7/30/2019 HealthcareReformNewsletter August Individual

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HealtHcare reormWhat You Need to Know

From healthy young adults to senior citizens to individuals

struggling with chronic disease, the eects o theAfordable

Care Act(ACA) will be ar-reaching. Starting January 1, 2014,new regulations will provide most Americans access to health

insurance that covers essential care. Major changes set to

impact individuals in 2014 include:

Individu mnd Most individuals will be required to

have health insurance or pay a penalty.

Hh Insun mkps Starting October 1,

2013, individuals without access to aordable, employer-

sponsored plans that provide qualiying coverage can

enroll in plans oered through state-based exchanges,

with coverage beginning January 1, 2014. They may also

qualiy or ederal subsidies.

Gund Issu Insurance companies must sell

coverage to everyone, regardless o pre-existing conditions,

and cant charge more based on health or gender.

Rates may vary based on age, tobacco use, geography

or amily size.

N annu lii liis Individual and grouphealth plans may not impose annual or lietime limits on

essential health benefts.

th Pnis Bing Uninsud

2014 $95 per individual, $285 per amily, or 1% o income*

2015 $325 per individual, $975 per amily, or 2% o income*

2016 $695 per individual, $2,085 per amily,

or 2.5% o income*

*Greater amount applies.

The impact on individuals depends on a variety o actors,

including insurance status, income, age and health. The

ollowing scenarios may assist when determining what, i any,

changes to expect.

Wi h nw w buy hh insun?

Wh i I n d i?

Individuals who dont have insurance wont be orced to get it,but will ace a tax penalty i they dont. Tax credit subsidies will

be provided through the exchanges to those earning up to our

times the Federal Poverty Level (FPL).

Wh Wi Quiy Hp?*

Income Level Premium as a % o Income/Ater Tax Credit

Up to 133% FPL 2% o income

133-150% FPL 3-4% o income

150-200% FPL 4-6.3% o income

200-250% FPL 6.3-8.05% o income

250-300% FPL 8.05-9.5% o income

300-400% FPL 9.5% o income

Hw Subsidis Wk

1 Eligible applicants apply when they sign up or

insurance on the exchange

2 The government calculates the tax credit (see "Ater Tax

Credit" column above), and the amount is paid directly

to the insurance company

3 The insured pays the remaining portion o the premium

I iv vg hugh y py

hw wi h nw us ip ?

I youre satisfed with your employers coverage, you can

keep it and do nothing. Those without access to aordable,

qualiying employer-sponsored coverage may receive subsidies

i they buy rom the state exchanges.

Wh is adb epy-Spnsd cvg?

A plan is not considered afordable when the individuals share othe premium exceeds 9.5% o their gross income.

Example: An employee earning $30,000 per year must pay

$237.50 per month or less or their share o the premium

($237.5 x 12 = $2,850 / 9.5 = 300) or coverage to be

considered afordable.

Inormation provided by:

Maria's Income Tax Service

1932 Hickory St.

Rhome, Tx 76078Office: 817)-636-2202

7/30/2019 HealthcareReformNewsletter August Individual

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Du p-xising ndiin, I uny

uninsub in h individu k. my py

dsn i bnf pn nd I wud ik

i b g 65. Hw wi gund issu

vg nd ss h xhngs y

biiy d s?

Employees considering early retirement (beore theyre

Medicare-eligible), will have access to guaranteed coverageboth in the exchanges and the private insurance market.

In addition, 2014 regulations require premiums or older

individuals to be limited to no more than three times what a

younger person would pay.

th piy I puhsd xuds vg y

p-xising ndiin nd is n up nw uni

Jun 2014. cn I dp y vg nd -n in

nh piy?

Yes, starting January 1, 2014, policies that are rated-up orinclude coverage restrictions will no longer be compliant under

ACA, with the exception o plans issued prior to March 23,

2010 (grandathered). I you decide to drop your coverage

and purchase through the individual market or exchange, you

can switch to a new plan during open enrollment each year.

Is Yu Piy cpin?

Rated-up (charging a higher premium based on health) and

ridered (excluding coverage or a pre-existing condition) policies

are not compliant under ACA in 2014.

I uny insud bu hv pd

nub nw inss v h ys.

Wh y pins?

I youre satisfed with your plan and its aordable and provide

qualiying coverage, you can renew your policy as is. I youre

not satisfed with your rates and/or your current policy is not

compliant with ACA requirements, you may purchase a new

policy in the individual market or rom the exchange.

Wi I b quid puhs h xhng,

n I ninu puhs vg hugh

y insun gn?

The ACA specifcally states individual and small business

owners may purchase coverage in the private marketplace

or through an exchange. The small group SHOP exchanges and

most individual exchanges will allow agents and brokers

to participate.

I gdu sudn wh dsn hv

ss n py-spnsd pn.

Wh y pins?

Young adults are eligible to remain on their parents health

insurance policy until they reach their 26th birthday. You

may also purchase individual coverage through the private

individual market, the individual exchange (where you may

qualiy or a ederal subsidy), or enroll in your institutions

student health plan.

cun s augus 2013

AR Ins. Lic. #245544 | CA Ins. Lic. #0633005d/b/a in CA Seabury & Smith Insurance Program ManagementSeabury & Smith, Inc. 2013

Inormation provided by: