Health Care Reform
Affordable Care Act
The Affordable Care Act was passed in 2010, and many changes are rolled out on January 1, 2014. You should be aware of the changes that affect how and where you purchase health insurance as a result of this health care reform.
The biggest changes for individuals and employers are coverage mandates.
Beginning January 1, 2014, most U. S. citizens and legal residents will be required to obtain health insurance or will be subject to a penalty tax for each year they go without coverage.
Where to Purchase Health Coverage
You can purchase coverage from an insurance agent or broker, or you can purchase it from marketplace exchanges. California and Nevada both have a state based exchange. We can assist you in using the state’s website to apply for coverage, compare options and costs, and enroll in your chosen plan.
Once you enter the marketplace for individual health insurance, you will find four plans to choose from, each offering different levels of cost sharing. The more you participate in cost sharing, the less your premium will be.
These plans will pay the following percentages of health care expenses:
- Bronze Plan – 60 percent
- Silver Plan – 70 percent
- Gold Plan – 80 percent
- Platinum Plan – 90 percent
- A catastrophic plan will also be available to those under the age of 30.
Purchasing your coverage through an exchange is not mandatory. It is simply a marketplace for uninsureds to shop for health care insurance. In fact, purchasing your insurance through Richard Votaw Insurance Agency will be to your benefit as we can answer your questions and guide you through the application process. Tax credits for premiums are available for many people with low incomes, as are cost sharing (deductibles and copays) reductions by limiting out of pocket expenditures.
What is Changing?
Other changes effective January 1, 2014 include:
- Insurers are prohibited from charging more or denying you coverage because of pre-existing conditions.
- Individual and group health plans may no longer place lifetime or annual limits on coverage.
- Companies may not cancel coverage because they find you uninsurable. They may cancel coverage only for nonpayment of premium and in cases of fraud.
- Waiting periods for coverage are limited to 90 days.
- Many preventive services are required without cost to you.
Changes for Small Groups
If you are a small business providing health insurance for your employees, you will also be able to purchase coverage through marketplace exchanges. Again, purchasing through an exchange is not mandatory. It is simply a place to shop. If you purchase coverage through an exchange, a tax credit will be available to help you pay for coverage. A credit of up to 50 percent of your contribution toward employees’ health insurance premiums is available if you contribute at least 50 percent of their total premium cost. This credit will be available January 1, 2014, and continue for two years.
Employers are assessed a penalty when employees receive tax credits for their coverage because the employer does not offer coverage or does not offer affordable coverage.
Businesses with fewer than 50 employees are exempt from this coverage mandate, and states can choose to make exchanges available to employers with 100 or more employees. Employers with more than 200 employees will be required to automatically enroll employees into health insurance plans offered, although employees may opt out of coverage.
Whether you are an individual or a small or large employer, let us to help you find the best health insurance coverage for your particular needs.
