Self-Service Insurance Resources For Individuals

Businesses click here for group health resources

For General Resources click here

Our agency is not taking on new individual/private health insurance clients at this time, other than Medicare clients. In light of the current circumstances, however, we have created this resource page to help give you direction.

If you have been laid off or your employer has cancelled their group health insurance plan, here are some options which are arranged in order of low to high income range. Start by checking this income chart first. The income chart shows if you may qualify for OHP, a tax credit to help buy private insurance through healthcare.gov, or if your income is too high for either option. Eligibility is based on 2020 income estimates, not 2019 or 2018 ‘known’ income.

State issues grace period order for insurance deadlines – Please note that no claims will be paid for services received during a grace period unless payment is eventually paid.
Oregon Health Plan:
  • Link to online OHP application
  • Link to OHP income eligibility requirements
  • Link to document showing local people who can help with OHP questions. Note they’re very busy right now!
  • Or call OHP at 800-699-9075
    • We recommend calling OHP because often they can advise whether or not you qualify and will be covered during the phone call
    • Please note OHP customer service will typically have a long hold time to get through, common hold times are in excess of 2 hours but stick with it a representative will answer
HealthCare.gov: (Private insurance with a tax credit to help pay for coverage)
  • Link to HealthSherpa online application
    • This is a tool to apply for coverage with HealthCare.gov but is a much smoother process than going through the HealthCare.gov website directly
  • Click here for the income table to see if you’d qualify for a subsidy
  • 800-318-2596
    • If your income has changed from what you initially expected for 2020 you can call the number above and update your income over the phone
    • If you get stuck during the application process you can call this number to apply and enroll in coverage over the phone
If you make too much money to qualify for OHP or a tax credit:
  • Consider enrolling in COBRA or Oregon State Continuation through your former employers’ group health plan
  • You can pay full-price for private insurance. We recommend PacificSource

Please note that our office is currently not accepting non-affiliated individual clients at this time and can only provide these resources for you.

Business Group Health Resources

Due to the Coronavirus, many of us are faced with loss of revenue but ongoing expenses, the largest of which is payroll. 

If you need to lay-off or reduce your employees’ hours to the point where they no longer qualify for benefits under your group health plan, then their coverage will end on the last day of the month in which they are let go or no longer meet the eligiblity requirements. At that point, there will be four options available to you and your employees.

  1. You can continue to pay for their health insurance for up to three extra months, without needing to complete any additional paperwork. Most health insurers allow this. If you’re not sure about yours, please ask us. Dental and other benefits will have different provisions. This option allows you to save the largest cost, payroll, while keeping goodwill with your employees. It may prevent them from finding a different job while laid off; it keeps them tied to you in a sense.
  2. You can offer them COBRA or Oregon State Continuation. These are similar to each other in that the employee can remain on your group plan at their own expense. COBRA is for employers with 20 or more employees and lasts for up to 18 months. State Continuation is for employers with 19 or fewer employees. Both options require the employee to complete an enrollment form; they can’t just start mailing you a check each month unless they first complete the form. They pay the full premium; you don’t pay part of it as you would if they were still on your payroll.
  3. Although employees always have option 2, above, it is likely they would qualify for the Oregon Health Plan or an Obamacare plan with a tax credit. You can send them this same webpage but direct them to the top of the page, which was created for individuals.
  4. You can cancel your group health plan. As your agent, we don’t like this option #4 at all! If you cancel the plan, options 1 and 2 or off the table because there is no plan to continue. You and your employees would turn to option 3. Employers can purchase group health plans on any given month. There is no ‘open enrollment’ requirement to purchase a group plan. If you cancel now, you are able to buy a new plan later in the year such as in June or July. Note that deductibles, co-insurance, and maximum out of pockets all start over in the same calendar year each time you buy a new plan. (Other than changing group health companies seamlessly).

Please click the below links for more specific information on each carrier.

General Resources and Information

Take care and we will all get through this together!