Health insurance Portability And Accountability Act

Be Well Benefits, Inc.
701 E California St, Suite 203
​Gainesville, TX 76240
(940)665-1938
Fax (940)580-1706

tina@bewellbenefitsinc.com
angie@bewellbenefitsinc.com

​​ACA 101


Despite what you may have heard, the Affordable Care Act is still the law of the land when it comes to comprehensive Major Medical coverage. Of course, that doesn’t mean there aren’t other options, but it is important to educate yourself on the differences between the ACA-compliant plans & non-qualified health insurance plans.

We’ve compiled a quick ACA “cheat sheet” for you to refer to for very basic answers to your ACA-related questions:


The Affordable Care Act requires insurers to offer 10 Essential Health Benefits (EHB’s) to their plan offerings. If an insurer offers plans that include all 10 EHB’s, they are considered ACA-compliant health plans. The 10 Essential Health Benefits include:


Inpatient Hospitalization

Outpatient Hospitalization

Emergency Services

Prenatal & Postnatal Care

Mental Health & Substance Abuse Services

Prescription Drug Coverage

Preventive Services

Pediatric Care (including dental & vision)

Rehabilitative Services
Laboratory Services


  • ACA-compliant insurance plans must cover pre-existing conditions with no waiting period.
  • There is an annual “Open Enrollment Period” that begins on November 1st and ends on December 15th. Plans applied for during this time will be effective January 1st of the following year.
  • Certain life events may deem a “Special Enrollment Period”. When a person has a SEP, they may be eligible to change plans or enroll in a new plan.
  • A tax penalty applies for those who decide to “opt out” of the Affordable Care Act. There are many exceptions to the penalty, and it will no longer be applicable for plans bought in 2019 and beyond.
  • Depending on their income, certain individuals may be eligible for an Advanced Premium Tax Credit, which is essentially a government subsidy that helps offset the cost of high premiums.
  • In addition to the Premium Tax Credit, some individuals may be eligible for Cost Sharing Reduction subsidies. These lower the deductible, out of pocket max, and copays on eligible insurance plans.


Please call us for more information about, or assistance with, ACA-compliant health plans or the alternative health insurance options available.