October Newsletter Details: How will the Affordable Care Act impact you?

The Affordable Care Act contains new health insurance coverage and financial assistance options for individuals and families, it also contains new benefits and responsibilities for employers.  In 2014 most people will have to have health insurance or pay a fee.  The Health Insurance Marketplace found at www.healthcare.gov helps uninsured people find health insurance.  Open enrollment for the Marketplace ends on March 31, 2014 and if you enroll by December 15, 2013, your coverage can begin as soon as January 1, 2014.  You will be considered covered if you are insured through an employer, an insurance plan bought on your own, Medicare, Medicaid, CHIP, COBRA, retiree coverage, TRICARE, or VA health coverage.

On the Marketplace website when you complete an application you will find out what you qualify for including private insurance plans, Medicaid, and the Children's Health Insurance Program (CHIP).  The Marketplace will tell you if you qualify for lower costs based on your household size and income.  Plans cover essential health benefits, pre-existing conditions, and preventive care.  If you do not qualify for lower prices you can still buy insurance at the standard price on the Marketplace website.   If you qualify for Medicaid or the Children’s Health Insurance Program (CHIP), the Marketplace will share that information with your state agency, many states are expanding Medicaid to cover more people in 2014.   If you are eligible for insurance through an employer you have the option to switch to a marketplace plan, however you will not qualify for lower costs based on your income unless the job-based insurance is not affordable or does not meet the minimum requirements.

The IRS will be administering the tax provisions.  There is a premium tax credit that may help make the cost of purchasing health insurance coverage.  In January of 2014, you must either have health care coverage, have an exemption from coverage, or make a payment when you file your 2014 tax return in 2015. If you do not have health insurance in 2014 you will pay a penalty of $95.00 per adult, $47.50 per child, or 1% of your income (whichever is greater). This fee is called the Individual Shared responsibility payment and these fees will increase every year, these fees will be due when you make your tax payment.  You may qualify for an exemption from paying the fee, there is a list on the Marketplace website, some of them include: if you were uninsured for less than 3 months of the year, the lowest-priced coverage available to you would cost more than 8% of your household income, you don’t file a tax return because your income is too low and different types of hardships that may have affected your ability to purchase an insurance plan.  You can apply for an exemption on the Marketplace website or when you file your 2014 federal tax return. If you get insurance through the Marketplace you may be able to claim a premium tax credit, which you can have advance payments sent directly to your insurer during 2014 or you can claim them when you file your tax returns.  If you choose payments in advance you will have to reconcile the payments on your 2014 tax return.

If you are a business owner, depending on the size of your business will determine if you are eligible for tax credits, health care options, and your responsibilities as a business owner.  If you have less than 25 full-time equivalent employees may be eligible for a Small Business Tax Credit to help cover the cost of providing coverage.  If you have less than 50 employees you might be eligible to buy coverage through the Small Business Health Options Program.  If you have 50 or more employees an annual return will need to be completed to state what insurance was offered their employees and they may also be subject to the Employer Shared Responsibility provisions.

All information in regards to the Affordable Care Act was found at www.healthcare.gov or www.irs.gov.