Two Choices. The Affordable Care Act requires every individual to either: 1. Maintain Minimum Essential Coverage, or

Size: px
Start display at page:

Download "Two Choices. The Affordable Care Act requires every individual to either: 1. Maintain Minimum Essential Coverage, or"

Transcription

1 Information last updated September 9,

2 Two Choices The Affordable Care Act requires every individual to either: 1. Maintain Minimum Essential Coverage, or 2. Make a Shared Responsibility Payment. Information last updated September 9,

3 Minimum Essential Coverage Minimum Essential Coverage is some form of major medical health care coverage such as: Medicare TRICARE or VA Medical Benefits Medicaid hawk-i Employer based health insurance, including from a family member s employer Major medical health insurance purchased on the individual market Must be comprehensive, not limited in scope. Information last updated September 9,

4 Shared Responsibility Payment If an individual does not have Minimum Essential Coverage (or an exemption), he or she must pay the greater of the two penalties on his or her taxes*. In years after 2016 the penalty is indexed to the rate of medical inflation. Parents are responsible for their children Minimum $95 $325 $695 Percent of Income After Filing Threshold 1% 2% 2.5% *Capped at $285 for 2014, $975 for 2015, and $2,085 for 2016 Information last updated September 9,

5 There are a number of exemptions to the requirement to maintain Minimum Essential Coverage For the months a person is incarcerated For the months a person is a member of a healthcare sharing Ministry For the months paying for health insurance would be a hardship for a person s household For the months a person has a short gap in coverage For the year if premiums for health insurance would cost more than 8% of a person s annual household income For the year if a person s income is below the filing threshold for taxes If a person is an undocumented immigrant If a person is a member of an Indian Tribe If a person qualifies for a religious exemption Information last updated September 9,

6 Does a person need to make any changes to avoid the penalty? Is the person uninsured? Shop on the Marketplace or individual market, contact the Department of Human Services, an Insurance Agent or Broker, a Navigator or Certified Application Counselor. Does the person like his or her current health insurance? The person may be able to keep it, or shop on the Marketplace Is the person on Medicare? No change needed Is the person on Medicaid? No change needed Was the person on IowaCare? IowaCare ended on December 31, All IowaCare members received instructions on how to find new health care coverage, under the Iowa Health and Wellness Plan or the Health Insurance Marketplace. Information last updated September 9,

7 The Iowa Health Insurance Marketplace Iowa is using the Federal Health Insurance Marketplace. The Marketplace is a way for people to look for minimum essential coverage* There is a single application process for Medicaid (including the Iowa Health and Wellness Plan), hawk-i, Tax Credits, and Cost Sharing Subsidies. Applicants shopping for insurance on the Marketplace have the choice of multiple private insurers. *People who qualify for Medicare and undocumented individuals cannot use the Marketplace. Information last updated September 9,

8 Health Premium Tax Credits Certain people may qualify for tax credits to help them purchase insurance The tax credit can reduce what a household owes in taxes OR what the household pays for health insurance premiums. They must: Have a household Modified Adjusted Gross Income between 100% and 400% of the federal poverty guidelines. Be lawfully present in the U.S., and may not be incarcerated. Must purchase health insurance through the Marketplace. Not be eligible for Minimum Essential Coverage from an employer or government program. A person may still qualify for tax credits if coverage from his or her employer is not Affordable or does not provide Minimum Value. Information last updated September 9,

9 What is considered Affordable under the law? What is Minimum Value? An Employer s plan is Affordable if the employee s contribution to insure the employee only is less than 9.56% of the employee s household income. An Employer s plan provides Minimum Value if it covers 60% of the expected medical expenses. Information last updated September 9,

10 Cost Sharing Reductions Cost Sharing Reductions are only available to those whose household income is between 100% and 250% of the FPL that elect to enroll in a Silver plan. Cost sharing reductions decrease the consumer s share of costs. A Silver plan has coinsurance of 30% paid by the consumer and 70% paid by the insurance company. With Cost Sharing Reductions, the coinsurance is instead reduced to the following: Federal Poverty Level Covered Consumer Pays 200% to 250% 73% 27% 150% to 200% 87% 13% 100% to 150% 94% 6% Information last updated September 9,

11 Information last updated September 9,

12 How do I sign up? Go to or call Persons can only sign up during Open Enrollment or Special Enrollment. Open Enrollment for 2015 starts November 15 th 2014, through February 15 th Navigators, Certified Application Counselors and Insurance Agents are available to assist people with enrollment, be it in person or over the phone. If people don t sign up during open enrollment, they might be able to sign up during a special enrollment period. Information last updated September 9,

13 Special Enrollment Period May enroll or change Qualified Health Plan Within 60 days in individual market and 30 days in small group market from qualifying event Special Enrollment Period Qualifying Events Loss of minimum essential Coverage (other than by nonpayment) Gaining or becoming a dependent Gaining lawful presence Enrollment errors of the Marketplace * Granted on a case by case basis. Material contract violations by Qualified Health Plans Gaining or losing eligibility for premium tax credits or cost sharing reductions Relocation resulting in new or different Qualified Health Plan selection Exceptional circumstances* Information last updated September 9,

14 1-24 Full Time Equivalent Employees, 40 Hour Full Time Work Week. * This is intended to give general guidance and explain the legal frame work. The Iowa Insurance Division is not an expert on Federal Tax law. This presentation is not intended to be legal or tax advice. Attendees are encouraged to seek assistance from their tax advisor or the IRS. Information last updated September 9,

15 What does the ACA do for Businesses? The ACA does two big things for small employers Creates the Small Business Health Insurance Tax Credit. Creates the SHOP Marketplace for small employers to share risks and costs. The ACA does one big thing for large employers Mandates they offer health insurance coverage meeting certain requirements for full time employees and their dependants starting in or Fewer FTEs Tax Credits 50 or Fewer FTEs SHOP Marketplace 50 or More FTEs Employer Mandate Information last updated September 9,

16 Reinsurance, Risk Corridors, and Risk Adjustment Premium stabilization programs established by the Affordable Care Act Information last updated September 18,

17 The Three Rs The Affordable Care Act established (1) Reinsurance, (2) a Risk Corridors Program, and (3) Risk Adjustment Programs. The purpose and goal of these programs is to provide certainty and protect against adverse selection in the market, while stabilizing premiums in the individual and small group markets. Information last updated September 18,

18 State-Based Transitional Reinsurance Established in each State (the U.S. Department of Health and Human Services, HHS, administers Iowa s) to help stabilize premiums for coverage in the individual market from 2014 through All health insurance issuers and third party administrators on behalf of self-insured group health plans, must make contributions to support reinsurance payments that cover high-cost individuals in nongrandfathered plans in the individual market. The uniform reinsurance contribution rate is $44 per capita for Information last updated September 18,

19 Transitional Reinsurance Contributions Reinsurance contributions are allocated in the following manner: Reinsurance payments: $10 billion in 2014, $6 billion in 2015, and $4 billion in 2016 U.S. Treasury $2 billion in years 2014 and 2015, and $1 billion in 2016 Administrative expenses Information last updated September 18,

20 Transitional Reinsurance Payments Eligibility is based on total annual medical costs for covered benefits of an enrollee in an individual market plan. Payments compensate a portion of those costs (coinsurance rate, 50% for 2015) incurred above an attachment point ($70,000 in 2015), subject to a cap ($250,000 in 2015) announced in the annual HHS notice of benefit and payment parameters. Information last updated September 18,

21 Temporary Risk Corridors Program Established by the Affordable Care Act, applies to qualified health plans in the individual and small group markets during the years 2014 through Protects against inaccurate rate-setting by sharing risk (gains and losses) on allowable costs between HHS and qualified health plans to help ensure stable health insurance premiums. Federal program, administered by HHS. Information last updated September 18,

22 Temporary Risk Corridors Program Relationship between plans allowable costs (essentially, claims and quality improvement activities) and target amount (premiums earned less allowable administrative costs) determines risk corridors charges and payments. Charges and payments are on percentage basis (not first dollar basis). If issuer s allowable costs are less than 97 percent of its target amount, it pays HHS a percentage of the difference. If issuer s allowable costs are more than 103 percent of its target amount, HHS pays it a percentage of the difference. Information last updated September 18,

23 Permanent Risk Adjustment Program The Affordable Care Act provides for a permanent risk adjustment program that applies to nongrandfathered individual and small group plans inside and outside Marketplaces (Exchanges). Provides payments to health insurance issuers that disproportionately attract higher-risk populations (such as individuals with chronic conditions). Transfers funds from plans with relatively lower risk enrollees to plans with relatively higher risk enrollees to protect against adverse selection. Administered by HHS, in Iowa. Information last updated September 18,

24 Permanent Risk Adjustment Program Uses a risk adjustment model Risk adjustment model is an actuarial tool used to predict health care costs based on relative actuarial risk of enrollees in risk adjustment covered plans Developed by HHS. The risk adjustment model is used to predict the risk of each plan, and to calculate the appropriate funds to be transferred from lower risk plans to higher risk plans. Information last updated September 18,

25 Iowa s Rate Hearing Process Major medical health insurance carriers licensed in Iowa must notify policyholders of any application for a rate increase exceeding the average annual health spending growth rate stated in the most recent national health expenditure projection published by the Centers for Medicare & Medicaid Services (6.1% in 2014). Commissioner holds a public hearing related to such hearings. Consumer Advocate solicits public comments and presents them to the Commissioner for consideration in determining whether to approve, disapprove or modify such health insurance rate increase proposals. All information related to the application for the proposed rate increase, including the application, consumer comments, and actuarial findings are public information and are posted on the rate hearing website at Information last updated September 18,

26 Rate Hearing Notice Notice is issued to potentially affected policyholders on the same day as application is filed with the Division. Notice follows a model and forms for Notice are approved by the Division prior to being issued to potentially affected policyholders. Notice contains: The contact information for the Consumer Advocate. The time, date, and location of the public hearing on the proposed rate increase. The specific rate increase proposed that is applicable to each policyholder. A ranking and quantification of the factors responsible for the amount of the rate increase. Information last updated September 18,

27 Rate Hearing Open to the public. Must take place no less than 45 days after the proposed rate increase application has been filed with the Division. Applicant contacts the Division in advance of filing to secure date, time, and location. Opportunity for members of the public to comment and testify. Consumer Advocate testifies as to comments received from members of the public prior to the hearing. Information last updated September 18,

28 Illustrative Health Insurance Premium Projections for Family Coverage, Assuming Average Growth Rate of 9.2% * 23% $66,474 Employer Portion Employee Portion Avg HHI** 47 $68,483 $70,553 $72,686 $74,882 $77,146 $14,981 $16,359 $17,864 $4,794 $5,235 $5,716 $19,508 $21,303 $6,243 $6,817 $27,739 $25,402 $23,262 $8,876 $8,129 $7,444 $36,121 $30,291 $33,078 $11,559 $10,585 $9,693 $10,187 $11,124 $12,148 $13,265 $14,486 $15,818 $17,273 $18,863 $20,598 $22,493 $24, Note: Health insurance premiums projected for assuming the average growth in premiums between 2010 and 2014 continues at 9.2% (average annual reported increase before benefit plan changes were made). ** 1.5% Annual Household Income Growth (Source: U.S. Census Bureau for Iowa in 2012) Copyright , David P. Lind Benchmark, LC. All Rights Reserved

29 Importance of Healthcare Delivery Performance Indicators (Based on a 10-point scale, with 10 being Most Important ) Performance Indicators < Overall Keeping Costs Reasonable Keeping Quality of Care Consistent Safety of Care Delivered to Patients Concern for Patient Satisfaction Focus on Wellness and Health Promotion Coordination of Care Between Providers Access to Services Ability to Engage Patients Transparency of Medical Outcomes Transparency of Costs Health Providers Embracing Electronic Health Records Efficiency in Care Delivered Copyright David P. Lind Benchmark. All Rights Reserved.

30 Overall Hospital and Physician Grades Performance Indicators Hospitals Physicians Access to Services B B- Trust Hospitals/Physicians B- B Concern for Patient Satisfaction C+ B- Electronic Health Records C+ C+ Consistent Quality of Care C+ C+ Ability to Engage Patients C C+ Focus on Wellness & Health Promotion C C Efficiency C C Coordination of Care Among Providers C C Transparency in Medical Outcomes C- C Cost Transparency D+ C- Keeping Cost Reasonable D- D Copyright 2013 Heartland Health Research Institute. All Rights Reserved.

31 29,163 individuals enrolled on the Marketplace 84% with tax credits 107,123 in Medicaid Expansion and Marketplace Choice 82,615 Enrolled in Iowa Wellness Plan 24,508 Enrolled in Marketplace Choice outside Marketplace Non-ACA 271,561 ACA Compliant off-exchange 56,859 Information last updated September 9,

32 Increasing costs Look at plan design Look at inputs driving costs ACO s and Physicians taking risk Focus on wellness Technology Information last updated September 9,

33 Contact Info o o 1 (800) o SHOP 1 (800) o Medicaid 1 (855) o SHIIP (Medicare Questions) 1 (800) or shiip@iid.iowa.gov o Attorney General (Fraud/Complaints) o o (515) or (888) o Iowa Insurance Division o 1 (877) o Information last updated September 9,

34 Go to Healthcare.gov to shop or enroll Call Presented By: The Iowa Insurance Division Information last updated September 9,

Reinsurance, Risk Corridors, and Risk Adjustment Final Rule

Reinsurance, Risk Corridors, and Risk Adjustment Final Rule Reinsurance, Risk Corridors, and Risk Adjustment Final Rule Center for Consumer Information and Insurance Oversight Centers for Medicare & Medicaid Services Department of Health and Human Services March

More information

And Changes under Healthcare Reform affecting businesses

And Changes under Healthcare Reform affecting businesses And Changes under Healthcare Reform affecting businesses 1 Individual Mandate 2 First there were two choices Under the Affordable Care Act every individual must have Minimum Essential Healthcare Coverage

More information

Health Policy Essentials: Private Health Insurance. Bernadette Fernandez, Annie Mach, & Namrata Uberoi February 13, 2015

Health Policy Essentials: Private Health Insurance. Bernadette Fernandez, Annie Mach, & Namrata Uberoi February 13, 2015 Health Policy Essentials: Private Health Insurance Bernadette Fernandez, Annie Mach, & Namrata Uberoi February 13, 2015 Briefing Agenda What is the purpose of private health insurance (PHI)? How is PHI

More information

Nebraska Health Insurance Exchange Update

Nebraska Health Insurance Exchange Update Nebraska Health Insurance Exchange Update Overview of the Affordable Care Act and the Federally Facilitated marketplace. September 2014 AFFORDABLE CARE ACT» The Affordable Care Act: Establishes a Health

More information

Health insurance Marketplace. What to expect in 2014

Health insurance Marketplace. What to expect in 2014 Health insurance Marketplace What to expect in 2014 Overview The Affordable Care Act (ACA) includes several provisions geared to extend greater access to health insurance benefits to more people. Beginning

More information

Presented by South Dakota Community Action Partnership

Presented by South Dakota Community Action Partnership Presented by South Dakota Community Action Partnership The project described was supported by Funding Opportunity Number CA-NAV-13-001 from the U.S Department of Health and Human Services, Centers for

More information

Understanding the Affordable Care Act Premium Tax Credit

Understanding the Affordable Care Act Premium Tax Credit Understanding the Affordable Care Act Premium Tax Credit Most Americans are Required to Have Health Care Coverage The Affordable Care Act (ACA), or health care law, requires most U.S. citizens and legal

More information

Exchanges and the ACA What You Need to Know for 2014

Exchanges and the ACA What You Need to Know for 2014 Exchanges and the ACA What You Need to Know for 2014 How the Affordable Care Act affects the Individual Health Insurance Market This presentation is for informational purposes only and does not constitute

More information

Exchange 101. August 2013

Exchange 101. August 2013 Exchange 101 August 2013 455430 27517 Penalties for individuals 2017 and beyond: Annual adjustments 2016: Greater of $695 or 2.5% of taxable income 2015: Greater of $325 or 2% of taxable income 2014: Greater

More information

The New Health Insurance Marketplace. Choices and Opportunities for Small Groups

The New Health Insurance Marketplace. Choices and Opportunities for Small Groups The New Health Insurance Marketplace Choices and Opportunities for Small Groups What is the Affordable Care Act? The Patient Protection and Affordable Care Act (ACA) was signed into law on March 23, 2010

More information

Understanding the Health Insurance Marketplace. August 2013

Understanding the Health Insurance Marketplace. August 2013 Understanding the Health Insurance Marketplace August 2013 Objectives This session will help you Explain the Health Insurance Marketplace Identify who will benefit Define who is eligible Explain the enrollment

More information

HEALTH CARE REFORM CHECKLIST

HEALTH CARE REFORM CHECKLIST HEALTH CARE REFORM CHECKLIST As a small employer, you need to be aware of the new regulations tied to the Affordable Care Act. Refer to this checklist to ensure you understand each one and that you re

More information

Everything about Exchanges you ve wanted to know... HHS Issues Proposed Rules

Everything about Exchanges you ve wanted to know... HHS Issues Proposed Rules This article originally appeared in the July 2011 Quarterly Review. Everything about Exchanges you ve wanted to know... HHS Issues Proposed Rules New Proposed Rules set standards, certify health plans,

More information

Presentation for Licensed Producers The Affordable Care Act

Presentation for Licensed Producers The Affordable Care Act Presentation for Licensed Producers The Affordable Care Act Bruce Donaldson, CHC Producer & Stakeholder Specialist Arkansas Insurance Department Affordable Care Act The ACA was passed by Congress and signed

More information

The Affordable Care Act Update

The Affordable Care Act Update The Affordable Care Act Update Presented by: The Union Labor Life Insurance Company SOLUTIONS FOR THE UNION WORKPLACE SPECIALTY INSURANCE INVESTMENTS Overview I. Key Provisions II. Major Challenges III.

More information

Douglas A. Conrad, PhD, Professor of Health Services University of Washington Member: Washington Health Benefits Exchange Board Presentation for:

Douglas A. Conrad, PhD, Professor of Health Services University of Washington Member: Washington Health Benefits Exchange Board Presentation for: Douglas A. Conrad, PhD, Professor of Health Services University of Washington Member: Washington Health Benefits Exchange Board Presentation for: Washington Policy Center Conference: July 10, 2012 1 This

More information

Federal Health Reform FAQs

Federal Health Reform FAQs Federal Health Reform FAQs Individuals 1. What is an exchange? An exchange, as created under the Affordable Care Act (ACA), is a place where consumers can purchase subsidized health insurance coverage.

More information

Health Care Reform PPACA. General Assembly Greensboro, NC 2013

Health Care Reform PPACA. General Assembly Greensboro, NC 2013 Health Care Reform PPACA General Assembly Greensboro, NC 2013 Near-term Provisions 1 These fees apply to both insured and self-insured plans. Additional Coming Changes PPACA Patient Protection and Affordable

More information

ACAP Guide to ACA Fees and Taxes for Health Insurers

ACAP Guide to ACA Fees and Taxes for Health Insurers Introduction ACAP Guide to ACA Fees and Taxes for Health Insurers Since being signed into law in March of 2010, the Patient Protection and Affordable Care Act (ACA) has introduced a wide range of health

More information

Affordable Care Act (ACA) Health Insurance Exchanges and Medicaid Expansion

Affordable Care Act (ACA) Health Insurance Exchanges and Medicaid Expansion Affordable Care Act (ACA) Health Insurance Exchanges and Medicaid Expansion Table of Contents Expanded Coverage... 2 Health Insurance Exchanges... 3 Medicaid Expansion... 8 Novartis Pharmaceuticals Corporation

More information

How To Get Health Care Reform For The United States

How To Get Health Care Reform For The United States Federal Health Care Reform: Implications for New York Division of Coverage and Enrollment Office of Health Insurance Programs Health Bureau Insurance Department June 2010 Federal Health Care Reform: Where

More information

HEALTH INSURANCE MARKETPLACE SURVIVAL GUIDE FOR SMALL BUSINESS. New York Edition

HEALTH INSURANCE MARKETPLACE SURVIVAL GUIDE FOR SMALL BUSINESS. New York Edition HEALTH INSURANCE MARKETPLACE SURVIVAL GUIDE FOR SMALL BUSINESS New York Edition NAVIGATING NEXT STEPS IN HEALTH CARE REFORM PAGE 2 www.discovermvp.com There s a constant stream of changes and updates related

More information

Find health care options that meet your needs and fit your budget.

Find health care options that meet your needs and fit your budget. Health Insurance Marketplace 101 Find health care options that meet your needs and fit your budget. October 2015 Objectives This session will help you Explain the Health Insurance Marketplace Define who

More information

HEALTH INSURANCE MARKETPLACE SURVIVAL GUIDE FOR SMALL BUSINESS. Vermont Edition

HEALTH INSURANCE MARKETPLACE SURVIVAL GUIDE FOR SMALL BUSINESS. Vermont Edition HEALTH INSURANCE MARKETPLACE SURVIVAL GUIDE FOR SMALL BUSINESS Vermont Edition NAVIGATING NEXT STEPS IN HEALTH CARE REFORM There s a constant stream of changes and updates related to health care reform,

More information

One of the more visible changes soon to be brought MONTANA S HEALTH INSURANCE A PREVIEW OF MARKETPLACE

One of the more visible changes soon to be brought MONTANA S HEALTH INSURANCE A PREVIEW OF MARKETPLACE A PREVIEW OF MONTANA S HEALTH INSURANCE MARKETPLACE by Gregg Davis and Christina Goe One of the more visible changes soon to be brought to the forefront by passage of the Affordable Care Act (ACA) is the

More information

Washington State Health Insurance Pool - Board Education March 2012

Washington State Health Insurance Pool - Board Education March 2012 - Board Education March 2012 What are the new 3 R s? The 3 R s are the risk leveling programs required by the Affordable Care Act (ACA) to help protect insurers in the individual and small group markets

More information

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE Scott Walker, Governor Theodore K. Nickel, Commissioner Wisconsin.gov 125 South Webster Street P.O. Box 7873 Madison, Wisconsin 53707-7873 Phone:

More information

MODULE 16: MEDICARE AND THE HEALTH INSURANCE MARKETPLACES

MODULE 16: MEDICARE AND THE HEALTH INSURANCE MARKETPLACES MODULE 16: MEDICARE AND THE HEALTH INSURANCE MARKETPLACES Objective This module will educate HIICAP counselors about how Medicare is affected (and not affected) by the health insurance Marketplaces. What

More information

EXPLAINING HEALTH CARE REFORM: Risk Adjustment, Reinsurance, and Risk Corridors

EXPLAINING HEALTH CARE REFORM: Risk Adjustment, Reinsurance, and Risk Corridors EXPLAINING HEALTH CARE REFORM: Risk Adjustment, Reinsurance, and Risk Corridors As of January 1, 2014, insurers are no longer able to deny coverage or charge higher premiums based on preexisting conditions

More information

SURVIVAL GUIDE FOR SMALL BUSINESS

SURVIVAL GUIDE FOR SMALL BUSINESS HEALTH INSURANCE MARKETPLACE SURVIVAL GUIDE FOR SMALL BUSINESS New York edition NAVIGATING NEXT STEPS IN HEALTH CARE REFORM PAGE 2 www.discovermvp.com There s a constant stream of changes and updates related

More information

THE AFFORDABLE CARE ACT: THE AFFORDABLE COVERAGE OPTIONS AND CONSIDERATIONS IN 2014 THE NEW HEALTH INSURANCE: MARKETPLACE AND MEDICAID

THE AFFORDABLE CARE ACT: THE AFFORDABLE COVERAGE OPTIONS AND CONSIDERATIONS IN 2014 THE NEW HEALTH INSURANCE: MARKETPLACE AND MEDICAID THE AFFORDABLE CARE ACT: THE AFFORDABLE COVERAGE OPTIONS AND CONSIDERATIONS IN 2014 THE NEW HEALTH INSURANCE: MARKETPLACE AND MEDICAID Deloris Summers Deaf In-Person Counselor Navigator Jacksonville Area

More information

Transitional reinsurance program results in significant new costs for group health plans

Transitional reinsurance program results in significant new costs for group health plans Transitional reinsurance program results in significant new costs for group health plans The Department of Health and Human Services (HHS) has issued additional guidance on the three-year transitional

More information

Patient Protection and Affordable Care Act (H.R. 3590)

Patient Protection and Affordable Care Act (H.R. 3590) on Health Reform Passing comprehensive health care reform has been a priority of the President and Congress. The U.S. House of Representatives passed the Affordable Health Care for America Act on November

More information

What Healthcare Providers Need to Know about the Affordable Care Act (ACA)

What Healthcare Providers Need to Know about the Affordable Care Act (ACA) What Healthcare Providers Need to Know about the Affordable Care Act (ACA) General Housekeeping If you experience any technical difficulties during the webinar, please contact GoToMeeting.com Corporate

More information

Affordable Care Act FAQ

Affordable Care Act FAQ Affordable Care Act FAQ Based on regulatory guidance issued as of March 2014 and subject to change. Contents General ACA Questions... 1 ACA Marketplace... 1 ACA Employer Shared Responsibility... 2 ACA

More information

Affordable Care Act: What The Health Care Law Means for Small Businesses

Affordable Care Act: What The Health Care Law Means for Small Businesses Affordable Care Act: What The Health Care Law Means for Small Businesses August 2013 Indian Country Business Summit These materials are provided for informational purposes only and are not intended as

More information

Health care reform for large businesses

Health care reform for large businesses FOR PRODUCERS AND EMPLOYERS Health care reform for large businesses A guide to what you need to know now DECEMBER 2013 CONTENTS 2 Introduction Since 2010 when the Affordable Care Act (ACA) was signed into

More information

Health Care Reform 101 for June 3, 2013

Health Care Reform 101 for June 3, 2013 Commercial & Personal Insurance Employee Benefits Retirement Plan Services Wealth Management Health Care Reform 101 for June 3, 2013 Requirements: Pre-HCR vs. Post-HCR Offering/Maintaining Health Insurance

More information

HEALTH BENEFIT EXCHANGE SURVIVAL GUIDE FOR SMALL BUSINESS. New York Edition

HEALTH BENEFIT EXCHANGE SURVIVAL GUIDE FOR SMALL BUSINESS. New York Edition HEALTH BENEFIT EXCHANGE SURVIVAL GUIDE FOR SMALL BUSINESS New York Edition NAVIGATING NEXT STEPS IN HEALTH CARE REFORM PAGE 2 www.discovermvp.com There s a constant stream of changes and updates related

More information

Health Care Reform Update

Health Care Reform Update Small Businesses No Financial Requirements for Small Businesses: The ACA imposes no financial requirements for small businesses to contribute to their employees health insurance. However, beginning in

More information

SURVIVAL GUIDE FOR SMALL BUSINESS

SURVIVAL GUIDE FOR SMALL BUSINESS HEALTH INSURANCE MARKETPLACE SURVIVAL GUIDE FOR SMALL BUSINESS Vermont edition NAVIGATING NEXT STEPS IN HEALTH CARE REFORM There s a constant stream of changes and updates related to health care reform,

More information

Article from: Health Watch. October 2013 Issue 73

Article from: Health Watch. October 2013 Issue 73 Article from: Health Watch October 2013 Issue 73 What Is Available in 2014 for 2015 Individual Health Insurance Rate Filings By Jeff Rohlinger Jeff Rohlinger, FSA, MAAA, is associate actuary at Health

More information

Individual Shared Responsibility Provision What You Need to Know

Individual Shared Responsibility Provision What You Need to Know Individual Shared Responsibility Provision What You Need to Know Virtual Town Hall The information contained in this presentation is current as of 5/28/2014. For the latest information about tax provisions

More information

AFFORDABLE CARE ACT FAQ

AFFORDABLE CARE ACT FAQ AFFORDABLE CARE ACT FAQ What is the Healthcare Insurance Marketplace? The Marketplace is a new way to find quality health coverage. It can help if you don t have coverage now or if you have it but want

More information

The Affordable Care Act (ACA) in Wisconsin

The Affordable Care Act (ACA) in Wisconsin The Affordable Care Act (ACA) in Wisconsin Caroline B. Gomez, MSW, Healthcare Outreach Specialist, Covering Kids & Families, Healthcare Outreach Specialist Nancy Crevier, Marinette County Family Living

More information

The New Healthcare Law and Its Impact on Small Business

The New Healthcare Law and Its Impact on Small Business U. S. Small Business Administration Washington Metropolitan Area District Office The New Healthcare Law and Its Impact on Small Business Julie C. Verratti Advisor U.S. Small Business Administration Julie.Verratti@sba.gov

More information

GLOSSARY OF KEY HEALTH INSURANCE CONCEPTS

GLOSSARY OF KEY HEALTH INSURANCE CONCEPTS The Affordable Care Act: A Working Guide for MCH Professionals Module 2 GLOSSARY OF KEY HEALTH INSURANCE CONCEPTS Overview A fundamental first step in accessing health care in the United States is having

More information

Nebraska Health Insurance Exchange Update

Nebraska Health Insurance Exchange Update Nebraska Health Insurance Exchange Update Overview of the Affordable Care Act and the Federally Facilitated marketplace. September 2015 AFFORDABLE CARE ACT OVERVIEW» The Affordable Care Act was enacted

More information

How To Get A Health Insurance Plan In Texas

How To Get A Health Insurance Plan In Texas Anticipating the Health Insurance Marketplace in Texas HFMA Lone Star Chapter Fall Institute September 16, 2013 1 About Community Health Choice Non-profit Health Maintenance Organization licensed by the

More information

Frequently Asked Questions Affordable Care Act (ACA) Taxes: Reinsurance Tax and Insurer Tax May 16, 2013

Frequently Asked Questions Affordable Care Act (ACA) Taxes: Reinsurance Tax and Insurer Tax May 16, 2013 Frequently Asked Questions Affordable Care Act (ACA) Taxes: Reinsurance Tax and Insurer Tax May 16, 2013 Background: One of the goals of the Affordable Care Act (ACA) is to ensure that everyone involved

More information

The Health Insurance Marketplace 101. July 2013

The Health Insurance Marketplace 101. July 2013 The July 2013 The Problem Insurance companies could turn away the 129 million Americans with pre-existing conditions Premiums had more than doubled over the last decade, while insurance company profits

More information

IRS Virtual Town Hall Series: Tax Impacts of Health Insurance Coverage for Individuals & Families in 2014

IRS Virtual Town Hall Series: Tax Impacts of Health Insurance Coverage for Individuals & Families in 2014 IRS Series: Tax Impacts of Health Insurance Coverage for Individuals & Families in 2014 The information contained in this presentation is current as of 10/23/2013. For the latest information about tax

More information

Affordable Care Act 101: What The Health Care Law Means for Small Employers

Affordable Care Act 101: What The Health Care Law Means for Small Employers Affordable Care Act 101: What The Health Care Law Means for Small Employers These materials are provided for informational purposes only and are not intended as legal or tax advice. Readers should consult

More information

Washington Health Benefit Exchange. Leading Age 2014 Annual Conference. Phil Dyer Board Member

Washington Health Benefit Exchange. Leading Age 2014 Annual Conference. Phil Dyer Board Member Washington Health Benefit Exchange Leading Age 2014 Annual Conference Phil Dyer Board Member DISCLAIMER; The views and information expressed are my personal opinions and perspectives and do not represent

More information

THE FUTURE OF EMPLOYER BASED HEALTH INSURANCE FOLLOWING HEALTH REFORM

THE FUTURE OF EMPLOYER BASED HEALTH INSURANCE FOLLOWING HEALTH REFORM THE FUTURE OF EMPLOYER BASED HEALTH INSURANCE FOLLOWING HEALTH REFORM National Congress on Health Insurance Reform Washington, D.C., January 20, 2011 Elise Gould, PhD Health Policy Research Director Economic

More information

IRS Proposes Rules for Federal Subsidy of Health Insurance Purchased in State Exchanges

IRS Proposes Rules for Federal Subsidy of Health Insurance Purchased in State Exchanges IRS Proposes Rules for Federal Subsidy of Health Insurance Purchased in State Exchanges August 2011 The Internal Revenue Service (IRS) on August 12, 2011 issued proposed regulations relating to the federal

More information

Health Insurance Exchange Proposed Rules

Health Insurance Exchange Proposed Rules Health Insurance Exchange Proposed Rules Karen Fisher, J.D. 202-862-6140 kfisher@aamc.org Jane Eilbacher 202-828-0896 jeilbacher@aamc.org Will Dardani 202-828-0541 wdardani@aamc.org Exchange Rules Overview

More information

The Affordable Care Act and North Carolina

The Affordable Care Act and North Carolina The Affordable Care Act and North Carolina Christopher J. Conover, PhD Center for Health Policy and Inequalities Research Duke University March 12, 2014 Roadmap What is in the ACA as it relates to healthcare/

More information

Health Care Reform: 2015 Refresher of the Affordable Care Act (ACA)

Health Care Reform: 2015 Refresher of the Affordable Care Act (ACA) Health Care Reform: 2015 Refresher of the Affordable Care Act (ACA) Brought to you by Aon Presented by: Ryan Comstock & Shawna Brown This information is provided for informational purposes only and is

More information

Understanding the ObamaCare Health Insurance Plans in North Carolina Understanding Insurance and Affordable Care Act Terminology: ACA- Marketplace

Understanding the ObamaCare Health Insurance Plans in North Carolina Understanding Insurance and Affordable Care Act Terminology: ACA- Marketplace Understanding the ObamaCare Health Insurance Plans in North Carolina As a result of the Affordable Care Act (a.k.a. ObamaCare) the following provisions are now in place for health insurance policies with

More information

What s News in Tax Analysis That Matters from Washington National Tax

What s News in Tax Analysis That Matters from Washington National Tax What s News in Tax Analysis That Matters from Washington National Tax The Impact of the Affordable Care Act on International Assignees and Their Health Care Plans Employers and individuals in the United

More information

Federally-facilitated Marketplace Agent and Broker Training Outline and Summary

Federally-facilitated Marketplace Agent and Broker Training Outline and Summary DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, Maryland 21244-1850 Center for Consumer Information & Insurance Oversight Federally-facilitated

More information

Parker, Smith & Feek - ACA Update: 2014 November 2013

Parker, Smith & Feek - ACA Update: 2014 November 2013 Affordable Care Act (ACA) Background Core of law is an attempt to reduce # of uninsured Multiple approaches to expanding insurance coverage Requires most in US to have health insurance Creates state-based

More information

Affordable Care Act 101: What The Health Care Law Means for Small Businesses

Affordable Care Act 101: What The Health Care Law Means for Small Businesses Affordable Care Act 101: What The Health Care Law Means for Small Businesses December 2013 These materials are provided for informational purposes only and are not intended as legal or tax advice. Readers

More information

Shared Responsibility: What It Means for Your Business

Shared Responsibility: What It Means for Your Business Shared Responsibility: What It Means for Your Business The provisions of the Affordable Care Act (ACA) apply to nearly all companies in the United States. The ways they apply, however, can be different

More information

Health Care Reform Update. Spring 2014

Health Care Reform Update. Spring 2014 Health Care Reform Update Spring 2014 Quincy Quinlan Texas Association of Counties 512 478 8753 quincyq@county.org http://www.county.org Today s Agenda Timeline Fees/Taxes Individual Mandate Marketplace

More information

HEALTH REFORM AND MULTIEMPLOYER PLAN COVERAGE 2014 AND BEYOND

HEALTH REFORM AND MULTIEMPLOYER PLAN COVERAGE 2014 AND BEYOND WWW.BKLAWYERS.COM HEALTH REFORM AND MULTIEMPLOYER PLAN COVERAGE 2014 AND BEYOND ABA SECTION OF LABOR AND EMPLOYMENT LAW EMPLOYEE BENEFITS COMMITTEE MID- WINTER MEETING 201 BLITMAN & KING LLP Franklin Center,

More information

The Health Insurance Marketplace 101. May 2013

The Health Insurance Marketplace 101. May 2013 The Health Insurance Marketplace 101 May 2013 Affordable Care Act Coverage Accomplishments 3.1 million young adults have gained insurance through their parents plans 6.1 million people with Medicare through

More information

Healthcare Exchanges / Marketplaces Frequently Asked Questions For Students & Campus Administrators

Healthcare Exchanges / Marketplaces Frequently Asked Questions For Students & Campus Administrators Healthcare Exchanges / Marketplaces Frequently Asked Questions For Students & Campus Administrators This FAQ is intended to provide our clients and customers with information about Healthcare Exchanges,

More information

Potential Impacts of the Affordable Care Act on Safety Net Providers in 2014

Potential Impacts of the Affordable Care Act on Safety Net Providers in 2014 Potential Impacts of the Affordable Care Act on Safety Net Providers in 2014 This information may not be changed, modified, adapted or altered so as to falsely imply Structure of this Presentation A. Impact

More information

THE AFFORDABLE CARE ACT ( ACT ), NEW EMPLOYER MANDATES, AND IMPACTS ON EMPLOYER- SPONSORED HEALTH INSURANCE PLANS

THE AFFORDABLE CARE ACT ( ACT ), NEW EMPLOYER MANDATES, AND IMPACTS ON EMPLOYER- SPONSORED HEALTH INSURANCE PLANS Community THE AFFORDABLE CARE ACT ( ACT ), NEW EMPLOYER MANDATES, AND IMPACTS ON EMPLOYER- SPONSORED HEALTH INSURANCE PLANS Prepared for the 2014 Massachusetts Municipal Association Annual Meeting On March

More information

The Affordable Care Act What does it mean to Arkansans? Sandra L. Cook, MPA Consumer Assistance Specialist Arkansas Insurance Department

The Affordable Care Act What does it mean to Arkansans? Sandra L. Cook, MPA Consumer Assistance Specialist Arkansas Insurance Department The Affordable Care Act What does it mean to Arkansans? Sandra L. Cook, MPA Consumer Assistance Specialist Arkansas Insurance Department PRESENTATION OBJECTIVES By the end of this presentation, participants

More information

REGULATORY UPDATE Vol. 1 No. 18

REGULATORY UPDATE Vol. 1 No. 18 REGULATORY UPDATE Vol. 1 No. 18 FAQs on Exchanges August 7, 2013 IN THIS ISSUE FAQs on Exchanges Employer Mandate Delay Transitional Guidance Issued Individual Mandate Final Rules Issued Possible Exchange

More information

HEALTHCARE REFORM: WHAT YOU NEED TO KNOW

HEALTHCARE REFORM: WHAT YOU NEED TO KNOW WHAT IS HEALTHCARE REFORM? Healthcare reform refers to the healthcare law passed in 2010 that significantly changed health policy in the United States. Healthcare reform includes numerous requirements

More information

Senate HELP Committee Affordable Health Choices Act (S. 1679) June 9, 2009 (passed by Committee July 15, 2009)

Senate HELP Committee Affordable Health Choices Act (S. 1679) June 9, 2009 (passed by Committee July 15, 2009) on Health Reform This side-by-side compares the leading comprehensive reform proposals across a number of key characteristics and plan components. Included in this side-byside are proposals for moving

More information

Kansas Insurance Department

Kansas Insurance Department Kansas Insurance Department The Affordable Care Act What Happens Now? Kansas Society of CPAs June 5, 2013 Linda J. Sheppard, Special Counsel & Director of Health Care Policy and Analysis 2010 Affordable

More information

Understanding the Health Insurance Marketplace

Understanding the Health Insurance Marketplace Understanding the Health Insurance Marketplace GMR Symposium Brenda Delgado, MPH March, 2015 The Health Insurance Marketplace Part of the Affordable Care Act Where qualified individuals and families directly

More information

Health Insurance Basics and the Federal Marketplace in Indiana. Module #3 Training Resource for Indiana Navigators

Health Insurance Basics and the Federal Marketplace in Indiana. Module #3 Training Resource for Indiana Navigators Health Insurance Basics and the Federal Marketplace in Indiana Module #3 Training Resource for Indiana Navigators 2 Module #3 Overview After reviewing this module, you will be able to: Explain basic health

More information

Health Insurance Exchange

Health Insurance Exchange Health Insurance Exchange Lynn A. Blewett, Ph.D. Professor, Division of Health Policy and Management, University of Minnesota School of Public Health Director, State Health Access Data Assistance Center

More information

What an employer should know about Health Care Reform

What an employer should know about Health Care Reform What an employer should know about Health Presented By David L. Fear, Sr. RHU NAHU Education Foundation Sponsored by PPACA - history Signed into law in March, 2010 2,700 page rough draft became the law

More information

Affordability & Individual Mandate Policies - Affordable Care Act and Massachusetts 2014

Affordability & Individual Mandate Policies - Affordable Care Act and Massachusetts 2014 Affordability & Individual Mandate Policies - Affordable Care Act and Massachusetts 2014 AFFORDABLE CARE ACT (FEDERAL) INDIVIDUAL MANDATE The federal Affordable Care Act (ACA) includes an individual mandate

More information

NJ CUPA HR The Affordable Care Act & Its Implication for Employers April 4, 2014

NJ CUPA HR The Affordable Care Act & Its Implication for Employers April 4, 2014 NJ CUPA HR The Affordable Care Act & Its Implication for Employers April 4, 2014 About NJBIA Represents 21,000 companies of all sizes and types, which employ over 1 million workers in the State. Advocate

More information

Find health care options that meet your needs and fit your budget. ctober 2014

Find health care options that meet your needs and fit your budget. ctober 2014 O Health Insurance Find health care options that meet your needs and fit your budget. ctober 2014 The Health Care Law In March 2010, President Obama signed the Affordable Care Act into law generally requiring

More information

THE HEALTH INSURANCE MARKETPLACE

THE HEALTH INSURANCE MARKETPLACE THE HEALTH INSURANCE MARKETPLACE Presented by Raffa Financial Services Source: Centers for Medicare & Medicaid Services Design 2013 Zywave, Inc. All rights reserved. OBJECTIVES This session will help you:

More information

STATE HEALTH INSURANCE EXCHANGE MISSISSIPPI INSURANCE DEPARTMENT P.O. BOX 79 JACKSON, MS 39205-0079

STATE HEALTH INSURANCE EXCHANGE MISSISSIPPI INSURANCE DEPARTMENT P.O. BOX 79 JACKSON, MS 39205-0079 STATE HEALTH INSURANCE EXCHANGE MISSISSIPPI INSURANCE DEPARTMENT P.O. BOX 79 JACKSON, MS 39205-0079 What Is An Exchange? o Essentially a marketplace for major medical insurance. o Travelocity, Expedia,

More information

Healthcare Reform: Patient Protection & Affordable Care Act (PPACA)- FACT.FICTION.FUTURE

Healthcare Reform: Patient Protection & Affordable Care Act (PPACA)- FACT.FICTION.FUTURE Healthcare Reform: Patient Protection & Affordable Care Act (PPACA)- FACT.FICTION.FUTURE Joanna Antongiovanni TX Assoc. of Health Underwriters - Past President 2014 Embedded Pediatric Dental VS Stand Alone

More information

Affordable Care Act 101: What The Health Care Law Means for Small Businesses

Affordable Care Act 101: What The Health Care Law Means for Small Businesses Affordable Care Act 101: What The Health Care Law Means for Small Businesses December 2013 These materials are provided for informational purposes only and are not intended as legal or tax advice. Readers

More information

The Affordable Care Act

The Affordable Care Act The Affordable Care Act What does it mean for internists? Joshua Becker MD 10/14/2015 VII. 2015 Reforms and Beyond Payment Penalties under Medicare s Pay-for-Reporting Program Value-Based Payment Modifier

More information

The Impact of Reinsurance on Group Health Plans

The Impact of Reinsurance on Group Health Plans Reinsurance and other fees could impact employer health care costs To help offset the cost of coverage expansion and other provisions, the Patient Protection and Affordable Care Act (ACA) imposes a number

More information

Healthcare Reform Provisions Unique to Small Employers/Financial and Other Benefits Concerns for All Employers (updated May 2, 2014)

Healthcare Reform Provisions Unique to Small Employers/Financial and Other Benefits Concerns for All Employers (updated May 2, 2014) /Financial and Other Benefits Concerns for All Employers (updated May 2, 2014) Lisa L. Carlson, J.D., Area Senior Vice President, Compliance Counsel Gallagher Benefit Services, Inc. While most healthcare

More information

EMPLOYEE S GUIDE TO HEALTH CARE REFORM S TAX CREDITS

EMPLOYEE S GUIDE TO HEALTH CARE REFORM S TAX CREDITS The EMPLOYEE S GUIDE TO HEALTH CARE REFORM S TAX CREDITS Calculate Your Health Insurance Tax Credit 2 Introduction Beginning in 2014, massive tax credits will become available to help individuals buy health

More information

Nebraska Health Insurance Exchange Update

Nebraska Health Insurance Exchange Update Nebraska Health Insurance Exchange Update State of Nebraska s Health Insurance Exchange A Presentation to the Public September, 2012 TODAY'S AGENDA Section 1: Overview of Health Insurance Exchanges Section

More information

Self-insured Plans under Health Care Reform

Self-insured Plans under Health Care Reform Brought to you by Good Neighbor Insurance Self-insured Plans under Health Care Reform The Affordable Care Act (ACA) includes numerous reforms affecting the health coverage that employers provide to their

More information

Health Insurance Marketplace 101 1

Health Insurance Marketplace 101 1 Affordable Care Act Coverage Accomplishments May 2013 3.1 million young adults have gained insurance through their parents plans 6.1 million people with Medicare through 2012 received $5.7 billion in prescription

More information

Kansas Insurance Department

Kansas Insurance Department Kansas Insurance Department A Kansas Guide to Health Insurance Changes Public Policy Session Panel Discussion KAMU Annual Conference Sept. 26, 2013 Sandy Praeger, Commissioner of Insurance 2014 Affordable

More information

Reporting Requirements for Employers and Health Plans

Reporting Requirements for Employers and Health Plans Brought to you by Cross Employee Benefits Reporting Requirements for Employers and Health Plans The Affordable Care Act (ACA) created a number of federal reporting requirements for employers and health

More information

The Affordable Care Act (ACA) introduces many new. The Affordable Care Act in Brief: A Look Into January 2014 Changes. Health Care Reform

The Affordable Care Act (ACA) introduces many new. The Affordable Care Act in Brief: A Look Into January 2014 Changes. Health Care Reform Health Care Reform The Affordable Care Act in Brief: A Look Into January 2014 Changes The Affordable Care Act (ACA) introduces many new mechanisms into the insurance marketplace that significantly impact

More information

Department of Health and Human Services. No. 57 March 23, 2012. Part IV

Department of Health and Human Services. No. 57 March 23, 2012. Part IV Vol. 77 Friday, No. 57 March 23, 2012 Part IV Department of Health and Human Services 45 CFR Part 153 Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and Risk

More information

AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST

AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST AFFORDABLE CARE ACT SMALL EMPLOYER Employers that offer health care coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Most health reform

More information

Health Reform Changes: What s New for 2014? New Hampshire Insurance Department September 11, 2013

Health Reform Changes: What s New for 2014? New Hampshire Insurance Department September 11, 2013 Health Reform Changes: What s New for 2014? New Hampshire Insurance Department September 11, 2013 1 New Hampshire Insurance Department Presentation Overview What s New in 2014 Key Questions for Individuals

More information