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HEALTHCARE REFORM

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THE AFFORDABLE CARE ACT (ACA)

To help you with Healthcare Reform.

How it affects Individuals and Businesses.  Healthcare reform is legislation intended to better our healthcare system in the US. Recent healthcare reform, known as the Affordable Care Act (ACA), will continue to be implemented over the next several years. It imposes complex new rules and guidelines for insurance companies, individuals and employers.

 

Below you will find some (but certainly not all) highlights of the new law and how it may impact employers and individuals under 65. To ensure you are compliance with the ACA, we recommend you call our office for assistance, as not everyone will interpret the law in the same manner.

Tax Penalties

Underwriting

Open Enrollment

Coverage

Tax Credits

Employers who have more than 100 or more full-time equivalent employees must offer those employees and their families and dependents to age 26, benefits that pays for 60% of the minimum essential benefits, as established by the ACA, or face a potential penalty. In 2016, the mandate applies to employers who have 50 or more full-time equivalent employees.

 

Individuals must now obtain qualifying coverage either through an individual policy or through their employer or face a potential penalty.

-No pre-existing clause. Insurance companies can no longer increase rates or deny coverage because of a pre-existing condition.

-Dependents up to age 26 may be added to an insurance policy for both individuals and employer coverage.

-Gender is no longer a factor in determining rates.

-Renewal rates are the same as new business rates.

-Waiting period should not exceed 90 days.

Individuals must purchase their health insurance during the annual open enrollment period. Failure to do so may result in penalties and having to wait until the next open enrollment to purchase coverage. Employers are able to offer benefits year round or during their normal open enrollment as usual.

Business and Individuals who purchase their health insurance through the new Health Insurance Marketplace and/or SHOP may be eligible for tax credits which are applied as a discount on your monthly insurance premium. To see if you are eligible for a tax credit (premium subsidy), please click the appropriate link below.

To be in compliance with the new healthcare reform laws and avoid costly penalties, you must purchase Insurance coverage that pays at least 60% of the costs of the following “essential benefits.

RELATED RESOURCES

ACA Certified

The consultants of Northwest General are ACA Certified by the National Association of Health Underwriters and are continually educating themselves to stay abreast of new laws, regulations and legislation within the healthcare and healthcare insurance industries.

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