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?

Case: Chayala Bronstein is a receptionist who has six children and makes $29k a year. Because of her family size, Chayala has been receiving $1,500 in rental assistance every month from the Section 8 program (aka HUD) for the past five years. 

At her grandmother’s 90th birthday party, her grandmother announced that she had a secret to reveal. At the birth of each grandchild, she had purchased $10,000 of stocks and bonds for the child in his/her name. Over the years, the value of Chayala’s stocks had grown to be worth $35,000. Chayala was shocked and thrilled. The only problem was that the stocks had been purchased in her name and may have affected the amount of Section 8 benefits she was eligible to receive over the past five years. This is an asset that she should have disclosed to Section 8. However, she had not been aware of it until now.

Question: What should Chayala do?

Case: Moshe Korn had a well-paying job in the technology industry, earning $120k a year. His wife works at a chessed organization and earns an annual salary of $20k. Unfortunately, the company Moshe worked for recently merged with a larger firm, and Moshe was told that his position was being eliminated. He was given two weeks’ notice. With little income, six young children and a sluggish economy, Moshe knew that he would need some help until he found another suitable job. 

Question: What governmental assistance is Moshe eligible to receive until he finds another job?