 THE AFFORDABLE HEALTHCARE ACT
IS HERE!!!
It is now mandated by law that ALL individuals must have health insurance by January 1st 2014. UNIA can provide you and your family access to the best healthcare insurance coverage offered. It is simple and easy and the choices and benefits have never been better. For the first time in history, individuals and families can receive tax credits that apply instantly to their health insurance premium. Starting October 1st, the Healthcare Market will be available to offer more healthcare insurance choices for individuals and families. Some individuals and families will even qualify for 100% tax credit which pays for the total amount of their health care premium.
UNIA is pleased to present the benefits that the Affordable Healthcare Act will offer individuals and families. Don’t delay! Sign up with UNIA today to improve your healthcare and your quality of life.
Who Qualifies for the Healthcare Market?*
Everyone can apply for the healthcare through the healthcare exchange unless you already have Medicaid or Medicare coverage.
Do I have to purchase health insurance?
YES! Starting January 1st 2014, all individuals who do not have health insurance will be penalized by the IRS for each month without health coverage. Individuals who are ineligible for an exemption and do not have coverage by 2014 may be required to pay a fee. The fee is $95 for plan year 2014.
What if I have a pre-existing condition?
Even with a pre-existing condition you are eligible for health insurance coverage without being denied.
What if I have coverage through my Job?
You can still apply for health insurance coverage through the exchanges even with current coverage through your employer. IF YOU ALREADY HAVE COVERAGE YOU CAN STAY WITH YOUR EXISTING HEALTHCARE PLAN!!!
Are the new plans for the healthcare exchanges complicated?
No, there are only 4 plans to choose from. You will be able to see to all 4 plans offered by all health insurance companies.
4 Plans to Choose From:
- Bronze - the Insurance Company pays, on average, 60% of the cost of health benefits coverage
(Example: If the doctor bill cost $100 then the insurance company pays $60 and you pay $40)
- Silver - the Insurance Company pays, on average, 70% of the cost of health benefits coverage
(Example: If the doctor bill cost $100 then the insurance company pays $70 and you pay $30)
- Gold - the Insurance Company pays, on average, 80% of the cost of health benefits coverage
(Example: If the doctor bill cost $100 then the insurance company pays $80 and you pay $20)
- Platinum - the Insurance Company pays, on average, 90% of the cost of health benefits coverage
(Example: If the doctor bill cost $100 then the insurance company pays $90 and you pay $10)
What are the benefits that the new Affordable Healthcare law provides?
- Extension of health insurance coverage to children up to age 26
- Expansion of the “guaranteed issue” requirement to ensure that health insurance issuers offer group and individual market policies to any eligible individual in a state, regardless of health status
- Prohibition on charging consumers a higher premium based on health status or gender
- Elimination of annual and lifetime coverage limits
- Prohibition on coverage limitations or exclusions based on pre-existing conditions
- Prohibition on precluding a qualified individual’s participation in an approved clinical trial, or discriminating against that individual based on such participation
- Protection against out-of-pocket costs above $6,350 for an individual and $12,700 for a family
- Introduction of an 80/20 MLR rule to ensure that at least 80 percent of the premium dollars paid to a health insurance issuer are spent on providing health care
What are the essential benefits all health insurance plans must provide?
- Ambulatory patient services, such as doctor's visits
- Hospitalization
- Mental health and substance use disorder services, including behavioral health treatment
- Rehabilitative and Living Assistance services and devices
- Laboratory services
- Emergency services
- Maternity and newborn care
- Prescription drugs
- Preventive and wellness services and chronic disease management
- Pediatric Services, including oral care
How can the tax credits reduce my healthcare insurance premium?
Tax credits to purchase health insurance are available to individuals and families based on their income. Tax credits are applied immediately to reduce premiums for health insurance. The higher the tax credit percentage received, the lower the premium you pay.
This simple chart below explains how the tax credits work to reduce premium cost for an individual and family of 4.
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INSURED:
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PLAN TYPE:
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HOUSEHOLD INCOME:
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TAX CREDIT % RECEIVED***
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INDIVIDUAL
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BRONZE PLAN
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$11,490
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100% OF PREMIUM PAID BY TAX CREDIT
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INDIVIDUAL
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SILVER PLAN
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$11,490
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92% OF PREMIUM PAID BY TAX CREDIT
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INDIVIDUAL
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BRONZE PLAN
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$32,000
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12% OF PREMIUM PAID BY TAX CREDIT
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INDIVIDUAL
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SILVER PLAN
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$32,000
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6% OF PREMIUM PAID BY TAX CREDIT
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FAMILY OF 4
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BRONZE PLAN
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$23,600
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100% OF PREMIUM PAID BY TAX CREDIT
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FAMILY OF 4
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SILVER PLAN
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$23,600
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96% OF PREMIUM PAID BY TAX CREDIT
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FAMILY OF 4
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BRONZE PLAN
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$94,200
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21% OF PREMIUM PAID BY TAX CREDIT
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FAMILY OF 4
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SILVER PLAN
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$94,200
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17% OF PREMIUM PAID BY TAX CREDIT
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***(Tax Credit % received is an estimate and not the official Tax Credit% received)
Important Dates to Remember:
Pre-Enrollment……………………….....…………………Oct. 1, 2014
Open Enrollment………………………………………...Nov. 15, 2014
Coverage Begins……………………………………….....Jan. 1, 2015
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