What’s Changing?

There’s a lot of talk about the Affordable Care Act and all the health insurance changes that come with it.

What does the new health care law really mean for you?

Key Features
Coverage will be guaranteed and required. You will be able to get health insurance coverage, even with a pre-existing condition. What’s more, you won’t have to pay more to have pre-existing medical conditions covered. Most Americans will be required to have health insurance coverage or pay a penalty.

All new plans will include coverage for essential health benefits. These are a comprehensive package of benefits including preventive services, maternity and newborn care, and emergency services.

You may qualify for cost assistance. Based on your income, you may now be able to get help paying for health insurance coverage. Premium tax credits and help with cost-sharing are available to those who qualify.

Are you an Employer?  Here is how the reform will affect you:

Beginning in 2015, employers with 50+ full-time employees or full-time equivalents must offer medical coverage that is “affordable” and provides minimum value to full-time employees and their children up to age 26 or face penalties.

Coverage is “affordable” if employee contributions are less than 9.5% of:
Employee’s W-2 wages
Employee’s monthly wages (hourly rate x 130 hours per month),

Federal Poverty Level for a single individual
A plan must pay 60% of the cost of covered health services to provide “minimum value.”

Employer Penalties

This chart below summarizes the coverage requirements and the penalties that apply if any full-time employee purchases coverage on an exchange and receives a federal premium assistance tax credit. The penalties will be adjusted in future years.

Employer Mandate



Individual Mandates in the Reform

Under health care reform law, all people must have minimum essential coverage beginning January 1, 2014.

People have “minimum essential coverage” if they have a:
Government-sponsored plan
Employer-sponsored plan
Individual plan
People can choose to buy health insurance on or off state insurance exchanges that will open in 2014. Some people can also get federal premium assistance on an exchange.

If a person cannot keep minimum essential coverage, the Internal Revenue Service will collect a tax penalty from him or her. The monthly tax penalty is described as 1/12th of the greater of:
For 2014: $95 per uninsured adult in the household (capped at $285 per household) or one percent of the household income over the filing threshold
For 2015: $325 per uninsured adult in the household (capped at $975 per household) or two percent of the household income over the filing threshold
For 2016: $695 per uninsured adult in the household (capped at $2,085 per household) or 2.5 percent of the household income over the filing threshold
The penalty will be half of the amount for people under age 18.

There are a few exceptions to the penalty, including:
Religious reasons
Not present in the United States
In prison
Not able to pay for coverage that is more than eight percent of the household income
An income that is below 100 percent of the poverty Level
Having a hardship waiver
Not covered for less than three months during the year

To see how to avoid the penalty, if you qualify for a subsidy or to shop rates complete the form below or contact us directly at 877-740-8683 or info@fbsagency.com


One response to “What’s Changing?

  1. Pingback: Obamacare Enrollment Checklist & Tips | Health Reform Enrollment Center

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