Individual health insurance in Utah is an emerging solution. In the last decade the market has grown dramatically. LegUp Health predicts the market for individual and family insurance will grow even more in the next decade.
Since the Affordable Care Act took effect in 2014, individual health insurance has changed a lot. Here’s how:
- All individual plans on the Utah Marketplace are ACA-compliant. This means they cover the ten “essential health benefits.”
- All Individual plans are also “guaranteed issue.” Pre-existing conditions are no longer a factor in your eligibility.
- Individual health insurance now has Advanced Premium Tax Credits (APTC). These tax credits lower your monthly premium cost for your plan. Most Americans qualify. This is a big deal. You can determine your eligibility with your modified adjusted gross income and household size. If you qualify for a premium tax credit of $200 per month and you pick a plan with a $300 monthly premium, you would only need to pay $100, for example. You can only get APTCs if you buy individual and family plans on the Utah marketplace.
Fewer than 85,000 Utahns enrolled in the Marketplace in 2014. In 2020, there were more than 200,000 enrollees. That’s a record high and a 136 percent increase in just six years. The number will likely increase steadily in the years to come.
Many Utahns are unaware of the opportunity to buy individual health insurance. Here are a few things you should know about health insurance plans in Utah:
Individual health insurance is regulated state-by-state. So it works differently in Utah than in other states.
First, Utah's health insurance marketplace is federally-facilitated. That means that it is run by the federal government at healthcare.gov.
Second, Utah has six insurance companies offering individual and family plans for 2021. See above for a link to a guide for company.
Third, there are two places to buy individual plans in Utah. You can shop on-marketplace or off-marketplace. If you shop on-marketplace, you go to healthcare.gov. If you shop off-marketplace, you buy a plan directly from an insurance company. All insurance companies offer on-marketplace plans. Some insurance companies sell off-marketplace. Some companies offer both options. The same is true at the plan level. Some plans can be bought on-marketplace. Some can be bought only off-marketplace. Some can be bought via both options.
Fourth, in Utah, you can buy any individual plan during the Open Enrollment Period. This runs annually from November 1st through December 15th. During this time, you can buy any individual or family health insurance plan available in Utah for the upcoming year. These plans usually take effect January 1st. This is the only time you can shop for plans unless you have a qualifying life event.
Fifth, if you have a qualifying life event, you can shop for plans during a Special Enrollment Period. Life events include getting married, having a baby, losing a job, moving, and more. Depending on your Special Enrollment type, you may have 60 days before or 60 days following the life event to enroll in a new plan. If you miss your Special Enrollment Period you’ll have to wait until the next Open Enrollment to enroll.
There are a lot of people who should consider shopping for individual and family health insurance plans in Utah. This includes people who don’t have access to public government insurance (Medicaid, Medicare, CHIP, Tricare). This also includes people who don’t have access to group plans through employers. In Utah, workers in these professions usually consider individual health insurance: Real estate, Start-ups, Small Business, Nonprofit, Massage therapy, Hair or cosmetology, Hospitality, Retail, Remote, Insurance agent, Dental hygienist, Freelancer, Gig worker, Contractor, Consultant.