurance tax, a tax to support Access Health CT, and a reinsurance tax.
We’ve been C

● New employee waiting period. The maximum waiting period is now 90 days.

Questions on these new requirements? Call my Google voice line (860) 451-9793 for a free consultation on how federal health reform will work here in Conn.

What happens to my premium support if I go from part to full time?

People here in Connecticut can begin to sign up for individual medical insurance this fall, through Access Health CT, and at the same time apply for help paying their premium. Eligibility for help will be based on the household income they reported to the IRS for 2012. This new program, which I call premium support is technically an Advance Premium Tax Credit (APTC), begins January 1st for those that qualify. It will be managed by Access Health CT and monitored by the IRS.

Let’s look at how eligibility works. A Single person, after being in a part time position for a couple years, applies and gets help starting in January. Then they get a new full time job in May. The IRS will:

● Have received information on their APTC and on everyone who was approved.

● Reconcile income changes, such as going to full time, when the person files their tax return for 2014.

● Request full repayment of the tax credit for months when the new income is higher than 400% of Federal Poverty Level (FPL). This level is about $46,000 for a single person and $94,000 for a family of four.

● Request a limited repayment if the new household income continues to be below 400% of FPL. When a person’s tax credit was too high for certain months their max liability for the year is currently limited to:
+ $2,500 when income is 300% to 400% of FPL
+ $1,500 when income is 200% to 300% of FPL
+ $600 when income is less than 200% of FPL

The new help program also enrolls individuals whose FPL is 400% and below in a plan with a lower maximum out of pocket (MOP) on the expenses for which they are responsible. When income is below 250% of the FPL individuals are also enrolled in a plan with reduced co-pays and cost sharing. Any benefit payments received under these cost sharing reduction provisions will not have to be paid back if their income increases above these levels.

This summary has focused on the eligibility for help, which is based on a person’s household income. How much of their premium will be paid, or the amount of APTC, however is based on an individual’s age.

Let’s look at how this special payment works: Person A is age 32 & person B is age 62. Both are Single & each earns $40,000:

● The max amount A & B will pay each month is based on a percent of their household income, which is 9.5% at $40,000. Thus, A & B will both have to pay $316.66 each month.

● The APTC is determined by taking the premium for the second lowest priced Silver plan for that person and subtracting their share or the $316.66 in this example from the total. A person's premium is based on their age and geographic location and the plan they selected.

● The resulting APTC will be sent to the Health Insurance Company they selected and the company will then send both person A & B an invoice at home for their $316.66 each month. Their payment will be made on an after tax basis.

Questions on the premium support program or other parts of federal health reform? Call (860) 451-9793.

John C Parker, RHU, LTCP
Niantic CT

Should I continue with my employer plan or go to Access Health CT for a discount?

This is a common question these days so I want to share a short article from WebMD with some things to think about.

To provide some information about Connecticut lets look at what a Single person might pay as their share of the medical insurance plan's monthly premium. A plan through Access Health CT for a person who earns 30k will cost them $237.50 a month. Some one at 40k will pay $316.66 each month. Couple points about this new way to obtain health insurance:

● The amounts above are more than the contribution many employees pay each month under their current Single coverage.

● Individuals with these incomes will qualify for premium support and this amount, which is called an Advance Premium Tax Credit (APTC), will be sent each month to the health insurance company they selected.
Note: A person's APTC is based only on income. Whether they are 32 or 62 if their income is the same their APTC will be the same.

● These individuals will get a bill each month from their plan and pay their share with after tax dollars.

● Individuals enrolled in a group medical benefit plan through their employer normally pay their share of the monthly premium with before tax dollars.

BTW - a Single person with incomes like above who currently has an Individual medical insurance plan will benefit from the new premium support program.

Question? Call (860) 451-9793 or send a note to JohnParkerAgency@gmail.com

Why can’t everyone have lower cost medical insurance?

Someone recently raised this question so I am sharing some comments.

The direct answer – federal health reform legislation does not provide a reason why the income based levels for help were selected.

BTW - if you have questions about any part of what federal health reform means to us here in Conn. Post your question.

The premium support program: Section 1401 of the law, which is entitled – Refundable Tax Credit Providing Premium Assistance For Coverage Under A Qualified Health Plan, includes details on the program. Various comments have been made about this since the law was signed in March 2010 and provide some insights. A couple points:

● It’s purpose is to lower the number of uninsured individuals.

● Another focus was to help individuals whose income is above the level for MedicAID eligibility and thus are a big part of the uninsured. The contribution or share of the premium for those with a lower income is smaller than for a person with a higher income.

Note: Perhaps the answer to the question is in the speculation of some - if additional individuals had been included, the cost to the federal government would have been too high to get the law passed. Eligibility was thus limited to people whose income is at 400% of Federal Poverty Level (FPL) and lower. Anyway 400% equals about $46,000 for a single person and $94,200 for a family of four.

The new “help to pay for coverage” program starts January 1st and has two parts:

First - federal funds will be sent each month to the person’s health insurance company. Technically this payment is an Advance Premium Tax Credit, the IRS will record it in the person’s record, and they will include it in their annual 1040 filing.

Second - the amount a person, who qualifies for help, has to pay their health insurance company each month is based on a percentage of their annual income. Their payment amount is subtracted from their plan’s age based premium to determine the amount of their premium support.

The level of help changes with income: The amount individuals who qualify will pay, based on different ranges of household income, is shown in the list below. The FPL percent amount is found in Section 1401 of the law in a chart which shows income ranges “expressed as a percent of poverty”. I converted the percent of annual income amount into the monthly contribution for people with this income. The first amount is what a Single person at that income level will pay each month, next is the payment for a Couple, than for a Family of 3, and the fourth amount is for a Family of 4.

● When at 133% of FPL a person pays 3% or $37 - $50 - $63 - $77

● When at 150% of FPL a person pays 4% or $56 - $76 - $95 - $115

● When at 200% of FPL a person pays 6.3% or $117 - $159 - $200 - $242

● When at 250% of FPL a person pays 8.05% or $187 - $254 - $320 - $387

● When at 300% of FPL a person pays 9.5% or $265 - $359 - $453 - $547

● When at 400% of FPL a person also pays 9.5% or $354 - $479 - $605 - $730

One other point about federal health reform. Regretfully very little in the law addresses the real problem we face today. What is that? Health insurance is expense because the rapidly growing cost of medical treatments is very expensive.

It is also important to understand another big reason medical insurance is so expensive - lifestyle choices. For example, people who smoke have higher treatment costs and big costs result from the obesity problem we face today since many adults and children do not follow an effective diet. Costs from lifestyle choices use up 70% or more of each premium dollar.

What's this about lower cost medical insurance for eligible individuals

Individuals in Conn will be able to submit an application when Open Enrollment begins this October to determine eligibility for lower cost medical insurance. They can apply for coverage to begin January 1, 2014 through Connecticut’s Health Insurance Marketplace, which is an on line enrollment site operating with the name Access Health CT.

I am pleased to share some points on eligibility and what the regulations to implement federal health reform say about how this new program will work:
● Eligibility is based on the person’s modified adjusted income (MAGI) and what it's percent of the Federal Poverty Level (FPL) is. Single individuals whose MAGI is at 400% of FPL (about $46,000) and below will be eligible.
● Individuals with dependents can also receive help based on their families combined MAGI. The maximum MAGI for a family of four would be $94,200. This is the 400% of FPL for a family.
● The share of the plan's premium for a single person making $40,000 is equal to 9.5% of their annual MAGI or $316.66 a month. The monthly share for a family of four whose MAGI is $94,200 would be $745.75. The monthly share for a person 22 and one who is 62 will be the same if each has the same income.
● The amount a person will be eligible for, which I call premium support, is calculated by subtracting, for example, the above Single individual’s $316 share from the premium for their age. If the premium was $600 it would be $284. Technically the amount a person qualifies for is an Advance Premium Tax Credit (APTC) and as a tax credit it will be reported to the IRS. Thus, a person will be responsible to reconcile this credit as part of their annual 1040 income tax report.
● The premium support or APTC amount is not based on the plan a person selects but only on the monthly premium of their second lowest cost Silver plan.
● The federal level Health and Human Services will send the individual's premium support to the medical insurance company they selected each month. This amount will vary based on a person’s age and the number of individuals they cover.
● The health insurance company will invoice them at home each month and they will pay their share on an after tax basis.

Initial plans for the application process was for a person to go to Access Health CT, enter personal and financial information, and while this was being done the system would:
● Interact with federal agencies, such as Homeland Security (citizenship), Social Security, and the IRS through a federal level data hub.
● Come back to them in real time and indicate, while still on line, if eligible for help and the amount they would have to pay each month. e.g. the above $316.
● Move them to the next step to review medical insurance plans from the three companies participating in the Individual plan part of Access Health CT. Eligible individuals will be able to select a plan, other than the second lowest cost Silver plan, which has more coverage by paying the additional premium.
● Then move them to the medical insurance company they selected to complete their enrollment.

As of today we do not know how much of the fully automated enrollment process will be available initially.

Want to take a look at whether you would be eligible for a premium discount and what your share might be? Go to AccessHealthCT.com. There is a link to a savings calculator on the home page.

What is the story on the discounts for medical insurance to be available next January?

Here in Conn and other states individuals will be able to go online and find out if they qualify for premium support on medical insurance. Some call it a premium discount and it is based on a persons family income. The online system is scheduled to be available for viewing this October and the premium support will be starting in January.

Single individuals with income of up to about $46,000 will be eligible for premium support. The most a Single person earning say $42,000 would pay is 9.5% of their annual income. This comes out to be a monthly payment of $332.50. When income is below $30,000 the percent they pay will be lower. Whether they are age 32 or 62 does not matter.

Individuals living in Conn can take a look at what they may pay by going to Connecticut's online enrollment site. AccessHealthCT.com. The home page directs you to the Savings calculator, which will make a projection.

The theory of the system is you go to an online site, enter personal and financial information, and in real time learn if you are eligible. The system is to check, as your information is entered, with what is called a federal hub and include agencies such as the IRS, Social Security, Homeland Security (to confirm citizenship). How much will be available in real time starting this fall is not yet known.

Interested in all the technical details on how premium support will work? How a person will have to reconcile the tax credit they receive? Take a look at this July 24th blog.

BTW - what a person technically will receive is an Advanceable Premium Tax Credit (APTC). If a person qualifies for premium support the system will send money to the medical insurance company the person selected and that company will send them a balance due invoice each month.

Questions? Call (860) 451-9793


John C Parker, RHU, LTCP
Niantic CT

What's this about delays in federal health reform

Starting just before the July 4th holiday federal agencies announced various changes or delays in health reform's implementation timeline.

My note today is to share a couple things which affect employers:

● The penalty for employers with over 50 employees who do not offer medical insurance will not be imposed beginning Jan 1, 2014. Instead the effective date will change to Jan 1, 2015. The requirement to offer coverage or pay penalty is still there - just not going to be enforced.

● The requirement for employers and health insurance companies to make various reports was also been delayed.

Couple things, which will affect individuals who are applying for premium support through the Health Insurance Marketplace. The Connecticut marketplace is calling itself Access Health CT.

● Individuals will be asked to attest if they currently have employer based medical insurance. Individuals will also be asked about the level of their coverage and it's cost. The planned online verification process will be delayed.

● An individual will also enter their income to determine what, if any, premium support for which they qualify. This will not be verified through the online enrollment system as planned. However, similar to other tax related reporting the confirmation will be made as part of a person's annual 1040 tax return. If an individual receives premium support, which is technically a refundable tax credit, and they are not eligible it will have to be paid back. If negligent reporting is found an individual can also be fined up to $25,000.

Contact if any questions. (860) 451-9793

A look at Access Health CT's role in federal health reform

Access Health CT is working, under federal health reform regulations toward becoming a new option to select and enroll in a medical insurance plan. Open Enrollment for Individuals and Small Employers in Conn begins October 1st for coverage effective January 1, 2014. Some information:

● The media campaign to increase awareness of this new option is now underway.

● Residents, as part of the enrollment process on the Individual part of Access Health CT site, may qualify for premium support. This support is based on income and is technically a tax credit. Information on the income range can be seen here.

● The page on the above link includes a calculator. By entering income information it will show what your share of the monthly premium will be.

● This pdf summary highlights 10 points about the Access Health CT program.

● Small businesses will be able to go to the Small Business Health Options Program or “SHOP” part of Access Health CT. Some information can be seen here.

● Certain small employers may be eligible for a tax credit to offset part of the expense of their medical benefit plan. In 2013 any small employer can apply for a tax credit of up to a 35%. This changes to 50% in 2014 and is only available if the firm selects a plan through the SHOP part of Access Health CT.
Note: The maximum credit is only be available if an employer has 10 or fewer employees, excluding the owner, and the average salary for these employees is $25,000 or less. The credit drops quickly and is not available to firms with 25 or more employees or if the employee average salary is $50,000 or higher.

Contact me - (860) 451-9793 - if questions about Access Health CT or the medical plans for Individuals or Small Employers, which are anticipated to be available.

John C Parker, RHU, LTCP
Niantic CT

Employers in Conn required to provide, by Oct. 1, all employees a letter on federal health reform

Federal health reform includes a requirement for all employers to notify their full and part time employees about the coming availability of the Health Insurance Marketplace. Here in Conn our Marketplace is known as Access Health CT. Information is available here.

Model letters on what is to be included in the letters was issued by the federal Department of Labor in early May. One letter is for employees who currently have medical insurance from their employer. The second is for employees who do not have employer provided medical insurance.

Note: Even though model letters were issued some of my professional association contacts in Washington DC indicate the letters may be changed. Then too, it is normally more effective to communicate to employees close to the time they can do something so it may be best to wait.

Call today if any questions on the federal requirement to notify employees about health reform. (860) 451-9793


In regard of Access Health CT. Four health insurance companies have submitted an application to become a Qualified Health Plan and offer medical insurance plans to individuals here in Conn. Aetna, Anthem BC & BS of CT, ConnectiCare, and HealthyCT. HealthyCT is a new type of health insurance company created by federal health reform, which is called a Consumer Operated and Oriented Plan (CO-OP). Here is some info on the Conn CO-OP. started by the Connecticut State Medical Society.

Looking around at what health reform means in Connecticut

My note is to review and comment on some of the things we do know about the impact federal health reform will have here in Connecticut. There is a lot more for employers and individuals to learn, from not yet released regulations.

● The Health Insurance Marketplace here in CT, called an Exchange in the legislation, changed it's name to Access Health CT. Individuals can go to this site and review medical insurance plan options beginning in October and select coverage, which will be effective January 1, 2014.


● Federal health reform requires various market reforms in the Individual and Small group markets:
One is - all plans available, whether through Access Health CT or direct from a company, will be placed in one of four levels. Platinum, Gold, Silver, and Bronze. The coverage must meet 10 essential benefits. One of which is preventive dental coverage for children. Individual plans will no longer be subject to a review of medical history or pre-existing conditions and will include maternity coverage. These two requirements will result in the premium being higher.

Another - The premium for a person age 21 will have a factor of 1. The factor will increase year by year up to a factor of 3 for a person age 64. A couple on the same plan will each have a different premium if their age is different and there will no longer be male and female rates. Children from birth to age 20 will have a factor of .635. Today the spread from 20s up to 60s is about 5 to 1 which tells us the change to 3 to 1 means individuals in their 20s and 30s will see an increase in premium. Connecticut will allow the premium, for a person in the Individual market who smokes, to be increased up to 50%. The smoker factor will not be applied initially in the Small group market.


● Access Health CT approved the plan designs for the Individual plan market. The Silver level, the plan premium support is based on, has a $3,000 deductible. Preventive treatments are not applied to the deductible and do not have any cost to an individual. Expenses for various diagnostic office visits will not go toward the deductible but will have co-pays. Hospitalization will be applied to the deductible and will also have co-pays for the first few days of being admitted.


● Individuals whose income is up to 400% of the federal poverty level (FPL) can qualify for premium support if the buy a plan through Access Health CT. The maximum a person at 400% FPL, which is about $45,000 for a single person, will have to pay as their share of the premium is 9.5% of their W2 income.

● Individuals with a lower income will pay a lower percentage and those at about 250% of FPL will have lower plan co-pays and other improvements. The amount a person who qualifies for premium support pays is not connected to their age. Premium support will be sent from a federal agency to the medical insurance plan the individual selected. The company will then bill the individual, at home, the balance due (the 9.5% above) each month.