ACA: Fed SHOP Delay, Small Businesses Enroll Through Agents
November 30, 2013
By Amy De Vore+
Healthcare.gov delayed the Affordable Care Act federal SHOP* exchanges purchased through their site till 2015. However, small businesses, if they qualify, may still receive SHOP tax credits when they enroll through insurance agents or brokers for the new ObamaCare small business plans.
*SHOP stands for Small Business Health Option.
This is just one of many delays, including the employer requirement that employers with 50 or more full-time equivalent employees must offer insurance or face a penalty. This was also delayed until 2015.
SHOP Employers Enroll Through Agents
Agents, like the team at Medicoverage, will be able to help employers find a plan(s) and enroll them, even though they cannot use the federal website. For employers to get an idea of plans click here to see the individual and family ACA Bronze, Silver, Gold, and Platinum plans available. Employers will need to contact their agent directly at 800-930-7956 to find out what works best for them.
If Your Employer Chooses Not to Enroll in SHOP
If you are an employee who will not receive job-based health insurance you are still mandated to have health insurance or pay an ACA penalty (tax). If you need your own health insurance go to HealthApplication.com to fill out your individual or family application. Once you send in this application your agent will inform whether you are eligible for federal subsidies and explain the plans to you.
Remember before you do anything, check with your employer to see if they enroll you in a plan. If your employer offers you qualifying insurance you cannot receive subsidies. For further questions contact Medicoverage.
Do you Live in one of the 24 States Not Expanding Medicaid?
November 07, 2013
By Amy De Vore+
24 states have decided not to expand Medicaid to about 5.4 Million eligible residents. The Affordable Care Act presented a plan to the states that 100% of the cost of Medicaid would be covered by the federal government for the first three years, after that the states would pay 10% of the cost in the fourth year. However, some states did not think was advantageous to its citizens. Individuals are still able to purchase the Bronze, Silver, Gold, or Platinum plans, but they would not be eligible for subsidies if they fall below 100% of the poverty line ($11,490 for 2013).
The following states have chosen not to expand Medicaid: Alabama, Alaska, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Wisconsin, and Wyoming.
For further questions call 800-930-7956.
Idaho Healthcare Exchange: Not Ready for Deadline
June 05, 2013
By Ray Wilson+
Idaho received conditional approval from the Secretary of Human Health and Services (HHS) to run a state-based exchange. However, Idaho is facing some time constraint issues in implementing the plans by the Healthcare Exchange deadline. Therefore the Idaho Health Insurance Exchange Board voted to work with the federal government. The federal government will help run the individual and SHOP (for group insurance) exchange until Idaho’s IT platform is able to perform on its own. Idaho will maintain its own plan management and consumer assistance functions, while the federal government will operate their IT system.
A state-based program is one in which the state follows the guidelines set by the federal government for but sets up their own exchange for the new Bronze Plan, Silver Plan, Gold Plan, and Platinum Plan. To learn about specific plans and premiums in your state call 800-930-7956.
Governor C.L. “Butch” Otter addresses why Idaho chose to create a state plan, “We have decided to build and operate a voluntary, state-based health insurance exchange rather than defaulting to total federal control. The folks who have agreed to serve on the Board will be our eyes, ears and most importantly the voices of Idaho in this process.”
To learn if your state will run a state-based, default to federal, or enter into a partnership between federal and state contact Medicoverage.
How the Affordable Care Act Helps the Uninsured
May 31, 2013
By Amy De Vore+
The Affordable Care Act helps the uninsured in a few ways. For instance, in the LA Times today there was an article about a woman making $12.68 an hour, mother of one child, lives in Los Angeles, and recently choose to forego surgery because she was uninsured. As of January 1st this woman would have options for health coverage.
How the Affordable Care Act Helps Uninsured
She isn’t qualified for Medicaid, however since she works she may qualify for job-based insurance as 2015. Until then and if her employer doesn’t offer insurance she would qualify for premium subsidies and cost-sharing subsidies, and her daughter would qualify for Medi-Cal.
Costs for Lower-Income Families
The article doesn’t state how old she is, but if she is 30, her Silver plan premium could be as low as $93 a month and her deductible would be reduced from $2000 to $500, and a reduced maximum out of pocket from $6,350 to $2,250. This would apply to any single parent to one child living in the Los Angeles area, making her salary.
How do Lower-Income Families and Individuals Get Insurance?
First, it’s important to remember for anyone purchasing a plan from the Health Insurance Marketplace you need your W2 paperwork and financial information handy like child support, alimony, assets. Then you can either go directly through your state’s newly established call center’s navigators or you can go through your insurance agent. Many don’t realize that agents can help with on and off-Exchange plans.
Lower Income Seniors
Seniors do not have to do anything as of January 1st. Seniors stay on Medicare and do not apply for the new metal plans. Make sure your friends and parents are aware that there is nothing for them to do, because states are vocally expressing their concerns about seniors being tricked by scammers into giving away personal information due to the lack of awareness in regards to the ACA.
To learn if you qualify for a subsidy call 800-930-7956 or contact Medicoverage.