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Health Care Reform Update

Posted: February 19, 2013
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Last week I attended a Health Care Reform Seminar. Below is some of the information I obtained from the seminar. Please note that some of the kinks are still be worked out and we are still waiting for some answers. As I obtain more information I will pass it along. Feel free to call or email with any questions and I will do my best to get an answer if I don’t know it myself.

 

INDIVIDUALS

*Will be required to obtain a qualified healthcare plan starting in 1/2014.
*Health insurers must cover EVERYONE that applies for a plan (i.e. all plans are guaranteed issue, will not contain a waiting period, and will cover all pre-existing conditions).
*Individuals may qualify for a subsidy; which is based on income.
*All plans will offer the same benefits (maternity and newborn care, emergency, fertility, obesity, mental health and substance abuse, perscription drugs, rehabilitative services and devices, dental, and vision).
*Plans in the marketplace are Platnum, Gold, Silver, and Bronze. You will be required to carry at least the Bronze plan to avoid the penalty.
*Platinum plan is 90% co-insurance, Gold is 80%, Silver is 70%, and Bronze is 60%.
*If you choose not to carry health insurance you will be required to pay a penalty of $95 for 2014, $325 in 2015, $695 in 2016. This penalty will be charged per person in the household. Chicldren under age 18 will be charged 1/2 of that amount (i.e. $47.50 for 2014).
*You may decide to carry no insurance for 1/2 the year. In that case the amount will be pro-rated to reflect the number of months without coverage.
*When you file your taxes for 2014 you will have to attach documentation from you health insurance carrier to show proof that you had purchased a qualified health plan.
*Coverage will be required to be maintained by all individuals, with exceptions; religious objections, financial hardship, undocumented immigrants, citizens not residing in the US, and those with short gaps in coverage.
*If you currently carry health insurance your plan MUST meet at least the Bronze plan benefits.

 

EMPLOYERS

*Under 50 full-time employees=no penalty
*Full time employees are considered 30 hours per week OR have a combination of full-time and part-time employees that is equivalent to at least 50 full-time employees
*The employer will need to make a decision on how they choose to handle covering their employees, especially employers with more than 50 employees.
*Employers will be required to offer at least the Bronze plan to their employees (assuming they are offering health insurance).