FAQ
Frequently Asked Questions
Below are some of our frequently asked questions. If you have any other questions or concerns, please feel free to contact us.
- Why is my house insured for so much more than it's worth? (i.e. Dwelling coverage is $350,000 when house is worth $175,000)
- Why do I need GAP insurance when I buy a new car?
- Why does my small business need general liability insurance?
- Is the life insurance policy provided by my employer enough?
- Do I really need health insurance?
- Covered California Information
- What is the Difference Between HMO, EPO and PPO?
Why is my house insured for so much more than it's worth? (i.e. Dwelling coverage is $350,000 when house is worth $175,000)
A home is insured for much more so that in the worst case scenario, should your home be a total loss, the debris from your home can be cleaned up and removed and a new home, meeting same specifications, can be built to today’s code in the original homes place. For a quote on homeowner's insurance, please visit our Homeowner's Insurance page.
Why do I need GAP insurance when I buy a new car?
It’s common knowledge that a new car starts to depreciate the moment you drive it off of the lot. Should you sustain a total loss with your car and you still own more on the loan than the car is worth, your GAP insurance will pay the difference between what the car was worth and what was still owed on your auto loan. To get a quote on car insurance, please visit our Auto Insurance tab.
Why does my small business need general liability insurance?
Being sued is probably the last thing on your mind while running your business…until it happens. Much like every time you are driving you are at risk for getting into an accident , every time you conduct business with the public, you are at risk for a customer suffering a loss and you being financially responsible. General liability insurance can help protect you in the event you are sued for almost any reason: negligence, personal injury, faulty products or workmanship, advertising misprints, libel, slander, etc. To get a quote on business insurance, please visit our Business Insurance tab.
Is the life insurance policy provided by my employer enough?
Chances are…probably not. A life insurance policy provided by your employer is a great benefit and a fantastic start to protecting your family’s finances in the event of your passing. However, in most cases the amount of insurance is not enough to replace your income long term for the family like you expected. Should you leave your job, you lose that policy and will be unprotected. The insurance may only pay out upon your demise and not that of your spouse, children, or anyone else you are financially responsible for. Best bet is to speak to a life insurance agent and find out what kind of life insurance would be best for you and those you care about. To get a quote on life insurance, please visit our Health/Life Insurance tab.
Do I really need health insurance?
YES! If you go uninsured, you will have to pay a tax penalty. With the tax penalty aside, if you get hurt or get sick, you'll be glad you have the coverage. For a quote on health insurance, visit our Health/Life Insurance tab.
Covered California Information
If I already have an existing Covered CA account, can I have Armstrong Fairway listed as my agent?
Yes! It’s a simple as 1, 2, 3.
- Go to CoveredCA.com to login and click on “Find Local Help or Get Help”.
- Click on “Find an Agent” and type in “Armstrong Fairway Insurance”
- You’ll see “Casey Armstrong” come up, click on her name and click on “Select Agent” and e-sign stating you’d like to delegate Armstrong Fairway Insurance as your agent.
Once you’ve done that, we have access to your account and are able to assist you throughout the enrollment process and throughout the year.
If I don’t qualify for premium assistance, do I have to get coverage through Covered CA?
Coverage is available outside of the exchange (Covered CA). They may have larger networks of doctors. You can call our agents and we can discuss your options.
Do I qualify for a premium assistance on Covered CA?
Your estimated Modified Adjusted Gross Income (MAGI) for 2017 is used to determine eligibility. (Usually line 37 of your taxes will give you a good idea, but remember the subsidy is based on future estimated income). Some of your income, like child support, workers compensation and Veteran’s disability payment should NOT be included.
I think I may be eligible for Medi-Cal. Where should I go to apply?
We can complete an application for you through Covered CA, you may go to your local County Offices or go online to www.c4yourself.com.
My spouse’s employer offers coverage, am I still eligible for a subsidy on Covered CA?
Chances are, no, you are not eligible. In 2013, the IRS issued a ruling that if the employee was paying less than 9.5% for coverage for themselves (self only), it is deemed “affordable” even though coverage to add on the family could be as high as $1000 a month. We know this is a huge problem, we will keep you posted on any changes in this ruling.
My children are on Medi-Cal or my spouse is on Medicare, why do I have do give their date of birth and social security info?
If they are part of your household and you report them on your taxes, we need everyone’s information, regardless if they are enrolling or not. As you can see above on the income grid, your subsidy is based on your total income and the number of people in the household.
If I over-estimated my income in 2016 and took too much subsidy, what will happen?
This will be worked out when you do your taxes for 2016. If you owe back part of the subsidy, you will have to pay the difference on your taxes.
If I under-estimated my income in 2016 and should have taken more subsidy, will I ever see that money?
Same as above, but you will receive a credit on your 2016 taxes.
I am self-employed. How do I calculate the income that I should report?
Calculate your taxable income. Total income minus the cost of doing business. We also recommend you speak to your tax professional for clarification on what should be reported if you are unsure.
What if I get a raise or a new job in 2017?
Call your agent or log into your account with Covered CA and report the income change. More than likely, because you have more income, your monthly premiums will go up, but it's better than getting a large tax bill next year.. Ultimately, the responsibility lies on you to report any income changes.
What are enhanced benefits?
If your income falls under 250% of Federal Poverty Level, you may qualify for Enhanced Benefits. These benefits lower your co-pays, deductibles and out of pocket maximums and help you with out of pocket expenses.
Does my doctor take plans through Covered CA?
This is one of the most frequent questions that we get at Armstrong Fairway. We can look them up for you and see if they take any of the plans under Covered CA, but we always recommend that you call the doctor yourself and ask as well. The reason for this is, we can’t tell from the online sites when their contracts are ending or if they are planning to terminate. If you are purchasing a PPO plan, it is very important to ask them if they are a “Preferred Provider” under that plan. Every doctor will say yes if asked if they take a PPO plan, because they all do. But, it makes a big difference if they are contracted as a Preferred Provider or not.
What are the deadlines to get my application in if I want coverage for 2017?
December 15…………for coverage beginning on January 1
January 15……………for coverage beginning on February 1
January 31…………..for coverage beginning on March 1
Open enrollment ends on January 31st, you will no longer be able to apply for coverage after this date.
What is the penalty for not getting coverage in 2017?
2.5% of your yearly household income or $695 for each adult and $347.50 for each child, whichever is greater. The penalty will be capped at the national average premium for the lowest-cost Bronze plan available through all of the marketplaces.
What is the Difference Between HMO, EPO and PPO?
We understand this can become confusing, but we are here to help! Below is a simplified breakdown of these plan choices. As always, if you have further questions, please contact our office, we're happy to help!
*HMO (Health Maintenance Organization): An organization that provides health coverage with providers under contract. An HMO differs from traditional health insurance by the contracts it has with its providers. When enrolled in an HMO policy, you are assigned a Primary Care Physician (PCP) and must be seen by them to obtain a referral to a Specialist, if needed. With HMOs there are no out of network benefits.
*EPO (Exclusive Provider Organization): When enrolled in an EPO you can use the providers within the EPO network, but cannot go outside the network for care. There are no out of network benefits. The benefit of enrolling in an EPO policy is that you are able to self-refer to Specialist if needed without having to go through your PCP.
*PPO (Preferred Provider Organization): A managed care organization of medical doctors, hospitals and other health care providers who have agreed with an insurer or third party administrator to provide health care at reduced rates to the insurers or administrators clients. With PPO policies, you are able to self-refer and go outside of your network (at a higher cost percentage) without being seen by your PCP.