2014 Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act (PPACA), also known as ObamaCare or ACA, will be effective January 1, 2014. Mactavish Benefits has spent considerable time analyzing the outcomes PPACA will have on our clients and their employees. We have sought out to develop strategies that sustain our convictions of offering the best medical benefit program at the lowest responsible cost for the employer and the employee. While our focus has been on how PPACA effects employers, we acknowledge that the employees, the individuals, the consumers, need to be informed as to how PPACA effects them.

Am I required to have health coverage?

Yes. Every individual will be required to obtain health coverage in 2014. If you already have health insurance, you are compliant with PPACA. If you do not have or do not obtain health insurance during an open enrollment, you may be subject to a tax penalty.

Open enrollment for MNSure (the state Exchange or Marketplace) or directly through a carrier is October 1, 2013 to March 31, 2014. If your employer offers a group health plan and you are not already enrolled, speak with your HR personnel regarding their open enrollment policy.

Can I wait until I need health insurance to obtain coverage?

No. You can only obtain health insurance during an open enrollment period or if a qualifying life event occurs. Policy holders can still add or change their policy outside of open enrollment when a qualifying life event occurs.

What if I lose my health coverage?

If you lose your health coverage due to a qualifying life event, you will need to have health coverage in place for the 1st of the month following your loss of coverage or wait until open enrollment.

What is the tax penalty if I do not obtain health coverage?

2014: $95 per adult and $47.50 per child (up to $285 for a family) or 1.0% of family income, whichever is greater.

2015: $325 per adult and $162.50 per child (up to $975 for a family) or 2.0% of family income, whichever is greater.

2016: $695 per adult and $347.50 per child (up to $ 2,085 for a family) or 2.5% of family income, whichever is greater.

If my employer offers health insurance, can I still use MNSure to get a subsidy?

No. Individuals who are offered group health insurance from their employers may not use MNSure for subsidies unless their employer’s standard plan fails to cover minimum insurance requirements of the law or their incomes are too low to afford the standard plan.

What if I was denied coverage in the past?

There are no longer pre-existing condition clauses under PPACA. Adults and children with pre-existing conditions will be eligible for health insurance, even if they had medical conditions that prevented them from getting health coverage in the past.

Want to know more? Visit Kaiser Family Foundation’s FAQ page or find us on FacebookTwitter and LinkedIn to ask us general questions you may have about PPACA.

 

Download November’s ProHealth Newsletter here! 

facebooktwittergoogle_pluspinterestlinkedinmailby feather