TERMINOLOGY

Learn the basics…
* Copay: fixed dollar amount you pay each time for a service.  ie. $50 Dr copay
* Coinsurance:  You and the carrier pay a percentage of the cost.  ie. 50% / 50%
* Deductible:  An amount you pay up to for a service.   ie. $500 deductible
* Max out of Pocket (MOOP): Combination of your “covered” copays, coinsurance & deductible charges including Rx.   
   If you reach your MOOP, you are then covered at 100% for the rest of the year.


* What is GetCoveredNJ:  NJ’s Health Insurance ACA Marketplace for Individual Health Insurance – Obamacare.
   Whether you are eligible for a premium reduction based on income or not, you can enroll thru GCNJ.
 

* Which 5 Carriers Does GCNH Offer:  1 Horizon BCBS, 2 Oscar, 3 Amerihealth, 4 UHC and 5 Wellcare
+ Bronze Plans:  Plans with high deductibles, many can be paired with H.S.A bank account.
+ Silver Plans: Plans with fixed predictable copays for some services, other services go towards ded then copay or co-ins.
+ Gold Plans: Lower max out of pocket but much higher premiums. Do the math before enrolling.

* What is Free GetCoveredNJ Broker:   I work on your behalf to you to help you find and compare health insurance plans, review your plan options, help you complete the eligibility application in order to enroll correctly and answer all your questions. Also, research to make sure your doctors, hospitals and Rx are covered.   And I’m a free service to you.

Learn More…

Member Portal:  Access your Member Portal at the carrier website to view ID cards, Claims, Billing, Change Payment Method, Find A Doctor/Hospital, View an EOB
 

H.S.A + High-Deductible Health Plans
Think of an HSA as a tax-free savings account specifically for healthcare expenses.

Benefits:  Tax-free contributions ~  Tax-free growth  ~ Tax-free withdrawals

HSA money can be used for many qualified medical expenses:  dr visits, Rx, dental care, eye exams and glasses, hearing aids, certain over-the-counter medications, medical supplies medicare premiums and many other items.

EOB - Explanation of Benefits:  An EOB is “NOT A Bill”.  It explains how your insurance processed your medical claim and shows what you owe.  EOBs includes:

• Provider, Date of Service & Services provided
• Amount billed, Amount allowed, Insurance paid & Your responsibility

Compare your EOB + Your Doctors Bill:

• If the amounts match, pay the provider what is due.
• If something looks incorrect (such as a service you didn't receive or a denial) contact your insurance company or healthcare provider before paying….or broker (me).

NEXT STEP:  How To Enroll At GetCoveredNJ
(Complete Steps 1, 2 & 3)
 

Step #1:  Create a username & password. Go to GetCoveredNJ and register.
Scroll to bottom and click "Skip and Sign up".


Step #2:   Assign Me As Your Free GCNJ Broker:
* You must be Logged in to your GetCoveredNJ account
* Select "HELP & SUPPORT"….then click "FIND LOCAL ASSISTANCE"
* Select "Find An NJ Certified Agent or Broker Near You"
* Search by my name "Christopher Kudryk"   /  Review & click “Select”
    If you can’t select me, then you are not logged in.  You have to be logged in.
 

Step #3:  Begin the Eligibility application
*From your Dashboard à Click “START NEW APPLICATION”.
Before you submit your eligibility Application, you can “Save & Exit” and I can review for accuracy before we submit.

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Last steps:
Step 4:  Shop health plan options
Step 5:  Select a health plan before the 1st
Step 6:  Pay 1st month's premium
              * Once funds are received by the carrier, you are approved. 
              * ID cards will be mailed expect 7-12 days to be delivered.

ACA Consumer Consent Form - GetCoveredNJ

This form acknowledges Chris Kudryk of KBenefits as my free GetCoveredNJ broker to serve as my GetCoveredNJ health insurance broker for myself and my entire household, for purposes of assisting with my enrollment into a Qualified Health Plan offered on GetCoveredNJ, a federally-facilitated marketplace.  I authorize Christopher S Kudryk to view and use the confidential information provided by me in writing, electronically, or by telephone only for the purposes of one or more of the following:

• Illustrate multiple health plan options from GetCoveredNJ healthcare marketplace
• Answer questions to help make an informed decision on health coverage options
• Review and complete the GCNJ application for eligibility & enrollment
• Assist with health plan selection, premium payment and enrollment
• Collaborate with GetCoveredNJ Help Desk and Member Services
• Assist in providing advice, information and plan options during yearly Open Enrollment Period.
• Providing ongoing account/policy support and maintenance, such as eligibility and billing questions
• If applicable, advise and navigate other government insurance affordability programs, such as Medicaid and CHIP

Privacy Notice: I understand that Christopher S Kudryk will not use or share my personally identifiable information (PII) for any purposes other than those listed above. The Agent will ensure that my PII is kept private and safe when collecting, storing, and using my PII for the stated purposes above.  I confirm that the information I provide for entry on my Marketplace eligibility and enrollment application will be true to the best of my knowledge. I understand that I do not have to share additional personal information about myself or my health with my Agent beyond what is required on the application for eligibility and enrollment purposes. I understand that my consent remains in effect until I revoke it, and I may revoke or modify my consent at any time by logging into GetCoveredNJ at nj.gov/getcoverednj or by calling Member Services at GetCoveredNJ 1-833-677-1010.    I am signing this application under penalty of perjury, which means I’ve provided true answers to all of the question to the best of my knowledge. I know I may be subject to penalties under Federal law if I intentionally provide false information.

I am also aware that I am responsible for the accuracy of the application information, even if the information is entered into the application on my behalf by an agent/broker assisting them.