Stay informed with the latest news.

Facts You NEED to Know About Healthcare Reform/”Obamacare”

Posted: September 16, 2013

1.  Open Enrollment begins October 1st and lasts through March 31st.  If you do not enroll in a plan or your plan does NOT meet the government’s standard for qualified coverage, you will NOT be allowed to purchase a plan unless you trigger a special election period (marriage, child birth, loss of employer-sponsored coverage, etc).


 2.  A qualified health plan (QHP) must offer at least 60% co-insurance and the essential benefit categories.  Plans that qualify can be purchased through the exchange, include Medicaid or Medicare, CHIP, TRICARE, or an employer-sponsored plan.


3.  Those with pre-existing conditions will NOT be denied coverage and will NOT be subject to a higher premium. 


4.  During Open Enrollment, plan effective dates are as follows

*October 1st-December 15th = January 1st

*December 16th-January 15th = February 1st

*January 16th-February 15th = March 1st

*February 16th-March 15th = April 1st

*March 16th-31st = May 1st


 5.  Essential Benefits will be added to all plans in 2014.  The benefits include

*Emergency Services


*Mental Health/Substance Abuse

*Prescription Drugs

*Maternity/Newborn Care

*Ambulatory Patient Services

*Preventative Care/Wellness

*Rehabilitative Services and Devices



 6.   The subsidy (also known as cost sharing) is based on household size and annual income.  If you qualify for the subsidy, you can elect to have the funds applied towards your monthly health insurance premium or you can have the funds applied towards your tax return.