This year’s open enrollment season for selecting workplace benefits comes just before major health care reforms under the Affordable Care Act (ACA) take effect. Because it’s never been more important to choose a health plan for you and your family, we offer these guidelines for enrollment: 

• You’ll need to have health insurance or face a tax penalty. If your employer won’t offer coverage or the plan doesn’t meet minimum standards, you must buy coverage from an insurance company or through statewide insurance exchanges, which opened for enrollment on October 1 (in some cases, you might be eligible for a premium tax credit.).

• Compare benefits and insurance plan networks. Check out provider networks to make sure that they include your doctors and preferred hospital system, especially if you’re being treated for a serious or chronic condition. You’ll pay a lot more to see providers outside the network with a preferred provider organization (PPO) and will probably have to pay the full cost of services for out-of-network providers with a health maintenance organization (HMO).

• Remember that your employer does not have to offer coverage in 2014, and will not cover your spouse – because the ACA limits the definition of “dependents” to children.

• Pick the plan with the best value. Your costs include deductibles and co-insurance (the percentage the plan pays after you satisfy the deductible); copayments for doctor visits, urgent care and emergency room treatment; and your portion of the premium. Run scenarios to see how much each health plan would cost, and choose the one that meets your unique needs.

Tracy-Driscoll’s health insurance professionals stand ready to offer you their advice – just give us a call at (860) 589-3434.

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