GEORGIA HEALTH INSURANCE MARKETPLACE (GHIM)
Directly enrolling Georgians into a
FEDERALLY FACILITATED HEALTH INSURANCE MARKETPLACE (FFM)
AFFORDABLE CARE ACT (Obama Care) QUALIFIED HEALTH PLAN (QHP)
With very little time or effort on your part, GHIM will enroll you and your family in a Low-Cost or a No-Cost
Qualified Health Plan via the Affordable Care Act (Obama Care). This is a free service to all Georgia residents.
If you or anyone in your family has a pre-existing condition or is uninsured or has a non-compliant or even a
compliant group plan or has a non-compliant individual plan, then you’re eligible for a Qualified Health Plan.
There are no medical questions. It’s against the law. Qualified Health Plans were created by federal law but the
policies are issued by private insurance companies. If a plan isn’t a Qualified Health Plan, it’s non-compliant.
The lower your family’s household income, the lower your Qualified Health Plan’s monthly insurance payment.
Qualified Health Plans (QHPs) are great plans with robust medical benefits and (for some) they can be expensive.
Federal law requires all eligible citizens to enroll, so subsidies were created (for some) to make QHPs affordable.
Eligibility for a direct monthly federal subsidy is based only on your family size and your household income.
Monthly federal subsidies are available only for families at 100% - 400% of the federal poverty level.
The lower your family’s income, the higher your monthly subsidy to help pay for your Qualified Health Plan.
The lower your family’s income, the lower your monthly payment (if any) for your Qualified Health Plan.
VITALLY IMPORTANT INFORMATION ON HOW YOUR FAMILY GROSS HOUSEHOLD INCOME IS CALCULATED
• Household Income is NOT calculated by take home pay. It is based on your gross income before taxes/withholding.
• Eligibility is based on the consumer’s “projected” gross 2015 household income. Having a new 2014 job is okay.
• Self-employed/1099 workers multiply average monthly net x 12 months. (Social security/disability also multiply x 12 months)
• With logical arithmetic calculations, GHIM helps Georgia residents to calculate “projected” 2015 household income.
• Not all family members must show income. Multiple family members may contribute to the total household income.
• These are gross hourly pay thresholds that may be helpful in showing minimum family gross household income.
(NOTE: Gross weekly “projected” paycheck(s) $ amount (NOT take-home pay) x 52 weeks should equal or exceed the appropriate Family Size Minimum Household Income)
If you're in a group plan, enrolling in a Qualified Health Plan (QHP) may save you a lot of money each week.
If you’re in a compliant group plan, it’s your employer (not you) who’s getting the subsidy. Please see the rate
sheet and see what your approximate monthly rate would be for a Qualified Health Plan. Now take a look at your last
weekly pay-stub and see what your employer takes out of your weekly paycheck. Multiply that weekly reduction x
4.33 (52 weeks divided by 12 months =4.33). If you’re in a non-compliant group plan, you aren’t receiving a
subsidy either and your non-compliant policy may unfortunately be cancelled at some point in time because your
policy is non-compliant. “Approximately 400,000 Georgians could lose their current health insurance policies because
the policies fail to meet the mandates required by the Affordable Care Act.” (Per the Georgia Insurance Commission)
Adding a 19-25 yr. old dependent to a Qualified Health Plan may further lower your monthly payment.
If family size increases and income stays about the same, the monthly rate decreases.
A Qualified Health Plan (QHP) covers you for virtually every medical need you may ever have in life.
The benefits are: (1) Unlimited Annual and Lifetime Inpatient and Outpatient Hospitalization, (2) Doctor Visits for
Preventive, Wellness and Chronic Disease Management, (3) Laboratory Services, (4) Prescription Drugs, (5)
Emergency Services, (6) Ambulatory Patient Services, (7) Maternity/Newborn Care, (8) Pediatric Services, (9)
Rehabilitative Services and Devices and (10) Mental Health, Behavioral Health and Substance Abuse Treatment.
A Silver plan has Cost Sharing Reductions that lowers the deductible for some lower income families.
Qualified Health Plan issuers have 4 levels: Platinum, Gold, Silver and Bronze. The biggest contrast between these
4 levels is the annual individual/family deductible. The Silver plan is the only plan that allows some lower income
families to have a lower annual deductible. Once your policy is issued, you are not required to pay the deductible
up front (and annual physicals are free). Once an individual's annual deductible is met, it’s satisfied for the year.
GHIM is available to all Georgia residents all year long and we live by our SEED Mission Statement.
- Simplify Georgians' enrollment throughout the year in the Special Enrollment Period and Open Enrollment Period.
- Educate Georgia residents about the benefits of QHP compliance, federal subsidies, and medical cost reductions.
- Enroll Georgians with the secure, seamless proprietary system directly connected to the FFM and private insurers.
- Document the enrollment with confirmation transmission emailed immediately to the enrolled Georgia resident.
GHIM is comprehensively trained, tested, certified and authorized to enroll eligible Georgia residents
Georgia Health Insurance Marketplace (GHIM) personnel have been fully trained, tested, certified and authorized
by the Department of Health & Human Services (HHS) and the Centers for Medicare & Medicaid Studies (CMS) to
navigate the federal system on your behalf for your lowest monthly rate and your highest monthly subsidy
on the best Qualified Health Plan for you and your family. Consider taking advantage of this free service now.
Ready to enroll in a Low-Cost or a No-Cost Affordable Care Act (Obama Care) Qualified Health Plan?
With little or no effort on your part, GHIM’s free service is simple. Apply using the button below.
This year’s QHP Open Enrollment starts real soon and GHIM invites you to allow us to enroll you now
We can’t begin working for you until we’ve received your completed Pre-Enrollment Application Form for
an Affordable Care Act (Obama Care) Qualified Health Plan (QHP).
GHIM’s free service was buried during last year’s enrollment and this year’s is much shorter than last.
Our staff processes forms on a first-come-first-served basis. Please complete your Pre-Enrollment Application Form
immediately to be sure that your enrollment will be completed on time.
Per C.F.R 156.200 (c) and C.F.R 156.225 (b), Georgia Health Insurance Marketplace (GHIM) does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation or health status in the enrollment and benefit determinations in the Federally Facilitated Health Insurance Marketplace (FFM), and although Georgia Health Insurance Marketplace (GHIM) enrolls consumers directly into the Federally Facilitated Health Insurance Marketplace (FFM), a consumer may instead choose to enroll using their own skills, methods and devices by going to www.healthcare.gov.