These resources are for anyone shopping (or helping someone shop) for health coverage within the health insurance marketplaces created through the Affordable Care Act (also known as the ACA or Obamacare).
This year, open enrollment begins on Nov. 1, 2020, and ends Dec. 15, 2020.
commonly asked questions regarding the ACA and how it affects you.
This cartoon explains health insurance using fun, easy-to-understand scenarios. It breaks down important insurance concepts, such as premiums, deductibles and provider networks. The video explains how individuals purchase and obtain medical care and prescription drugs when enrolled in various types of health insurance, including HMOs and PPOs.
This is the third YouToons video written and produced by the Kaiser Family Foundation. The video is narrated by former U.S. Senate Majority Leader Bill Frist, a nationally-recognized surgeon and Foundation trustee.
Also available in Spanish: http://youtu.be/mDPhCo11z0E
“Health Insurance Explained – The YouToons Have It Covered” The Henry J. Kaiser Family Foundation, accessed 10/19/2017, www.kff.org/understanding-health-insurance
According to Blue Cross and Blue Shield, the Affordable Care Act (ACA) — formally known as the Patient Protection and Affordable Care Act (PPACA) — puts individuals, families and small business owners in control of their health care.
The ACA is intended to significantly reduce the number of uninsured Americans by providing a continuum of affordable coverage options through new insurance options.
It reduces what families will have to pay for health care by capping out-of-pocket expenses and requiring preventive care to be fully covered without any out-of-pocket expense.
A central goal of PPACA is a U.S. federal statute signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act, it represents the most significant government expansion and regulatory overhaul of the country’s health care system since the passage of Medicare and Medicaid in 1965.
Starting in 2014, virtually every American will be required to purchase or have employer-provided medical insurance because of the Patient Protection and Affordable Care Act, or ACA. Those who don’t purchase the insurance will face a tax penalty at the end of the year.
Everyone is responsible for purchasing and maintaining the “minimum essential coverage” for basic health needs.
Minimal Essential Coverage
Minimum essential coverage means securing coverage either through a government-sponsored or employer-sponsored health insurance plan, a private health plan, or any other health benefit plans recognized by the Health and Human Services secretary.
Currently in the U.S. there are millions of Americans who are uninsured and who rely on taxpayer-supported programs when they need health care.
Starting in 2014, most people will be required to have health insurance or pay a penalty if they don’t. Coverage may include employer-provided insurance, coverage someone buys on their own or Medicaid.
Several groups are exempt from the requirement to obtain coverage or pay the penalty, including:
Tax penalties for Americans who don’t purchase the minimum essential coverage mandated by the Affordable Care Act (ACA) have been eliminated as of January 2019.
If you or someone in your family has a pre-existing health condition – such as heart disease, asthma, or even a pregnancy – you will find it much easier to obtain coverage or change plans starting in January 2014.
As of August 2013, we are not aware of any changes to our existing Medical plan offerings through Blue Cross and Blue Shield of Texas. The federal government has decisions to make and until we have further clarification, CRI will continue to service our existing medical plans. As of Jan. 1, 2014, we have not been able to offer the Association plan to new members. We have alternate plans available.
As the federal government announces decisions, we will post information on this page about how those decisions will affect your coverage through TSCRA and Blue Cross and Blue Shield of Texas.
Bookmark this page and check back periodically for those updates. Watch for ACA updates in The Cattleman News Update, and on The Cattleman NOW (smartphone app).
The health reform law contains a provision that requires private insurers to continue dependent coverage of children until age 26.
Department of Health and Human Services regulations specify that a young adult can qualify for this coverage even if he or she is no longer living with a parent, is not a dependent on a parent’s tax return, or is no longer a student.
The Department of Health and Human Services (HHS) recently released final regulations regarding the transitional reinsurance program that the Affordable Care Act (ACA) requires each state to establish beginning in January 2014. The transitional reinsurance program is intended to help stabilize premiums in the individual market during the first three years that the state-based exchanges are in effect (2014 – 2016).
The ACA requires all health insurance issuers and third-party administrators (TPAs) (on behalf of self-insured group health plans) to contribute to the reinsurance program.
The total fees to be collected nationwide will equal $12 billion in 2014, $8 billion in 2015, and $5 billion in 2016. The fee will no longer be collected beginning in 2017. The amount that each insurance carrier or TPA must pay will be determined based on all covered enrollees of that organization.
It is important to note that HHS must still develop the exact methodology that will be used to determine the amount of the fee as it applies to any particular state, carrier, or TPA. However, since the total to be collected is fixed by the law, it is possible to estimate the impact the fee may have on a global basis.
(Source: Parker/Smith/Feek/Insurance & Risk Management Brokerage Firm | www.psfinc.com)
The allocated annual fee on Health Insurer Fee and the Reinsurance Fee has been finalized for Blue Cross and Blue Shield of Texas fully-insured groups (51+ employees) at 3.5 percent of premiums in 2014. Medical premiums will be adjusted to include these fees beginning with the bill for January 2014 coverage. (Source News from the Blues/Insurance Carrier | www.bcbstx.com)
Requiring all companies, both large and small, to carry insurance for employees is thought to level out the playing field. The employer mandate gives employers that pay at least 50 percent of their employee’s contributions the ability to write off their insurance payouts by 35 percent. In 2014, that same write off increases to 50 percent. With the money saved, many employers say they can attract better employees, which builds their business and adds back to the economy.
Some features of your employer coverage may already have changed as a result of the ACA law. For example, if you are a parent, your children may now stay on your policy until they reach age 26.
Your plan also now likely covers preventive services like immunizations and screenings at no cost to you. Some employer plans in place in 2010 are exempted from this requirement.
Fees of $2,000 per full-time employee, excluding the first 30 employees, for employers with more than 50 employees that do not offer coverage and have at least one full-time employee who receives a premium tax credit. Employers with more than 50 employees that does offer coverage but haa at least one full-time employee receiving a premium tax credit, will pay the lesser of $3,000 for each employee receiving a premium credit or $2,000 for each full-time employee, excluding the first 30 employees.
The Affordable Care Act (ACA), also known as the health care reform law, affects health care benefits and costs for businesses and employees. Among the provision of the ACA are federally required fees and taxes. These provisions take effect January 1, 2014 and are accounted for in all renewals, as some coverage months, even when renewing in 2013, fall past the January 1, 2014 effective date.
Please be aware that the required taxes and fees are apply to all insurers who offer health insurance benefits, regardless of the health plan carrier. The ACA fees are assessed on insured and self-funded health plans, on a national per capita or per covered life basis. The fees will help fund temporary reinsurance programs (established under ACA) that would operate in each state from 2014 through 2016.
(Source: news from the www.bcbstx.com)
Special enrollment is open to those who experience any of the life events below that occur outside of the U.S. Health Care Open Enrollment window, which is Nov. 1, 2018 to Dec. 15, 2018.
Current year coverage
Open Enrollment for the current year ended January 31st. You can still get health insurance 2 ways:
- If you qualify for a Special Enrollment Period due to a life event like losing other coverage, getting married, or having a baby.
- If you qualify for Medicaid or the Children’s Health Insurance Program (CHIP). You can apply any time.
Insurance plans for next year
The Open Enrollment Period runs from November 1 to December 15 each year.
Plans sold during Open Enrollment start January 1 of the following year.
Cattle Raisers Insurance has devised a navigation aid to help you in your decision making process, click here to learn more.