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Market Place Individual Policies     Off-the-Exchange Plans      Short Term Medical (STM) Plans 

We offer you the choice of helath plans on the Market Place or off the Market Place based on your qualifications.  We are also able to provide you the option of a Short Term Medical policy up to 364 days.

Market Place Plans - Affordable Care Act

These are individual health insurance plans that provide your standard policy benefits designated by the Affordable Care Act (ACA).  Market Place plans
are also sometimes referred to as "on the Exchange".  These policies are guaranteed coverage with a limited enrollment period.  
allow for a credit based on your income to reduce your monthly premium
.  Depending on income and family size, the premium may be subsidized.  The subsidized premium is considered as taxable income.  The policies are issued by a limited number of companies within the geographical area.
After the Open Enrollment Period has closed, you are unable to purchase a policy from the exchange unless you have a qualified Life Changing Occurance.  The most common of these are below.

Life changes that can qualify you for a Special Enrollment Period

Changes in household

You may qualify for a Special Enrollment Period if you or anyone in your household in the past 60 days:

  • Got married. Pick a plan by the last day of the month and your coverage can start the first day of the next month.
  • Had a baby, adopted a child, or placed a child for foster care. Your coverage can start the day of the event — even if you enroll in the plan up to 60 days afterward.
  • Got divorced or legally separated and lost health insurance. Note: Divorce or legal separation without losing coverage doesn’t qualify you for a Special Enrollment Period.
  • Died. You’ll be eligible for a Special Enrollment Period if someone on your Marketplace plan dies and as a result you’re no longer eligible for your current health plan.

Changes in residence

Household moves that qualify you for a Special Enrollment Period:

  • Moving to a new home in a new ZIP code or county
  • Moving to the U.S. from a foreign country or United States territory
  • If you're a student, moving to or from the place you attend school
  • If you're a seasonal worker, moving to or from the place you both live and work
  • Moving to or from a shelter or other transitional housing

Note: Moving only for medical treatment or staying somewhere for vacation doesn’t qualify you for a Special Enrollment Period.

Important: You must prove you had qualifying health coverage for one or more days during the 60 days before your move. You don't need to provide proof if you’re moving from a foreign country or United States territory.

Loss of health insurance

You may qualify for a Special Enrollment Period if you or anyone in your household lost qualifying health coverage in the past 60 days OR expects to lose coverage in the next 60 days.

Coverage losses that may qualify you for a Special Enrollment Period:

More qualifying changes

Other life circumstances that may qualify you for a Special Enrollment Period:

  • Changes that make you no longer eligible for Medicaid or the Children’s Health Insurance Program (CHIP)
  • Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
  • Becoming newly eligible for Marketplace coverage because you became a U.S. citizen
  • Leaving incarceration
  • Starting or ending service as an AmeriCorps State and National, VISTA, or NCCC member

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"Off-the-Exchange" Policies

These policies are similar to the policies "on-the-Exchange", such as limited enrollment period, however, there would be no opportunity for a premium credit.  These policies may have additional benefits not included in a Market Place policy.

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Short Term Medical (STM) Plans

STM policies provide limited duration insurance coverage for 30 to 364 days, which varies by state. Not all states allow
for durations of 364 days. STM policies provide flexible temporary coverage. It is important that you understand what you’re buying so you can make a fully informed
choice for you and your family.

Why STM insurance?

STM insurance plans provide insurance coverage during life transitions. When you are between
group insurance or individual major medical policies, STM insurance policies help pay for covered
medical expenses due to unexpected illnesses or injuries. Covered expenses may include
diagnostic physician visits, emergency room treatment, hospital stays, surgery, intensive care and
more, but do not include maternity care or outpatient prescription drugs.


• Affordable

STM insurance policies are affordable. STM provides limited benefits and requires you to
answer medical history questions in order to qualify for coverage.


• Customizable

Select from various benefit levels which best meet your insurance and premium needs. You
can also add other coverage such as dental insurance or a discount prescription drug program.
Discount prescription coverage is not insurance.


• Convenient

Coverage can begin as early as the day following acceptance of your online application. In
addition, policy forms and ID cards as well as claims information are available online.

Keep the following in mind as you plan for your needs and explore your options:

• STM plans do not meet the Minimum Essential Coverage requirements under the ACA and
may result in a state tax penalty. STM plans are designed to provide temporary healthcare
insurance during unexpected coverage gaps.
• The ACA-compliant medical plans are guaranteed issue, meaning you cannot be denied
coverage based on your health history. STM plans are underwritten, which means you must
answer a series of medical questions when applying for coverage. Based on your answers,
you may be declined for coverage.
• Unlike the ACA plans, which are required to cover the 10 Essential Health Benefits (EHB),
STM policies are not required to cover EHBs at the same benefit level as an ACA plan.
Policies will vary in what they cover, so you should check your policy’s details carefully.

An STM policy may be right for you if you:

• Have missed the open enrollment period and aren’t eligible for special enrollment under
the ACA
• Are waiting for your ACA coverage to start
• Are waiting for health insurance benefits to begin at a new job
• Are looking for coverage to bridge you to Medicare
• Are needing an alternative to COBRA

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