2022 & Beyond for Individual & Family Health Insurance

We are proud to represent Blue Cross Blue Shield of Florida (Florida Blue). This is the top Health Insurance Company in Florida, with the most Health Plans and the best rates!

They also have a number of large Networks of quality Service Providers and Facilities throughout the state of Florida, as well as nationwide affiliate Networks.

As of 2017, FLORIDA BLUE became the ONLY Insurance Company offering Individual and Family Affordable Care Act (ACA) Health Insurance Plans in BOTH Collier & Lee counties. 

Then in 2020 several other insurance companies came into Southwest and to other parts of Florida, but NONE could compare with the quality and strength of FLORIDA BLUE! 
  
Back in October of 2013 (before the first Obamacare Open Enrollment Season) we became Certified Health Care Reform Specialists. Every year before Open Enrollment starts we MUST re-certify with the Government and with Florida Blue in order to provide this service to those who need it.

Since this program started we have been able to help THOUSANDS of NEW Clients who were NOT insured because their Employer DID NOT offer group insurance and they could not afford the high cost of individual insurance.

Women and couples having a baby are thrilled that these new Health Plans include maternity, delivery and newborn baby care with no waiting periods or exclusions.

We are thrilled that we have been able to help HUNDREDS of people that up to January 2014 were NOT INSURABLE due to serious illnesses such as diabetes, cancer, heart problems, etc. Now those individuals have quality and comprehensive health insurance coverage and NO EXCLUSIONS OF ANY PRE-EXISTING MEDICAL CONDITIONS!

WHAT TYPE OF HEALTH COVERAGE IS AVAILABLE?

There are several general classifications of Comprehensive and Quality Major Medical Coverage (by Law) and three types of Health Insurance Plans (Health Insurance companies regulations). If you are considering a Health Plan that DOES NOT have the features below, it IS NOT a LEGITIMATE ACA Health Insurance Major Medical Plan. 

WHAT IS AN AFFORDABLE CARE ACT (ACA) HEALTH PLAN?

These are Major Medical Insurance Plans that are approved by the State and are complying with all the new Federal Health Care Reform Laws, which became effective as of January 1st, 2014. An ACA Health Plan will include the following (in writing): 

  • Guaranteed Issue (NO Pre-Existing Conditions can be excluded)
     
  • The price of the policy cannot be higher based on marginal or poor health (Pre-Existing Conditions)
     
  • The rates for men & women are no longer different (only based on ages).
     
  • The exception is that Smokers are rated Higher than Non-Smokers.
     
  • Maternity, Delivery & Well Baby Care is now covered by all ACA Health Plans (same as any other illness / procedure based on the coverage)
     
  • Annual Prevention / Wellness Visit to the In-Network Primary Care Physician or Pediatrician, Immunizations & Lab Tests are $0 (Zero) Cost. 
     
  • Every ACA Health Plan has Essential Health Benefits which are: In addition to the Annual Free Prevention & the Maternity Benefits described above, also Labs, X-Rays, Diagnostic Tests, Prescription Meds, Urgent Care, Hospital Emergency Room Care, Ambulance Services, Out-Patient Surgical Services, Hospitalization, Physical Therapy, Skilled Nursing, Hospice, Mental Health Services & Substance Abuse Recovery.
     
  • ACA Health Plans NO LONGER have a Maximum Lifetime Cap of Benefits, such as $3 Billion, $5 Billion. Now All Policies have UNLIMITED Lifetime Benefits.  

MANAGED CARE

Managed-care plans became popular in the 1990s as a way to help reduce rising medical costs. In managed-care plans, insurance companies contract with a network of health-care providers to provide cost-effective health care. Managed-care plans include health maintenance organizations (HMOs), preferred provider organizations (PPOs), and point-of-service (POS) plans.

HEALTH MAINTENANCE ORGANIZATIONS (HMOs)


An HMO is a network of physicians, hospitals, clinics, other health-care providers and facilities who contract with an insurance company to provide health care at reduced rates to individuals insured in the plan. Health care providers accept the HMO’s network fee schedule and guidelines. In addition to FREE preventive and wellness services, the insured usually has affordable co-payments for routine medical care.

The annual deductible and co-insurance only apply to catastrophic illnesses or injuries which require a visit to the emergency room, major diagnostic tests, hospitalization and / or a surgical procedure. 

Each covered member MUST select a "Primary-Care Physician" from doctors in the HMO Network of the plan. They must also ensure that ALL other providers they see (Specialists) and facilities they use are in the HMO network of their plan. HMOs DO NOT have Out-of-Network benefits. Consequently, the monthly premiums for these health plans are a lot less expensive than PPOs or POS plans.

PREFERRED PROVIDER ORGANIZATIONS (PPOs & POS)

A PPO or POS is a network of physicians, hospitals, clinics, other health-care providers and facilities who contract with an insurance company to provide health care at reduced rates to individuals insured in the plan. Health care providers accept the PPO’s network fee schedule and guidelines. In addition to FREE preventive and wellness services, the insured usually has affordable co-payments for routine medical care. 

The annual deductible only applies to catastrophic illnesses or injuries which require a visit to the emergency room, major diagnostic tests, hospitalization and / or a surgical procedure.

Although PPOs and POS plans DO HAVE limited Out-of-Network benefits, and insured individuals can choose health care providers and facilities outside the network, this decision will increase their annual deductible, co-insurance, annual out-of-pocket costs and eliminate the affordable co-pays in their health plan. Also, the monthly premiums for PPO health plans are 30% to 40% higher than HMOs. 

HIGH DEDUCTIBLE HEALTH PLANS / HEALTH-SAVINGS ACCOUNT COMPATIBLE PLANS (HSAs)

An HSA plan provides comprehensive coverage for high-cost medical bills and is usually combined with a health savings bank account that enables participants to build savings that will cover current and / or future medical expenses. 

Like ALL other POST Health Care Reform plan designs, HSA health plans also OFFER FREE preventive and wellness services. However, the IRS requires these plans to have higher annual deductibles, higher annual out-of-pocket expenses, higher co-insurance percentage and NO co-pays for routine medical care.

The insured enrolled in an HSA plan can open a health savings account at any local bank in order to build a medical emergency fund. There are calendar year annual limits on how much can be invested in an HSA account.

This money and any interest accumulate tax deferred. HSA funds can be withdrawn free of income tax and free of penalties provided the money is spent ONLY on qualified health-care expenses for the participant and his or her spouse and dependent children. Unused funds stay in the account and continue to grow. 


The 2022 Open Enrollment will start NOVEMBER 1ST, 2021 and end approximately DECEMBER 15TH, 2021. The coverage will begin on January 1st, 2022. 

Please call us if you would like to schedule an appointment.