ACA Health Insurance Marketplace
ACA-compliant health insurance plans designed to provide comprehensive coverage and potential subsidies for eligible individuals and families.
Navigating the Marketplace shouldn't be overwhelming
The Affordable Care Act created the Health Insurance Marketplace to provide Americans with access to comprehensive health coverage. But navigating plan options, understanding subsidies, and enrolling during open enrollment periods can be confusing and overwhelming. The HealthCare.gov website serves as the federal marketplace for ACA-compliant plans.
At Premier Health Solutions, we help simplify the process. We work with agents and associations to connect members with ACA-compliant plans that fit their healthcare needs and budget — including guidance on subsidy eligibility and plan selection.
What ACA plans cover
ACA-compliant plans are required to cover essential health benefits, providing comprehensive coverage that goes well beyond what many supplemental or short-term plans offer.
Hospitalization & Emergency
Coverage for hospital stays, emergency room visits, and surgical procedures — essential protections for unexpected medical events.
Preventive & Wellness
Preventive services like annual checkups, vaccinations, and screenings are covered at no additional cost under ACA plans.
Prescription Drug Coverage
ACA plans include prescription drug benefits, helping members afford the medications they need for ongoing and acute conditions.
Mental Health Services
Mental health and substance use disorder services, including behavioral health treatment and counseling, are covered as essential health benefits.
Maternity & Newborn Care
Comprehensive maternity care including prenatal visits, labor and delivery, and newborn care are required benefits under ACA plans.
Rehabilitative Services
Coverage for rehabilitative and habilitative services and devices to help members recover from injuries or manage chronic conditions.
Simplifying ACA enrollment and support
We help agents and associations guide their members through ACA plan selection and enrollment, ensuring they find the coverage that best fits their needs and budget.
Enrollment Guidance
We help members navigate the enrollment process — from understanding plan options and metal tiers to completing applications and selecting the right coverage level.
Subsidy Assistance
We help eligible members understand and apply for premium tax credits and cost-sharing reductions that can significantly lower their monthly costs.
Plan Comparison Support
We provide tools and guidance to help members compare plans by premiums, deductibles, provider networks, and covered benefits to find their best fit.
Year-Round Member Support
Our support doesn't end at enrollment. We provide ongoing assistance with plan questions, qualifying life events, and annual re-enrollment.
What you can expect from Premier Health Solutions
At Premier Health Solutions, we provide comprehensive, end-to-end services for your administration, benefits, and management needs.
Help members maximize subsidies
We ensure eligible members take advantage of available premium tax credits and cost-sharing reductions.
Access to comprehensive ACA coverage
ACA plans include all essential health benefits — hospitalization, prescriptions, preventive care, and more.
Reliable and member-focused services
Customer support services that put members first every step of the way, from enrollment through claims.
A focus on compliance
Compliance built into every process, with dedicated support for independent agents who partner with us.
About ACA Health Insurance
The Health Insurance Marketplace is a platform created under the Affordable Care Act where individuals and families can shop for and enroll in health insurance plans that meet ACA standards. Plans are available in four metal tiers — Bronze, Silver, Gold, and Platinum — each with different premium and cost-sharing levels.
Most U.S. citizens and legal residents who are not incarcerated and do not have access to affordable employer-sponsored coverage that meets minimum standards are eligible to purchase coverage through the Marketplace. Income-based subsidies may further reduce costs for eligible individuals and families.
Premium tax credits are financial assistance from the federal government that lowers the monthly premium cost for eligible individuals and families who purchase coverage through the Marketplace. Eligibility is based on household income and family size.
ACA Marketplace plans have an annual open enrollment period, typically running from November through mid-January. Outside of open enrollment, you may qualify for a Special Enrollment Period if you experience a qualifying life event such as marriage, birth of a child, or loss of other coverage.
ACA-compliant plans must cover ten categories of essential health benefits: ambulatory services, emergency services, hospitalization, maternity and newborn care, mental health and substance use services, prescription drugs, rehabilitative services, laboratory services, preventive and wellness services, and pediatric services.
Yes. While ACA plans provide comprehensive coverage, members can add PHS-administered supplemental products like dental, vision, critical illness, or accident insurance to create an even more robust benefits package.
We work with agents and associations to help members navigate plan options, understand subsidy eligibility, compare plans, and complete the enrollment process. Our team provides support throughout the year for questions and qualifying life event enrollments.
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At Premier Health Solutions, we simply do things the right way — for our customers and your members.