Guide to

The ultimate guide to buying insurance on

Posted by Sarah Kliff on December 10, 2013 

This guide is what you need to know — and we’ll be updating it going forward, as we get new questions from readers.


Today’s number: 17

17% of potentially eligible Americans visited Affordable Care Act marketplaces in October, according to a survey by the Commonwealth Fund.  Of those visitors,  20% were young people between the ages of 19-29, and 20% of those who visited actually enrolled in a plan.  60% of survey respondents were aware of aware of the purpose of the health care exchanges; of those that did not enroll,  37%  cited technical problems with the exchange web sites as the reason for not enrolling.


17 million individuals will qualify for insurance subsidies, according to an analysis by the Kaiser Family Foundation. This number represents nearly 6 in 10 Americans eligible to participate in the ACA health insurance marketplaces.   To receive a subsidy through the ACA, individuals must earn between 100-400% of the federal poverty line.  Most of the individuals qualifying for subsidies reside in Texas, California, and Florida.


Silver plans turning out to be best choice in N.C.

Yesterday my wife and I met with seven employees of a company to get started on enrolling them and getting them health insurance. Most of them were part time employees making about $17,000 to $20,000 a year; the two full-time employees made a little over $35,000. We can’t verify their eligibility for subsidies yet, but Blue Cross/Blue Shield has now implemented a way to “estimate” the amount of subsidy you might receive, and has calculated the plan rates accordingly.

What we’ve found so far is that the bronze level plans, while extremely inexpensive ($10/month for someone making $17,000 and single), have very high deductibles ($5000 plus $200 on prescription drugs). While the silver plans have higher monthly premiums (about $50 to $70 for the same person depending on which network of providers you get), the deductible was $500/$200 and the total out-of-pocket was only $700.

This is one problem the navigators face that we don’t: Navigators are not supposed to give advice about which plan you should choose. Whether the navigators are following that rule is unknown to me, but it seems to me to be fairly inevitable that anyone looking at those plans would instinctively blurt out that “The bronze plan is NOT in your best interest unless you know you’re not going to get sick at all in 2014.”

Another problem we had: While the website showed the estimated subsidy and gave one range of plans, when we clicked the button to email the quote to the client they got an email without the subsidies and with a slightly different set of policies. That’s something we’re going to bring to the attention of BCBS today when they have a webinar for all their agents in North Carolina.

It’s also been a revelation to us how little people know about the ACA in general. More on that in my next post.

The ACA still doesn’t exist in North Carolina

In this state, you have only two options if you want an ACA-compliant health insurance policy: Blue Cross/Blue Shield (“BCBS”) and Coventry.

Correction: If you live in one of the 39 counties that Coventry covers you have two options. In the other 61 counties in N.C., you have only one option: BCBS.

But you can’t get a subsidy through BCBS because their website can’t connect to, and I’ve been told you can’t even get a quote from Coventry. I’ve heard that some people have managed to set up an account at but I’m not one of the lucky few, and I’ve tried maybe 20 times by now. Continue reading

Hello, I’ll be guest blogging here

Bill Bryan

Bill Bryan

My name is Bill Bryan and my wife and I are licensed health insurance agents — and more importantly, certified Marketplace agents — in Raleigh, North Carolina (I use the term ‘Marketplace’ instead of ‘Exchange’ because it’s a more accurate term). Freelancer has invited me to be a guest blogger here, and it’s a privilege to be able to participate. I’ll be writing about what’s happening in the world of the Affordable Care Act in my neck of the woods. In North Carolina, the state decided not to open its own Marketplace, so ours is officially known as an “FFM” for “federally facilitated marketplace”.

There are two insurance companies which will be participating in the Marketplace in North Carolina: Blue Cross/Blue Shield and Coventry. As of today, I’m appointed to represent only Blue Cross/Blue Shield. We’ll be applying for appointments by Coventry next week, and the company for which my wife and I work (we run our own operation but with the support and direction of a bigger agency) assures us that obtaining that appointment will be routine. Continue reading