5 Types of Clients Who Could Qualify for ACA Coverage

The events of the last two years have caused many individuals and families to reevaluate their priorities and explore their options.

More of your clients may be retiring, cutting back on their working hours, freelancing or otherwise customizing their work situation to better suit their needs. These clients might be happy to learn that they also have more options than they previously thought when it comes to health care coverage in the year ahead.

An estimated 12.1 million uninsured Americans are eligible to purchase health coverage through the Affordable Care Act (ACA) Marketplace. Many don’t take advantage of this coverage because they are under the false assumption that qualifying for Medicare or Medicaid is a prerequisite.

Not only do ACA plans offer coverage for those who don’t qualify for government assistance, but they also may be more cost-effective than COBRA and employer sponsored insurance. The open enrollment for ACA plans is Jan. 15 — in other words, Saturday — the past few weeks have been the time to tell uninsured or underinsured clients about this opportunity.

But some states have regular open enrollment periods that are running past Jan. 15, and others are offering residents broad access to special enrollment periods.

We’ve identified prime candidates for conversations about the ACA plan opportunity.

1. A person working part-time in a job that doesn’t offer insurance.

Part-time is a great schedule, offering workers a way to earn money and be productive while also having enough time to pursue their hobbies, pick up a few hours at another job or care for members of their family.

One downside? Federal law does not require employers to provide part-time staff health benefits, so many do not offer it. Clients in this situation might find that ACA coverage is cost-effective while also offering 10 essential benefits like hospitalization, preventive care and mental health services.

2. A business owner with no employees.

With the number of new businesses opened exceeding 500,000 in 2021, the entrepreneurial spirit is alive and well in the United States. Business owners can make their own hours and add their personal touch to products and services.

However, finding coverage for a business can be hard, especially if your client is the sole owner and operator. A business owner with no employees may want to see if there’s an ACA health insurance plan that works for them.