The Patient Protection and Affordable Care Act of 2010 requires that every American have minimum essential coverage beginning January 1, 2014. There are three ways to achieve minimum essential coverage as required by the Affordable Care Act. The first is to purchase your health coverage from our state exchange called Connect For Health Colorado. If your income is below 400% of the federal poverty level you may be eligible for a tax credit that will help offset the cost of your health insurance. You may also qualify for a reduction in your deductibles, copays and out of pocket maximums. In order to receive these benefits, you would have to purchase your health insurance through the exchange. The second option is to purchase your health insurance outside of the marketplace and directly with an insurance company. The third option is to sign up under your employer’s sponsored plan.
The Affordable Care Act offer’s plans are like Olympic medals. There are Bronze, Silver, Gold and sometimes Platinum plans available. Each plan offers different benefits. The Bronze plans are the least expensive. If you are employed by a larger company, your options might not be labeled like the gold medals. Individual and Small Employer Group plans are set by law, so using a health insurance broker or coverage guide does not cost you more than if you purchased a policy directly with the insurance company.
Many things have changed because of the Affordable Care Act. One of the most important things is that no one can be declined for a pre-existing health condition. You can keep your children on the plan till their 26th birthday. Wellness visits are free. There are no more lifetime limits on your insurance coverage. Companies have to pay claims out to unlimited lifetime maximums. And insurance companies now must spend at least 80% of the premium payments toward medical expenses, called the MLR-Medical Loss Ratio, instead of advertising, contests, or big bonuses to executives. If they do not comply, they must refund a portion of your premium back to you. These are just a few of the updates. For more in depth information please go to the website mentioned below.
If you do not have health insurance, you will be charged a penalty. The penalty is going up every year. If your income is less the 133% of the Federal poverty level, you will automatically qualify for Medicaid.
If you are a small business owner with less than 25 employees, there are tax credits available to you through the exchange. Employers with 50+ full time equivalents must offer medical coverage that is “affordable and provides minimum value to full time employees and their dependent children up to age 26 or face penalties in 2016. For employers with more than 100 + employees, the employer must offer coverage to 70% of full-time employees and dependents to age 26 or be charged a penalty for 2015. New fees and taxes are supposed to generate revenue of help fund expanded programs. Employers will pay some fees while others will be paid by the insurance companies and individuals.
New rules take affect each year. For more in depth information on Healthcare Reform, please go to InformedOnReform.com or contact our office by email or phone with questions.