Rodolfo E. Urias is the founder of Rudy Urias Health Insurance, based in El Paso, Texas. Rodolfo, also known as ‘Rudy’ by his clients, is a specialist in the Affordable Care Act (Obamacare) and has helped many people get access to a great health insurance plan that makes perfect sense for their financial circumstances and their medical needs.
Rodolfo kindly answered a few questions.
What caused you to want to help people get health insurance?
I don’t think that anybody as a kid grows up aspiring to be an insurance agent, but a person can grow up and learn attributes to be a great insurance agent. A great insurance agent is someone that genuinely cares for his customers, not only his commissions, and knows what is best for his customers based on his product knowledge and training. They need to understand the customer needs with empathy and know a solution. During my life, I learned to care for others, to share feelings, and this eventually pushed me towards obtaining health insurance training, knowledge, and experience.
In 2014 something big happened all over America for people who wanted health insurance. The Affordable Care Act, also known as Obamacare, came into effect. Naturally, I prepared myself with studying everything about the new law, the health insurance companies, the health plans, the tax code, the network, etc.
I can proudly say that I have been helping people understand and benefit from Obamacare since its day of inception November 1st, 2014. That is the day I found my passion in health insurance. It gives me such great joy to see my customers every year, to see them express their gratitude toward me for all I have done for them. I have saved them money on premiums, saved them thousands of dollars with their health insurance, make sure they kept their doctors, help them max their health benefits, help them with their claims and appeals. I learned that helping people get their health insurance its not a just a job, it is a gratifying experience that fills me with joy and humility.
What are the most common questions your clients ask you about health insurance?
1-Do I qualify for Obamacare?
- To qualify for a tax credit, family income must be between 100% – 400% of the poverty level. For example, for a family of 2, the income has to be between $17,240 – $68,960
2-Can I get health insurance?
- The best time to get health insurance is during open enrolment. November 1st – December 15th. To get health insurance during the special enrollment period, the person must have a qualifying exemption such as lost or will be losing employer/government insurance in the last/next 60 days.
3-Can I get better insurance than my work insurance?
- If your work offers you affordable health insurance, then you do not qualify for government tax credits (Obamacare). Unless what they offer is considered unaffordable. The government considers the plan unaffordable if the yearly premium is more than 9.78% of their yearly income.
For example, let’s run the math on a $55,000 income. 55,000 x .0978 = $5379 yearly premium, Let’s divide that by 12 and get a monthly premium, and we get $448.25. Now we know that if you are paying more than $448.25 a month with your employer (employee coverage only), then you qualify for government tax credits and will most likely get a better deal.
Source: https://www.healthcare.gov/glossary/affordable-coverage/
4-What information do you need for a quote?
- Zip code, age, sex, family size, and family income
Source: https://www.healthsherpa.com/?_agent_id=rudyurias
5-Is Obamacare over?
- The Affordable Care Act (Obamacare) has many enemies in congress and in courts. Is has been upheld in the supreme court twice and will go to trial for a third time this November 2020. Regarding the outcome of the trail, Obamacare is ready to stay for 2021. With the popularity of covering pre-existing conditions present in both political parties, it is likely that if dismantled, provisions for the pre-existing conditions will prevail in the future of health care.
Source: https://ballotpedia.org/Obamacare_lawsuits
6-Will I pay any penalty for not having health insurance?
- Since 2019 there have been no tax penalties for not having health insurance. Just beware of confusing it with the tax reconciliation. That’s when you do your taxes and turn in your 1095-A form. Depending on what yearly income you put on your marketplace application and the actual income, there will be a tax reconciliation. In other words, if you earned more than the expected income you owe uncle Sam because he gave you a tax credit in advance and had to pay the difference of what you should have qualified for. But if you earned less than the expected income, you would get a larger tax refund.
How do you help your clients get the ideal health insurance plan to suit them?
First, I must assess the situation and need. Everybody is quite different from the other. So, I gather information. What is their current situation? What are they looking to get coverage from? Those two questions will help me determine the level of coverage they need. Then we go into the quote and financial questions to determine if they get the accurate tax credit and price. Then I ask about the doctors they visit to make sure we pick the right company with all his doctors, all his medical needs, all at the right price. After they have selected a plan, I tell them what to expect from the insurance companies, and if they need to send additional documentation to the marketplace, I tell them that I can always be of assistance, that I’m their agent to help them, to represent them in their best interest and finally that all my services are free and available at any time.
What unique benefits do you give your customers compared to other insurance agents?
The experience that I have accumulated, having been a specialist in the Obamacare program since it began six years ago. Knowledge from all my studies, firsthand customer and personal experiences of enrolling, troubleshooting, claims, customer service, changes etc.
Also, trust – my clients know that I will always be looking out for their best interests. The best part of being an independent agent is that I can be contracted with all the health insurance companies, I get to know them all of their advantages and faults. When it is time to help my clients, I tell them what plan is best for them, and they like my recommendation. I know this because I see them every year, and every year, they refer me to more friends and family members.
Why do you think so many people neglect to get health insurance?
- In the borderland where I live, El Paso, Texas. The most common answer would be because they can easily go to Mexico if they feel sick. But that is not the case anymore. The pandemic has made a lot of people realize that their health is not for granted, and we may need medical attention immediately with no time to spare to take a trip to Mexico. It’s striking that people will ensure their possessions like cars, house and even their phone they just bought – but they will not insure themselves, their health. Most people don’t see the value of health insurance until they run into an emergency situation, and they will forever be grateful they have it when its time to see the bills. Quick question: Who can you prepare for the unexpected? The answer is with health insurance. If you are healthy or sick, a health insurance plan will protect you from any unexpected sickness, accident, and financial disaster from uninsured hospitals bills.
What kind of changes do you predict in the health insurance industry in America?
- I do not expect many changes even if the supreme court rules in favor of Texas vs California. In short, Texas is claiming that the Affordable care act is unconstitutional and should be removed from the law, and California is defending the law. Let us have fun and try to predict the future in the case that Texas won and another that California Won.
If Texas won:
The republican party will be celebrating its long due victory against the Affordable Care Act they have been fighting since 2010. But now they have a bigger task at hand, replacing it. During this 10 year fight, I have seen multiple proposals to replace it with some good ideas like making the tax credit based on age and not on income to some bad ones where it’s stepping back to health insurance of the 90s. In the majority of the cases, I see that covering pre-existing conditions is becoming more and more popular in both parties, so I don’t foresee a change in there. I don’t think they will take away the subsidies because, without the tax credit, health insurance is unaffordable to most Americans, but they will change how the subsidies are distributed and how much assistance (probably less) it will provide.
If California won:
The democratic party will cherish this win on its successful defense of the Affordable Care act. The democrats understand the Obamacare is not perfect and full of flaws, but they remain proud and are willing to fix the law in a way that it can have all Americans with health insurance. In the extreme possibility, they will probably expand Medicaid in some states like Texas if it turns blue and lowers the age requirement to 55 for Medicare.
How would you improve the health insurance industry in America?
Health insurance is a major need in the United States and unfortunate its broken, that’s why we have the government involved, and it won’t be changed unless we fix it at its core. Do not overcharge patients for medical the medical attention they need. Having a baby should not cost from $10,000 – $30,000 for a natural non-surgical delivery. Here is how the ball rolls out – the hospital bill is $30,000. It collects $27,000 from the insurance company and $3,000 to the patient. The insurance gets his money back plus profits from all the customers and government, so let us say the insurance determines that if everybody pays $600 a month that will cover 95% of medical expense and they keep %5 profit. The government knows that not everybody can pay 600 dollars a month, and it will subsidize a portion of the cost, costing the government trillions.
Now let us imagine that the cost of childbirth is only $3,000. The insurance will pay $2,700, and the insured 300 dollars. The insurance company will charge 10 times less premium of 60 dollars a month and the government won’t need to help because that’s affordable health insurance saving the government trillions.
Summary: Rodolfo Urias is a US health insurance specialist based in El Paso, Texas. He is dedicated to helping his clients get the best health insurance plan possible, taking into consideration their medical needs and their budget. As an insurance agent, he helps his clients get the maximum benefit from their health insurance plan and keep their costs as low as possible. As part of his business, he provides free online quotes. Rodolfo Urias can be reached via phone on 915-526-8179, via his website https://texashealth-insurance.com, and even via Whatsapp.
