Learn About the Individual Marketplace

The federal government runs the Individual Marketplace through HealthCare.gov and/or SHOP (Small Business Health Plans). Several states (MD, PA, WA) have their own State-based individual and small business Marketplaces.

Brokers help clients enroll in Qualified Health Plans (QHPs) on the Marketplace, both during annual Open Enrollment and throughout the coverage year. Brokers may also help employers understand their options for enrolling in SHOP coverage and assisting the owner and employees enrollment.

Only certified brokers can assist clients to determine their eligibility for insurance affordability programs, including advance payments of the premium tax credit and cost-sharing reductions. When helping clients enroll in health coverage, the Marketplace may ask for documents to confirm information on the application. For more information on Affordable Care Act Tax Provisions for Individuals and Families, click here.

Not Sure if You'll Qualify?

I will help you determine your eligibility by asking you a few quick questions to give you an idea if you may qualify to get or change health coverage during Open Enrollment or with a Special Enrollment Period.
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New, Lower Costs

With the American Rescue Plan Act of 2021, you may qualify for a premium tax credit that lowers your monthly premium. The amount of this tax credit depends on the estimated household income for 2021.
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Open Enrollment

It's really important that you act by January 15, 2022, or you can’t get 2022 coverage unless you qualify for a Special Enrollment Period. Enroll by December 15, 2021 for coverage that starts January 1, 2022.
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Federal Poverty Level (FPL)

A measure of income issued every year by the Department of Health and Human Services (HHS). Federal poverty levels are used to determine your eligibility for certain programs and benefits, including savings on Marketplace health insurance, and Medicaid and CHIP coverage.

The 2021 federal poverty level (FPL) income numbers below are used to calculate eligibility for Medicaid and the Children’s Health Insurance Program (CHIP).

2020 numbers are slightly lower, and are used to calculate savings on Marketplace insurance plans for 2021.