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Understanding the Affordable Care Act

Posted October 16, 2013 in Advice Column, Winterset

I have written about the Affordable Care Act multiple times, but feel it is timely to write about it again.

As I prepare this article the federal government has been shut down and much of the debate is centered around “Obamacare.”  The following information assumes that there are no additional changes to the law before the final pieces of the law are implemented Jan. 1, 2014.

Large group (51+ employees) mandate. The implementation of this provision of the law has been delayed to Jan. 1, 2015.

Individual mandate. Effective Jan. 1, 2014, nearly everyone is required to have health insurance. If you do not have health insurance, you will owe a penalty of $95 per adult and $47.50 per child (up to $285 for a family) or 1.0 percent of family taxable income, whichever is greater. Penalty is increased in 2015 and further increased in 2016.

Insurance subsidies. Depending on your income you may qualify for a health insurance tax credit and a reduced cost sharing plan. Example: a family of four with household income of less than $94,200 will qualify for a health insurance tax credit, and with an income of less than $58,875 will qualify for reduced cost sharing. In order to take advantage of these the policy must be purchased from the Marketplace.

Marketplace. By visiting consumers now have the ability to learn if they qualify for subsidies or cost sharing, compare coverage options side by side and enroll in a plan. We recommend that consumers meet with their local agent who can help guide them through the difficult process of choosing a plan that best fits their needs. Cooportunity Health is a new provider that is the only provider offering small group plans through the Marketplace for Madison County. Cooportunity and Coventry are both offering individual plans through the Marketplace.

Small business tax credit. If your business qualifies and plans to take advantage of the small business tax credit in 2014 you must purchase your group plan through the Marketplace. Therefore, since Cooportunity Health is the only provider offering a plan through the Marketplace, anyone utilizing the tax credit will have one of their plans.

Guaranteed issue. Effective Jan. 1, 2014, all health insurance is guaranteed issue. This means no one will be turned down for existing health conditions. Additionally, there will not be any increase in premiums based on health conditions.

Beginning in mid-October Johnson Insurance will be holding weekly seminars on the Affordable Care Act and its impact to consumers. Watch for advertisements of the time and location.

Information provided by Eric Johnson, Johnson Insurance, 1217 N. Sixth Ave., Suite 4, Winterset, 515-462-4553.

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