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Open Enrollment Period (OEP)

November 1, 2015 - January 31, 2016

Coverage Can Start

January 1, 2016

Individuals may qualify for Special Enrollment Periods (SEP) outside of Open Enrollment Periods (OEP) if they experience a Qualifying Life Event.

Carriers in Iowa

  • A


  • CO


  • GHP

    Gunderson Health Plan

  • W


  • TI

    Time Insurance

  • GR

    Golden Rule

Your State's Health Insurance Marketplace

STATE-PARTNERSHIP MARKETPLACE We can help you get health insurance here.

Qualifying Life Events

If you don’t experience a Qualifying Life Event but still need insurance, Short-Term Health Insurance is an option until Open Enrollment.

  • Marriage, Divorce, Legal Separation
  • Loss of Coverage
  • Moved to a new Location
  • Birth or Adopton of a child
  • OtherGaining or losing a dependent, death, change in disability status, certain changes to income, release from incarceration, gaining eligible immigration status

ACA Standardized Benefits

  • Ambulatory Patient Care

  • Emergency Services

  • Hospitalization

  • Mental Health Services

  • Rehabilitative & Habilitative Services

  • Prescription Drugs

  • Preventative & Wellness Care

  • Pediatric Care

  • Lab Services

  • Maternity & Newborn Care

Marketplace Coverage Plans

Coverage plans are comprised of 5 categories. Percentages are based on the total costs of an average persons' care. The actual percentage you pay will depend on the services administered during the year.

Metal Plan Carrier Pays You Pay
Bronze 60% 40%
Silver 70% 30%
Gold 80% 20%
Platinum 90% 10%

Catastrophic: Plans pay less than 60% of the total average cost of care on average. They’re available only to people who are under 30 yrs. old or experience a hardship.

Plan Types

Health Maintenance Organization(HMO) Preferred Provider Organization(PPO)
  • Primary Care Physician (PCP) Required
  • Referral Required
  • No coverage for out-of-network doctors
  • Generally Lower Premiums
  • Primary Care Physician (PCP) Not Required
  • Referral Not Required
  • Choose the doctor or specialist
  • Generally Higher Premiums
Exclusive Provider Organization(EPO) Point of Service(POS)
  • No coverage for out-of-network doctors
  • Generally Lower premiums than HMO & PPO
  • Mix between HMO & PPO
  • Primary Care Physician (PCP) Required
  • Referral Required
  • May use out-of-network providers

Exemptions From Health Insurance and the Tax Penalty

  • Religious Objections
  • Incarcerated
  • Illegal Immigrant
  • Cost of healthcare exceeds 8.05% income
  • Uninsured for no more than 2 months in a year
  • Experienced a hardshipHomeless, evicted in the past 6 months, received a shut off notice from a utility company, recently experienced domestic violence, recently experienced death of a close family member, fire or flood causing substantial damage to your property, filed for bankruptcy in the past 6 months, medical expenses you couldn’t pay in the last 24 months, plan was canceled, ineligible for Medicaid

Common Policy Terms

Deductible: The portion you pay out-of-pocket before the insurer begins to pay for services.

Out-of-pocket limit: The most you’ll have to pay during the policy period.

Copayment or Copay: Fixed payment you pay for a covered service.

Coinsurance: Your share of the costs of a covered service.

Premium: The amount you will pay for your insurance policy (Monthly or Annually).

Insurance Reference Guides

Where you live may affect your coverage options. Our reference guide will assist you in finding plans available in your state.

Insurance Terms Glossary

From "absolute liability" to "written premiums," we've done the work for you to define commonly used insurance terms.

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