Deductibles and premiums remain a barrier to ACA enrollments

Contact Sales@LeClairGroup.com with your questions about this communication or to request an appointment.


We are in the middle of a Special Enrollment Period, a time where anyone under 65 can sign up for an ACA plan. There are reasons eligible members might not sign up for ACA coverage–one key deterrent, even after subsidized premiums, is out-of-pocket costs up to $7,000.

Agents are always educating clients on the importance of health insurance and overcoming blockages to coverage. Having ACA and alternative options is important for all communities. It is well known that affordability is a struggle without subsidies, especially for older enrollees who, even after subsidies, find premiums amounting to over 20% of their income.

If people cannot afford ACA premiums or deductibles and do not want to live without health coverage – what can agents do?

  • Indemnity plans– Members may sign up for an indemnity plan with or without an ACA plan. If members can afford the additional premium, indemnity plans provide first dollar coverage for accidental injury, which takes away much of the financial risk of the deductible. Members also have the option of utilizing ‘richer’ indemnity plans that have enough features and benefits to operate as a lower cost ACA alternative. Consider UnitedHealthOne or LifeSecure for indemnity plans.
  • Faith Based Plan– This plan operates by sharing members’ medical costs. The plan designs mirror elements of ACA plans, often with features similar to networks, copays, deductibles, etc. There are caps on total benefits, with maximum benefits up to $1 million or less depending on plan level. The benefit caps, underwriting and lack of all the ACA features can make Faith Based Plans more affordable to individuals and families. Consider OneShare for faith-based coverage.
  • Short Term Medical– In some states, members can sign up for 12 months of short-term medical coverage leading up to their Medicare enrollment date. STM plans cost much less than an ACA plan– they have caps on maximum benefits and may not cover pre-existing conditions, which reduce the cost of premiums. Where states have less than 12 months enrollment, clients can enroll in the three or six months prior to aging in. Consider UnitedHealthOne for wide network STM plans.
  • Dental Insurance – One of the most important predictors of good overall health is dental health. With dental insurance, clients of all ages will have better health, reducing claims and improving lifestyles for all. Consider Ameritas or UnitedHealthOne for affordable, wide network dental insurance.

All of the ACA alternatives are open for enrollment year-round, as their underwriting requirements and benefit caps reduce the risks that drive open enrollment periods for ACA and Medicare plans.

Reach out to LeClair Group’s sales team to learn more or to add a plan to your portfolio.