By Brian Tribbitt, MBA

Following nearly two years of a public health crisis, the American Rescue Plan drastically lowers health insurance premiums for lower- and middle-income families into 2022. Following in the federal government’s footsteps, Pennsylvania is staying ahead of the curve by providing its residents with state-affiliated health insurance.

On November 21, 2020, Pennsylvania rolled out Pennie —’s newer and cooler replacement that makes health care coverage more accessible for Pennsylvanians. Here’s everything you need to know about the online health insurance marketplace.

Do I Qualify for Pennie?

If you are a resident of Pennsylvania and a citizen, U.S. national or individual pending immigration status, you can enroll in health care coverage through Pennie. The annual enrollment period runs from November 1 to January 15, but you may enroll outside of that timeframe if you have experienced a qualifying life event (QLE). A QLE is a sudden change in circumstances such as a change in residence or change in household size (birth, death, marriage, etc.). If you’ve experienced a QLE, you have 60 days to report it and enroll outside the open enrollment period.

How Pennie Works

Say Pennsylvania resident John Doe is 30 years old and single, making $55,000 a year. He’s in the market for affordable health insurance and decides to check out Pennie. After he submits some basic demographic information, Pennie filters health and dental plans that match his qualifications. From there, John can compare the offered plans and estimate the total costs, including deductibles, co-payments and co-insurance of various plans that pique his interest.  Here are some examples of plans John could enroll in:

Pennie Marketplace Example

If he decides Pennie’s insurance offerings, such as the ones seen above, are worth his while, he can apply to receive coverage. Assuming his application is accepted, John can then compare features across different plans and choose the one that best fits his needs and wants. Finally, John pays his first month’s premium and continues monthly payments to receive future health insurance coverage.

Four Categories of Insurance Plans

Pennie categorizes medical plans into four categories (platinum, gold, silver and bronze) based on how the individual and their insurance company plan to split the cost of health services:

  • Platinum: Highest premiums, lowest deductibles.
  • Gold: Higher premiums, lower deductibles.
  • Silver: Lower premiums, higher deductibles.
  • Bronze: Lowest premiums, highest deductibles.

Pennie dental plans are categorized as high and low, high being higher premiums with a lower co-pay and deductible and low being lower premiums with a higher co-pay and deductible.

Can I Receive Financial Assistance Through Pennie?

The short answer: Yes. The long answer: Yes, but only under certain circumstances. There are two types of financial assistance offered through Pennie—Advanced Premium Tax Credit (APTC) and Cost-Sharing Reduction (CSR).

APTC is a tax credit you can take in advance that lowers your monthly health insurance payment or premium. For you to qualify, your household income must fall between 100% and 400% of the federal poverty level, which was $26,500 in 2021.

The other assistance option, Cost-Sharing Reduction, lowers out-of-pocket costs associated with health care such as deductibles, co-payments and co-insurance. After reaching your out-of-pocket maximum (the maximum amount you would have to pay for covered medical services per year), your insurance plan will cover 100% of all covered services. For you to qualify, your estimated income must fall between 100% and 250% of the federal poverty level for your household size. To take advantage of CSR benefits, individuals must enroll in one of Pennie’s Silver plans.

You can visit for more information about the exchange. If you have questions concerning which health plan is right for you, you can reach out to Stonebridge Financial Group through our online contact form or by calling us at 717-736-7007.