Welcome to Solid Health Insurance Services!
At Solid Health Insurance Services, we believe that the most important thing for you, and those you care about, your family and your employees, is to have affordable health insurance in California.
Our mission is to find you affordable health insurance by comparing the rates from carriers such as Anthem, Blue Shield, Kaiser Permanente, Cigna, Health Net inside and outside the California State Health Insurance Exchange, Covered California.
We believe that affordable life insurance and long term care insurance will protect your family from unexpected life events. We provide you with affordable life and long term care insurance comparison quotes with carriers such as Transamerica, Allianz, Genworth, ING and other carriers.
What does solid mean? It means that your health, life, home and business are adequately insured. We want to make sure that your hard-earned assets are protected, so that you can concentrate on achieving your family dreams and financial and business goals.
Our mission is to find affordable health insurance, life insurance and long term care insurance, which best fits your individual, family and small business needs!
Picking Insurance is Difficult
Biography of Barbara Schmalz
Barbara’s strong sense of organization and hard work has allowed her to be a successful business expert in Los Angeles for 25 years.
After handling the insurance matters for a manufacturing company for 5 years, Barbara founded Solid Health Insurance Agency in 2008 and enjoys serving her community ever since.
Her clients enjoy her very personal approach to find the best insurance package for them. Her consultative approach helps the client to understand the many different choices and helps to find a “solid” plan.
10 Tips to Find Affordable Health Insurance in 2016
TIP # 1 - Shop the Insurance Market On and Off the State Health Insurance Exchange Covered California
With the introduction of the California State Health Insurance Exchange, Covered California, every policyholder in California should compare their current health insurance plan with the new qualified health plans. These health plans are guaranteed to provide essential levels of coverage and comply with consumer protections set forth in the Affordable Care Act (ACA). The health plans are, based on the metal rating inside and outside the exchange. The health insurance plans have a metal rating – Platinum, Gold, Silver or Bronze – based on actuarial value calculations. For example, Platinum plans will provide for 90 percent of costs while policyholders pay 10 percent of medical cost; Silver plans will offer 70 percent coverage while policyholders will pay 30 percent of medical cost.
Tip #2 - Will I qualify for a financial subsidy?
Many Americans will qualify for a federal subsidy to pay part off of their health insurance premium, which depends on their Modified Adjusted Gross Income (MAGI) . Individuals and families earning up to 400% of the Federal Poverty Level will be eligible to qualify for a federal subsidy. The Federal Subsidy depends on your family size and modified adjusted gross income, to calculate please use the federal subsidy calculator.
If your Modified Adjusted Gross Income (MAGI) is in between 139% and 250% of the Federal Poverty Level(FPL) the Silver Plans are offering next to the subsidy also a costsharing towards copayments, coinsurance and outof pocket maximum.
Tip #3 - Will my doctor and hospital be in the network?
In 2016 there will be wider choices of medical networks, and therefore check if your particular doctor or hospital is in the network of your insurance choice. In general to lower the cost the Affordable Care Act health plans (ACA plans) insurance companies offer smaller networks. Therefore it is a critical to research if your preferred doctor and hospital is in the network of the exchange health plans. The good news for 2016 is, that Anthem is going back to a true PPO (Preferred Provider Organization) in the Southern California area meaning you can choose doctors outside the network. A new Health Insurance Carrier named Oscar , will be offering intuitive technology tools with a health risk assessment online guide and a preventative care checklist. Blue Shield remains a PPO plan and is contracted now also contracted with UCLA and Cedar Sinai and has the Providence Health & Services as their preferred hospital.
Tip #4 - How will the insurance premium vary in California?
In California the only rating factors for premiums are based on geography, age and family size.
a) Geography : There are 19 regions in California, each rating area will have their own cost of care applied
b) Age: Rates based on age will differ by no more than a 3:1 ratio. In the past this ration was 5:1 or higher. The 3:1 ratio says that the cost of the highest age may be no more than three times the cost of a young adult. We expect that the rates for young adults will increase.
c) Family Size
In determining a family’s total cost, all adults (subscriber, spouse, adult children) age 21 and above are rated separately under family coverage, and only the three oldest children who are under age 21 will be rated in the total family premium.
Rates for a health plans are guaranteed for a full calendar year, or the duration of the calendar year for special enrollment. Rate adjustments due to age changes can only occur during open enrollment or special enrollment periods
TIP # 5 Do not use out-of-network doctors
Double check with your insurance if your doctor is an In Network Provider. Using out-of-network doctor can be very costly, as the insurance companies with a PPO plan are only paying their standard rate and you are responsible to pay the doctor the remainder. With the introductions of EPO’s ( Exclusive Provider Organization) covered benefits are not paid for services rendered by a provider who is not part of the provider network except in emergency or plan approved care outside the provider network.
TIP #6 - Pay for Brand Prescription
Bronze Plans plan are less costly than the other metal plan of the ACA plans. If you have a Bronze plan you need to meet the annual medical deductible of $ 6000 before Emergency Visits, Xray, Diagnostics, Hospital and OutPatient Medical Treatment will be covered. The drug deductible will be $ 500. After the drug deductible is reached you pay $15 for generics $ 50 for preferred Drugs $ 75 for nonpreferred drugs or 20% coinsurance for Specialty Drugs. The Out Of Pocket Maximum is $ 6500. On the Silver Plans the drug deductible is $ 250 for brand prescriptions. Gold and Platinum plans will not have a drug or medical deductible.
TIP #7 - Go into Higher Deductible Plans - or Limited Doctor Visits
In order to offset the steep increases in health insurance premium, many families increase the deductible on their health plans. If you do this, start putting each month $ 100 towards a saving account, so that you are able to pay your bills when the unexpected happens. With the new metal plans evaluate if a Bronze plan is really suitable for your needs. Bronze plans have a deductible of $ 6000 for medical and $ 500 drug coverage, the outof pocket maximum is $ 6500 for an individual and $ 13000 for a family. You have only limited doctor visits before the deductible applies. Please compare the Silver Plans to the Bronze Plans although the Silver Plans are more expensive they offer over all a better benefit package
TIP #8 - Add Supplemental Insurance
To be prepared for the unexpected add a supplemental insurance. Add a critical illness insurance, which will pay you a lump sum, if you have a critical illness. Young families can add an accident insurance, for as little as $40, – per month, or singles for $20, – a month.
TIP #9 - Always Read the Out-Of-Pocket Maximum
After the deductible is reached, you have to pay a coinsurance, which can be as little as 10% Platinum Plans or as high as 40 % Bronze Plans until you reach the Out-Of-Pocket Maximum.
In-Side the Networks of an Insurance Carrier’s Health Plan , Platinum Plans have a maximum out-of-pocket limit for an individual of $ 4000, for a family of $ 8000. Gold and Silver Plans have maximum outpocket limit of $6250 for an individual and for a family of $12500. Bronze Plans have a maximum outpocket of $ 6500 for an individual and $ 13000 for family .
Out-Side the Networks of an Insurance Carrier’s Health Plan the out-of pocket maximum can be considerable higher.
Tip #10 - Contact Solid Health Insurance Service - Your Insurance Agent
In order to do our job properly we keep up to date with the newest insurance plans and newest health care reform changes. We know, which plans have loopholes and research the networks of each health plan. We will determine if you qualify for subsidies. We will guide you through the application process. Filling out an insurance application can be very difficult. A meeting or telephone conversation with us, will help you to successful guide your through the application process.
When our company was looking for group health insurance, Barbara was the most knowledgeable agent we spoke to by far. She recommended the plans that best fit out staff without any agenda and saw us through every step of the process with a smile.Greg Dixon
Barbara of Solid Health Insurance Agency has cut my workers’ compensation premium in half. Thank you for saving me thousands of dollars.Abe Vasquez
With Barb’s help, I now have great insurance that I can afford. Thanks Barb!Sarah T.
Barbara’s innate knowledge of insurance and her tireless efforts to inform us of the seemingly endless litany of insurance possibilities provides us with a sense of relief and trust that we’re being taken care of. She, quite literally, has saved us thousands of dollars.Rumba art. design. decor
I have found Barbara Schmalz of Solid Health Insurance Services to be very proactive in representing my interests in getting the best insurance coverage at the best rates. I appreciate how much time she puts into serving my individual interests.Barbara T.
Barbara helped me find excellent insurance after I began working from home. She was a big help and always available for questions/concerns. Thanks!Matt B.
Barbara has handled the insurance issues for my companies for 6 years. She is highly knowledgable and finds the most affordable plans. in the waste amount of plans, she finds the plan which fits the best for my company.
Barbara has been a tremendous help for me over the past two years. She is consistently available and eager to help with any of my insurance needs. She is always patient and helpful. She represents me as a client with full commitment and integrity.Juliet M.
Call 310-909-6135 for Free Quote
We look forward to building a solid relationship with you.
Please contact us at:
Solid Health Insurance Service
CA Licence # 0G05625
11639 Chenault St.
#406 Los Angeles