Open Enrollment FAQs
1. Can Anyone Enroll in Open Enrollment?
Yes, all full-time staff members are eligible for this benefit. To claim it, you must also be a staff member in good standing (maintaining at least an ME rating as noted on their most recent IDP). All other employees are not eligible for this program.
2. How Do I Enroll?
In order to enroll you must register through www.healthcare.gov between
December 1st – December 15th. Make sure to gather all pertinent information, such as your social security number, adjusted gross income, and any other family members you wish to enroll. You will also need to provide your current address and contact information. It is vital to ensure all of your information is accurate and up to date in order to avoid any issues with your coverage.
3. Why Should I Enroll?
We often don’t plan for major life-altering events. However, health insurance is a great way to provide stability and safety for you and your loved ones.
4. What Are The Benefits?
Marketplace offers a wide variety of healthcare benefits. Some of the benefits you can expect with marketplace plans are:
- Lower monthly premiums
- Better coverage formularies for on-marketplace plans
- Lower deductibles and out-of-pocket maximums(On Marketplace Plans) versus off Marketplace plans
- The AD Leaf cost shares your premium with your medical and dental benefit stipend
- Prescription drug coverage
- Maternity and newborn care
- and more!
We are excited to offer our employees an opportunity to access comprehensive, affordable health coverage through The AD Leaf’s medical and dental stipend benefit. Our goal is to provide our employees with the resources they need to maintain a healthy lifestyle and manage their healthcare costs.
5. How Does It Work?
The AD Leaf provides a medical and dental stipend each month. The staff member must provide a receipt in their staff portal at the end of each month to provide confirmation of insurance benefits and costs.
6. When Do My Benefits Begin?
January 1, 2025. If you qualify for a special enrollment period, coverage can begin anytime (*exclusions may apply).
7. If I change my mind after Open Enrollment, can I change my health plan selection?
You cannot change the plan you’ve chosen after health coverage begins in January 2025 until your next open enrollment period. The one exception is if you have a qualifying life event. Therefore, it’s imperative to plan ahead and choose the health insurance plan that will meet your needs for the next 12 months. Review your options and compare plans before making your final decision.
8. Can I Enroll My Child in Open Enrollment?
You can add family members during the Open Enrollment period. If it is outside the Open Enrollment period, you may only add family members under certain qualifying circumstances, such as marriage, birth, or adoption of a child, or if your spouse loses coverage through their employer or another plan.
9. If I miss the Open Enrollment deadline for making benefit changes or new elections, is there an extension?
When a staff member fails to submit their enrollment documentation on time for new coverage, they will have to wait until the next Open Enrollment to join. That’s why it’s vital to submit everything as soon as possible and pay attention to deadlines.
10. If I Terminate My Employment, Can I Keep My Benefits?
You may keep your insurance plan after your employment terminates with The AD Leaf. However, the medical and dental benefit stipend you receive, which helps offset your premium costs, will cease after your last date of employment.
11. Can I cancel my insurance plan at any time?
You may cancel your plan at any time, however, you will not receive your medical and/or dental stipend if you cancel your insurance plan.
12. What plan options are available?
Florida Blue Select Bronze or Silver marketplace plans are available and are qualifying plans to receive The AD Leaf’s medical and dental stipend benefit. You may choose the plan you feel best fits your needs, and you are not required to keep the same plan year-to-year.
13. How do I prepare for Open Enrollment?
Review the plan options to find the right fit for you. Consider how much healthcare you use, your budget, and how each plan could benefit you. Make sure you have all of your information and documents up to date. Also, be aware of any changes in your life that could impact your health insurance, such as marriage or the birth of a child.
14. Why are you requiring us to use Marketplace?
Marketplace covers comprehensive benefits and can’t deny coverage or charge higher prices to people with pre-existing conditions. A few DE entities exclusively sell qualified health plans, but most also sell other health products, such as short-term health plans, fixed-indemnity plans, and health care sharing ministries. Such non-ACA plans often are not in the consumer’s best interest. They can reject or charge higher premiums to people with pre-existing conditions, charge more based on age, gender, or any other factor; impose lifetime and annual benefit limits; require cost-sharing of any amount, and leave out ACA essential health benefits. Therefore, the Marketplace is often the best decision.
15. Is the decision to use Marketplace a politically driven decision?
The AD Leaf Marketing Firm values its employees, and the decision to utilize Marketplace is based on offering premium and affordable healthcare options to benefit its staff members. The firm’s ability to remain successful and offer quality services is contingent on having a healthy and productive workforce. The decision to use Marketplace is not politically driven. Rather, it is based on the fundamental belief that quality healthcare should be accessible to everyone, regardless of their economic status. As a company committed to DEI, the AD Leaf Marketing Firm proudly offers its employees a comprehensive and affordable healthcare plan through the Marketplace.
16. Doesn’t Marketplace provide bad insurance policies?
One of the benefits of health insurance through the Marketplace is that all health insurance plans cover the same set of essential health benefits, even for a pre-existing health condition. In addition to coverage for doctor visits, lab tests, hospitalization, surgery, and emergency care, here are a few more:
- Pregnancy, maternity, and newborn care before and after your baby is born. You receive this coverage even if you were pregnant before your coverage starts. Most plans also provide breastfeeding benefits.
- Preventive services for adults, children, and women. Women’s preventive services include well-woman visits and contraceptive care.
- Mental health and substance abuse services, including behavioral health treatment like counseling and psychotherapy
- Prescription drugs
- And more!
We are excited to offer our team comprehensive and beneficial health insurance coverage. With this plan, you can feel confident that you and your family are protected.
17. Aren’t plans more expensive on Marketplace versus private insurance?
Marketplace plans offer affordable, reliable coverage options. Under the American Rescue Plan Act (2021), many individuals and families are eligible for lower monthly premiums for Marketplace health coverage.
18. Will I be penalized on my taxes if I do not sign up for insurance?
If you do not enroll, you may have to pay a fee when you file your taxes.
