The Affordable Care Act Points that we know so far (As of August 21, 2013):
1. The open window to purchase the new Marketplace or Exchange policies is Oct. 1, 2013 through March 31, 2014. Everyone must have some health coverage on Jan 1, 2014 or be subject to a penalty. This penalty will increase each and every year and is proposed to be a tax that is the higher of $95 or 1 percent of your income.
2. KEY POINT: If people want to be covered by January 1, 2014, they MUST enroll by December 15th. If they enroll on December 16 through December 31, the effective date for the policy will be February 1 and NOT January 1, 2014. Trent Perry at our agency can aid you in choosing coverage options.
3. There will be 4 plans offered for individuals to purchase on the Marketplace (also referred to as the Exchange):
Bronze Silver Gold Platinum
4.These 4 plans will be offered by each Insurance Company and can differ as far as the benefits. We have learned that the maximum premium charged for those closer to age 65 can not be more than 3 Times the amount of a younger person. Example: a 22 year olds premium is $200 per month for the Silver Plan, the 62 year old will pay no more than $600 a month for that same silver plan.
5. Many who are insured currently outside of work on individual plans are getting letters notifying them that their plans are ending January 1, 2014. This is because certain high deductible health policies do not comply with the Affordable Care Act and they will not be available for purchase in 2014. For example, a $10,000 deducible will not be allowed in 2014 but lower deductibles will—we just don’t know what the deductible limit is yet—My guess around $5000 could be the maximum deductible allowed.
6. The application for the new Marketplace policies will be short as there are only 4 or so questions. The ONLY health type question allowed will be if you use tobacco or not.
7. KEY POINT: Tobacco use is proposed to increase your premium by as much as 50%. This increase is NOT eligible for a subsidy that reduces your true premium. Example: You subsidized premium is $200 per month for a particular plan. If you use tobacco, the rate may be $300 or more per month and that surcharge of $100 or more will be paid 100% by the insured.
8. KEY Point: If you have group health coverage where you work, you can NOT receive a subsidy to reduce your premium on a plan that you purchase through the Marketplace. The only exception is if you premium at work for health insurance exceeds 9.5% of your income. Some employers with 2-49 full time employees may actually hurt their employees by keeping group medical insurance since the Marketplace plans can be quite affordable to those with qualifying incomes.
9. To get a Subsidy to reduce your premium you have to fall into an income limit. Here is a couple of examples:
a. A single person that wants to buy coverage for him or herself can not make more than around $45,000 per year.
b. A family with 2 children that wants to buy coverage can not make more than around $94,000 per year to get a Subsidy.
10. Here is a link to a website that will give individual consumers an idea of what a plan might cost under the Affordable Care Act:
11. The requirement for employers to provide group medical coverage that have 50 or more full time employees has been delayed and will NOT be enforced until January 1, 2015.
12. Consumers do not have to go online and hope they make the right choice on the Marketplace starting October 1, 2013. Our licensed and certified agent,Trent Perry, can help consumers enroll in a plan and there is no extra cost for this service.
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