Believe it or not, 2013 is half over. As we begin the 2nd 1 / 2 of the entire year, there are several big changes coming which could affect you whether you realize it or not. It wasn’t sometime ago whenever we had a large divide within our country on the healthcare reform and the passing of PPACA (Obama Care) in 2010. Since that time, there were small changes occurring in medical insurance industry, and most likely, your health insurance policy. However, a lot of these changes have gone unnoticed by most people.
That is focused on to improve! Starting January 1, 2014, four of the largest changes in the reform legislation are set to be implemented colorado health insurance marketplace. This really is once the “rubber will meet the street” and it all goes from theory into practice. Whether or not this can be a big success or another financial burden on our national debt, only time will tell. But, what’s important now is to understand what is expected of you and/or your organization and which decisions are best for you.
The 4 biggest changes are:
Individual Mandate- The PPACA requires all Americans and legal residents to purchase qualified medical insurance coverage. If not, then you definitely can pay the absolute minimum fine of $95 up to 1% of your household income. The fines increase in 2016 to $695 per person or 2.5% of income up to $2085.
Guaranteed Coverage- Coverage can’t be declined as a result of pre-existing conditions. For persons who have been unable to obtain coverage on the average person market as a result of pre-existing health conditions, they’ll now manage to get exactly the same coverage and price as a healthier person exactly the same age (smokers are charged additional).
Health Insurance Marketplace (Exchange)- For individuals and small businesses, the Federal government and some states will provide an Exchange to gain access to medical insurance in addition to the original way of an insurance agent/broker. Actually, some insurance agents/brokers will provide plans both inside and away from Federal or State Exchange. Both important points are 1.) an individual can just only qualify for a subsidy and 2.) a small company can just only qualify for the tiny business tax credit through a Federal or State Exchange. The Enrollment for the Exchanges opens October 1st this year.
Pay or Play Rule- For businesses with 50 (FTE/Full-Time Equivalent) employees or more, a reasonable “minimum essential coverage” health plan must be provided to their employees or pay a fine. If a company doesn’t provide qualified coverage, the penalty would be the lesser of ($2000 times the # of F/T employees minus 30) or ($3000 times the # of F/T employees that obtain a subsidy for coverage through the Exchange). This penalty is set on a regular basis so can pay 1/12 those amounts times the # of months they are not in compliance.
They are the largest, but definately not the sole, changes which can be coming in 2014. How can you be affected? Do you know the most effective method of take? For many, you may not see much difference. For those individual and businesses who desire answers to your questions, my suggestion is to speak by having an agent/broker which will be providing coverage both inside and away from Exchange to compare your options and allow you to make the most effective decision.