Preparing for Health Reform; Senate Concerns!

The Affordable Care Act (ACA) continues on a “rocky road” toward implementation with the major provisions to be effective January 1, 2014. Considerations:

1. Employer Plan: If you will have employer sponsored group coverage (that complies with minimum requirements) you could be good to go. 
2. If you are uninsured or have private coverage, you should review your plan for compliance with the new law (let’s call it an “ACA Plan”). 
3. January 1, 2014, your coverage benefits must be at an “actuarial level” of 58% or above (to be detailed in future blogs). If they aren’t you may face a penalty (tax).
4. You can purchase a private plan or shop in the Federal Exchange marketplace (still under construction). Georgia is not doing a state exchange.
5. If your income is below 4 times the Federal Poverty Level (FPL) you may qualify for a premium subsidy for exchange purchases. This will be detailed in future blogs. The income test can get surprisingly high dependent on your family size.
6. Exchange enrollment can begin October 1, 2013. Effective date for coverage is January 1, 2014.
7. If your current insurance plan was purchased after March 23, 2010 you need to review it to determine if it is an “ACA Plan.” If it was purchased before this date you might be grandfathered and exempt from this requirement.

It is expected that insurance premiums will increase. There are new taxes, mandated coverages, and no underwriting is permitted. The insurance companies are still working on how they will restructure their plans to become “ACA Plans.” Review your program and determine the following:

1. What is my Federal Poverty Level Status (FPL)?
2. Did my coverage begin before March 23, 2010? Is it an“ACA Compliant Plan?”
3. If I don’t buy an ACA Plan, what would my tax penalty be after January 1, 2014?
4. Prepare to budget for premium changes dependent on your FPL status.  Hopefully we will start hearing from insurance carriers this summer as to how they will modify plans and premiums.
5. Stay in touch with your carrier/professional as ACA moves forward. 

Finally, it would not surprise me if there are changes in the implementation plan.  Take note of the recent Senate Hearing led by Max Baucus. Senator Baucus (D) was a leading proponent of the ACA and a big reason the law was passed. He has every political reason to be positive so his concerns are real.   

See also: http://news.yahoo.com/top-dem-sees-train-wreck-165302491.html

Coming Soon:  Federal Poverty Level Review; Exchange “shopping” for an ACA Plan; What is a “Navigator”; Any ACA implementation updates; Is an Exchange really an Exchange?