It’s supposed to be easy and ensure that every American has health care coverage. But so far, it’s contributed to a stalemate that has led to the federal government shutdown. And, I’m hearing people, especially those employed by small business owners, say “I’m so confused by the new healthcare system.”
At DM Accounting, we have two employees on our group health insurance plan. Small business owners, who have less than 50 employees, are not required to carry health insurance, but as an incentive, DM Accounting normally subsidizes 50% of our employee’s health insurance costs. Our two employees say they no longer want to renew their health insurance, so now they’re looking into new healthcare options. I wanted to know what’s out there, so I’ve been digging around for information and here is what I learned:
JOB-BASED INSURANCE vs. THE MARKETPLACE
If you receive job-based insurance, you can switch to ACA options, but you may not qualify for a lower cost insurance. It will depend on your income, or if your job-based insurance is unaffordable or doesn’t meet minimum requirements. Before you switch, also consider that you may lose any contribution your employer makes to your premium.
PRIVATE INSURANCE PLANS vs. LIMITED INCOME OPTIONS
There are four private insurance plan levels for families and individuals including: Bronze, Silver, Gold and Platinum. The Bronze plan has a lower annual cost, but higher deductibles and co-payments. Platinum programs will cost you more annually, but you will pay less for doctor or hospital visits. If you have limited income, you may be eligible for a government subsidy to pay for the plan or for a Medicaid or Children’s Health Insurance (CHIP) program.
PENALTY FOR NO INSURANCE
If you don’t have health coverage in 2014, expect to pay a penalty of $95 per adult/$47.50 per child, or 1% of your income (whichever is higher).
There are some exemptions, such as those who don’t have to file a tax return because their income is too low, people not lawfully present in the US, individuals who are uninsured for less than 3 months of the year, or people with a hardship exemption, such as victims of domestic violence.
ENROLLMENT DATES
If you want your new ACA option to kick in January 1, 2014, then you need to enroll at www.healthcare.gov between October 15th and December 15th of this year. The enrollment period runs through March 31, 2014.
SIGN UP
To find out about health coverage or to sign up for it, you need to create an account by visiting www.healthcare.gov. Nearly five million people logged onto the website on the first day it was up, resulting in technical problems, glitches in the system and users getting locked out of the online health insurance exchange. Be patient and try again in the coming weeks.
You can also call 1-800-318-2596 with questions about the exchange. Finally, there are Healthcare Navigators who have been certified to help guide consumers through the healthcare marketplace. For a list of navigators in Florida, check out http://bit.ly/1a4D8CG.
We believe health insurance is an added incentive to work for DM Accounting, so we’re trying to find our place within the new, healthcare marketplace. Wish us luck!
