How do the benefits differ? What would you owe in out-of-pocket costs if you were to be injured or get seriously ill? How does that compare with your out-of-pocket exposure on the employer-sponsored plan? Are your doctors in the network of the individual plan? You'll want to carefully consider all of these things before switching, and keep in mind that you won't be able to rejoin your employer's plan until the next open enrollment window offered by your employer.

There are premium subsidies available in the exchange, but you're not eligible for them if the plan offered by your employer is considered affordable and provides minimum value (this is true for your family members as well, if they have access to your employer-sponsored plan, even if the employer-sponsored plan is only affordable for the employee's portion of the coverage; this is known as the family glitch). Most employer-sponsored plans are affordable and do provide minimum value. So if you're shopping for an individual market plan instead, chances are high that you'll have to pay full price for it, without any subsidies.
Humana group medical plans are offered by Humana Medical Plan, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Health Plan of Ohio, Inc., Humana Health Plans of Puerto Rico, Inc. License # 00235-0008, Humana Wisconsin Health Organization Insurance Corporation, or Humana Health Plan of Texas, Inc., or insured by Humana Health Insurance Company of Florida, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Insurance Company, Humana Insurance Company of Kentucky, or Humana Insurance of Puerto Rico, Inc. License # 00187-0009, or administered by Humana Insurance Company or Humana Health Plan, Inc. For Arizona residents, plans are offered by Humana Health Plan, Inc. or insured by Humana Insurance Company. Administered by Humana Insurance Company.
But the ACA changed all that. Medical underwriting is no longer used, although applicants can now only enroll during open enrollment or a special enrollment period triggered by a qualifying event (similar to how enrollment works for employer-sponsored plans). Essential health benefits are now covered on all new individual major medical plans in every state. And millions of people are receiving premium subsidies that cover the majority of their premiums for plans purchased in each state’s health insurance exchange (the ACA’s consumer protection reforms apply to plans sold outside the exchanges as well, but the subsidies are only available in the exchange). The ACA also limits the percentage of premiums that insurers can use for administrative costs, including profits and executives’ salaries; insurers have refunded billions of dollars to consumers as a result of the new rules.

There are other online brokerages, both large and small, that can help you sort out the individual market health insurance options available in your area. Most of them can show you plans that are available in the exchange as well as options that are only available outside the exchange (no subsidies are available outside the exchange, but as noted above, you're probably not eligible for subsidies anyway, if you have access to an employer-sponsored plan).

There are premium subsidies available in the exchange, but you're not eligible for them if the plan offered by your employer is considered affordable and provides minimum value (this is true for your family members as well, if they have access to your employer-sponsored plan, even if the employer-sponsored plan is only affordable for the employee's portion of the coverage; this is known as the family glitch). Most employer-sponsored plans are affordable and do provide minimum value. So if you're shopping for an individual market plan instead, chances are high that you'll have to pay full price for it, without any subsidies.
Nearly a century later, private health insurance continues to dominate the U.S. health care landscape. Despite attempts by U.S. Presidents, including Harry S. Truman, John F. Kennedy and Bill Clinton, government-sponsored universal health care never materialized. And, although President Lyndon Johnson signed Medicare into law in the 1960s to provide a safety net for citizens over age 65, the majority of Americans under 65 continue to get their health care from private insurers.
Our health benefit plans, dental plans, vision plans, and life insurance plans have exclusions, limitations and terms under which the coverage may be continued in force or discontinued. Our dental plans, vision plans, and life insurance plans may also have waiting periods. For costs and complete details of coverage, call or write Humana or your Humana insurance agent or broker.
Custom Health Plans is a full-service Texas health Insurance broker providing affordable Texas health insurance quotes to individuals, families, small businesses and the self-employed. Based in Dallas, TX, our team of professionals has more than 30 years of experience in the health insurance and financial services fields. Our integrated suite of online services and partnerships with top health insurance carriers positions us to offer the highest level of service and guarantees the best health insurance quotes in Texas.
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