Health Insurance Basics

Helpful Information on Health Care Reform in Oklahoma

2019 CMS Certified Oklahoma Agents Listing

Tax Information Regarding the Affordable Care Act

Click here to find licensed agents and brokers affiliated with a professional organization, the National Association of Health Underwriters (NAHU), that have certification to sell insurance available on the federally facilitated marketplace
(as designated by: PPACA or Exchange Broker Certification OK)

Federal Resources

Federal Reform Insurance Provisions

  • A federally-created marketplace opened for individuals and small employers on October 1st, 2013. During Open Enrollment all Oklahomans can shop and enroll for coverage. Outside of Open Enrollment, you may apply for coverage if you fall into a category of eligibility called Special Enrollment. People with incomes between 100 and 400 percent of federal poverty level may be eligible for premium and cost sharing reductions. https://www.healthcare.gov/will-i-qualify-to-save-on-monthly-premiums/
  • Find more information on www.healthcare.gov.

Essential Health Benefits

Pre-existing Conditions

Individual Mandate

Employer Mandate

  • Beginning January 1, 2015, employers with 100 or more full time equivalent employees and beginning January 1, 2016, employers with 50-99 or more full time equivalent employees will be required to pay tax assessments if their employees receive subsidized coverage through the marketplace because the employer doesn’t offer minimum essential coverage or because the coverage offered is unaffordable. For more information on employer responsibilities.  https://www.irs.gov/affordable-care-act/employers/employer-shared-responsibility-provisions
  • Employers with 25 or fewer full time equivalent employees may be eligible for tax credits if they provide health coverage.
  • General Information for Employers with less than 50 full-time equivalent employees – FF-SHOP. https://www.healthcare.gov/small-businesses/

Grandfathered Plans

Premium Tax Credit