Case: I recently graduated law school and am working for a firm with an annual salary of $195,000. My wife is an assistant English principal in a local girl’s school and receives a salary of $55,000 per year. We have three children and are considering buying a house, however we are having trouble coming up with a down payment. We spent all our savings on college tuition and it will take us several years before we build up enough capital for a proper down payment. By then, I am scared that the housing prices will double and we will be forced to buy a house in a different community or settle for a significantly smaller house.

With our community growing by leaps and bounds, more and more people are turning to the LRRC for help with navigating the health insurance marketplace. Over this past Open Enrollment period, the LRRC helped an astonishing 11,461 individuals with their health insurance needs. "Open Enrollment is always our busiest season, but this year - with Open Enrollment lasting only 45 days - was especially hectic. It was an intense six weeks, but our staff worked overtime and managed to meet the community's needs," said Sarah Sternbach, executive director of the LRRC.

Healthcare Open Enrollment is Here!

November 1st - December 15th

What is Healthcare Open Enrollment? It is the only time during the year that an individual who is eligible for Medicaid may apply for health insurance. During this time, consumers can sign up for private health insurance plans either through the Marketplace or through a private broker. If you are not offered health insurance through your employer, Medicare, Medicaid, CHIP, or another source that provides qualifying coverage, the Marketplace can help you get insured.

Case:  After years of drudgery working in an office, Levi and Penina Klein both decided to venture off and start their own businesses. Penina was naturally artistic, and so she started a business designing high-end maternity wear. Levi enjoys working with his hands and makes most of his parnassah selling esrogim before succos, as well as working as a general handyman for local shuls. Some years the Kleins are successful and make a decent living, while other years are harder and they struggle to pay their bills. One of the most difficult elements of their career choices has been navigating government programs. Working in the office had many downsides, but it had supplied consistent salaries and made reporting their income to government programs very simple. The Kleins now enjoy the benefits of self-employment, but they are confused about how to navigate government programs.

Question: What advice would you give the Kleins regarding how they should navigate government programs?

Case: Yitzchak Kupersmith is a freelance graphic designer with seven children and an income of $50k a year. Because of his income and family size, he was eligible to enroll in health insurance through NJ FamilyCare. Recently, however, he accepted a job as manager of a graphics department for a media company with an annual salary of $70k. Because of his new income, NJ FamilyCare terminated his and his wife’s health insurance policies. Without insurance, Yitzchak had two options. He could either purchase the insurance plan offered by his employer or buy an insurance plan through the Health Insurance Marketplace. His employer offered three insurance options: a single plan that would cover just Yitzchak for $50 a month, a couple plan that would cover him and his wife for $600 a month, and a family plan for $1,100 a month. While the plan offered by his employer was reasonable and cheap to cover just him, the plan that included his spouse was expensive, offered lousy coverage, and was not accepted by the OB/GYN that his wife used. 

Conversely, the insurance plan offered on the Marketplace was accepted by his wife’s OB/GYN, yet at $490 a month, it was also expensive. However, because of his family size, Yitzchak was told that his wife would be eligible for government assistance in paying the premiums, bringing the monthly cost down to $280. This seemed like a good option. However, when Yitzchak completed the application, he was informed that they would receive no government subsidies, because his employer offered affordable insurance. This made no sense to him, as his employer’s couple plan was prohibitively expensive and was not even an option in their situation. 

Question: How does insurance offered by an employer affect one’s ability to receive financial assistance through the Marketplace?