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Healthcare Reform

The Affordable Care Act (ACA) is recent healthcare reform currently being implimented and it is intended to insure that all U.S. Citizens and legal residents have access to affordable healthcare insurance.

 

The law is complicated.  Among other compliance requirements, the ACA mandates that everyone purchase qualified coverage or pay a tax penalty. This affects both individuals and employers.  

 

Below you will find some (but certainly not all) highlights of the new healthcare law, the Affordable Care Act (ACA) and how it may impact employers and individuals under 65.  Because of the complexities of the ACA, we urge you call us for more information and to be sure you are compliant with the new law, as some may interpret parts of the new law differently.

Highlights of the Affordable Care Act (ACA)

Additional Resources

The health insurance experts at Eichberg Associates can show you how to maximize your benefits, whiling reducing costs and staying compliant.

Tax Penalties Imposed by the ACA

Employers who have more than 100 or more full-time equivalent employees must offer those employees and their families and dependents to age 26, benefits that pays for 60% of the minimum essential benefits, as established by the ACA, or face a potential penalty.  In 2016, the mandate applies to employers who have 50 or more full-time equivalent employees.  

 

Individuals must now obtain qualifying coverage either through an individual policy or through their employer or face a potential penalty.

No pre-existing clause. Insurance companies can no longer increase rates or deny coverage because of a pre-existing condition.  

New Underwriting Rules of the ACA

Dependents up to age 26 can now be added to an insurance policy for both individuals and employer coverage.

 

Gender is no longer a factor in determining rates.

 

Renewal rates are the same as new business rates.

 

Waiting period should not exceed 90 days.

Open Enrollment Periods of the ACA

Individuals must purchase their health insurance during the annual open enrollment period.  Failure to do so may result in penalties and having to wait until the next open enrollment to purchase coverage.  Employers are able to offer benefits year round or during their normal open enrollment as usual.

Qualifying Coverage of the ACA

To be in compliance with the healthcare reform avoid costly penalties, you must purchase Insurance coverage that pays at least 60% of the costs of the following  "essential benefits."

Premium Tax Credits of the ACA

Business and Individuals who purchase their health insurance through the new Health Insurance Marketplace (Covered California or SHOP) may be eligible for tax credits which are applied as a discount on your monthly insurance premium.  

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