Affordable Care Act Deadlines You Need To Know

Time is running out for individuals who want to enroll in an Obamacare plan.  Enrollment so far has been lagging, and it will be interesting to see if people are not interested in enrolling or if there is not enough information available.  In any event, if someone does not have coverage by March 31 they will be required to pay a tax for not having heatlh insurance.  In order to avoid inadvertently being left out in the cold, here are some dates to be aware of.

February 15, 2014

Deadline for March 1 Enrollment

As a general rule, an individual must be signed up by the 15th of a month in order to have coverage start on the 1st of the following month.  Therefore, if you need coverage on March 1, you need to have signed up for an exchange plan by February 15.  Even if you miss this deadline by 1 day, you will most likely have to wait until April 1 to have health insurance.

Technically, since enrollment after February 15 would result in coverage that would not begin until April, the individual would be subject to the penalty for not having coverage if he or she was without coverage since January 1 (i.e. 3 consecutive months).  However, the federal government has said that as long as someone enrolls during the Open Enrollment period (through March 31) that person will not have the penalty applied.  Be aware that a hardship waiver may be required when filing 2014 taxes.

March 15, 2014

Deadline for April 1 Enrollment

As mentioned above, if you want coverage by April 1, 2014, you must be enrolled by March 15.  If you enroll between March 16 and March 31, you will still be in the Open Enrollment timeframe, but now you have pushed your effective date of coverage back to May 1.  And you’ll probably be required to complete a hardship waiver at tax time.

March 31, 2014

Last Day of Open Enrollment

In order to completely avoid a penalty for not having health insurance you must have your enrollment completed by March 31, 2014.  The first day of coverage will be May 1.

Do Not Wait

If you are wanting to enroll in an exchange plan, do not wait until the last minute to complete your enrollment.  While the marketplace websites are vastly improved over what was rolled out in October, there is no guarantee that you will not experience technical difficulties when trying to sign up.

Also, if you want the coverage, why wait?  Get signed up and covered as soon as possible.

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Young and Female? The ACA is Looking for You

One of the biggest challenges so far to the Patient Protection and Affordable Care Act has been the enrollment of young people.  A key piece of the insurance puzzle is to get those with low risk of loss to help pay for the claims resulting from those with a high risk of loss.  In the world of health insurance, this means getting young, healthy people to participate.  Without enough of this population, the cost of an insurance plan will be higher than anticipated.  For the ACA’s supporters, this could be a disaster.

So to combat this potential problem, a new campaign is being launched that targets young women.  The reason?  Enroll America, the advocacy group behind the campaign believes women will be likely to enroll their male counterparts.

It is still to be determined whether the lackluster enrollment in the ACA is due to lack of information about the program and subsidies available or if people just are not interested.  Less than two months remain in the Open Enrollment period.


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What is a Health Insurance Exchange Notice and Why is it Important?

With the health insurance exchanges, also known as health insurance marketplaces, set to open for business on October 1, 2013, the world of health insurance is about to change dramatically.  Through these exchanges individuals will be able to purchase medical insurance by comparing plans, insurance companies, and premiums side by side on their computer screen.

One of the advantages of buying insurance through the marketplace is the possibility of obtaining a tax credit subsidy to help pay for the cost of the coverage.  However, not everyone is eligible for the subsidy.  One of the ways to not be eligible is to be offered affordable coverage with a certain level of benefits through your employer.  But how do you know if your group coverage makes you ineligible for the tax credits?  Your employer will provide you with a health insurance exchange notice.

What is the Health Insurance Exchange Notice?

The health insurance exchange notice will explain to you whether or not your coverage eliminates you from the subsidy.  Employers are required to provide this notice to existing employees by October 1, 2013 and to new employees within 14 days of employment.

There has been some confusion about possible penalties given to employers who do not comply with the requirement to provide a health insurance exchange notice.  Some reports suggested that there would be a $100 per day per employee penalty.  The Department of Labor came out later and confirmed that there would not be a penalty for lack of compliance.  Still, employees are encouraged to send the notice.

If your employer does not provide a notice, it is still important to find out if you are offered coverage that will keep you from being able to access the tax subsidy.

Why is the Health Insurance Exchange Notice Important?

The Patient Protection and Affordable Care Act requires every American to purchase health insurance or else face a tax.  Since health insurance is an expensive addition to the budgets of many people, the law allows for subsidies to help pay for the premiums.  However, if medical coverage is available through an employer, the subsidy is not available.

When an individual applies for coverage through the exchanges, the site will ask if group coverage is offered.  To be accurate in answering this question, people can rely on the health insurance exchange notice provided by their employer.

Are Model Notices Available?

Model notices are available through the Department of Labor’s website.

Model notice for employers that offer a plan

Model notice for employers that do not offer a plan

Group Coverage can be an Inexpensive Option

Even if you are not eligible for a subsidy because of employer sponsored coverage, the group coverage is still a great option.  The Affordable Care Act mandates that employers cannot charge employees more than 9.5% of their salary for coverage.  In many cases, this premium will be less expensive than coverage purchased through an exchange, even with a subsidy in place.  Therefore, not being able to get the tax credits because of available group coverage is not necessarily a bad thing.

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Subsidy for Health Insurance – How to Qualify for Assistance

On October 1, 2013, the health insurance marketplaces, also known as exchanges, created by the Patient Protection and Affordable Care Act (Obamacare) will go live for Open Enrollment.  The exchanges will be a great way for individuals and small businesses to find a variety of health plans from a variety of health insurance companies at (hopefully) a competitive cost.

One of the things that helps people, especially young people, afford the premiums on the marketplaces is a tax subsidy for health insurance plans.  Some people will be eligible for this assistance, but not everyone.  Here is how you can have a rough idea if you are eligible for the tax credits.  You must meet all of the following criteria.

No Employer Provided Health Insurance

Obamacare made it mandatory for employers with at least 50 employees to provide all full-time employees with the option of enrolling in their group medical plan.  The plan must pay for at least 60% of allowed charges and no employee may pay more than 9.5% of their salary to purchase the plan.  If an employer offers a plan that fails those two standards, there is a fine they must pay.

The definition of a full-time employee is important in figuring out if you are eligible for a subsidy for health insurance through the exchange.  A full-time employee is defined as someone who average 30 hours per week or more.  There are some calculations that your employer will do to determine hours worked, but in general, 30 hours is a full-time employee.

So, all this to say, that if you are offered coverage at work that meets the two standards above, then you are NOT eligible for a tax subsidy.  If you are not offered coverage, then you still may be eligible for the subsidy.

Annual Earnings

Subsidies are only available to households that earn less than 4 times the federal poverty level. In addition, the amount of the subsidy depends on the household income.  Folks that make less can get a larger subsidy for health insurance in the marketplaces.

Medicaid and Medicare Eligibility

If someone is eligible for Medicaid and Medicare, two government programs that help pay the cost of medical expenses, then that person is not eligible for a subsidy.  A tricky aspect of this rule is that while Obamacare expanded Medicaid coverage, not every state expanded Medicare coverage.  So your eligibility for Medicaid depends on where you live.  You could be eligible in one place, but not eligible in another place.

Medicaid is administered by the states, so check with your local Medicaid office for more information.

How are Subsidies Applied?

For the most part the subsidy for health insurance bought on the exchanges is in the form of tax credits in the following year.  For example, you pay your premium in 2014 and the tax credit is applied on your 2015 tax form.  However, if this arrangement causes a hardship, there are ways to reduce the actual premium.

How to Apply for the Subsidy for Health Insurance

The subsidy for health insurance on the exchanges is designed to be a quick and easy process.  Someone can apply right on the marketplace’s website and find out if they are eligible.  In fact, here is a nifty calculator from Kaiser to help determine if you fit the eligibility requirements.

Find the Best Option for You and Your Family

The marketplaces and the subsidy for health insurance purchased through the marketplaces are designed to make affordable health insurance more available.  However, that does not mean that the exchanges are your best option.  Take a look around to see how you can find the best coverage at a price you can handle.

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Is Health Insurance for College Students Available Through the Exchanges?

Health insurance for college students can be a tricky thing.  For one, health insurance plans have limits on how long a dependent child can be on their parent’s medical plan.  Second, it can be hard to find a health insurance plan that is affordable for students while they are not making much money.

Both of these issues are addressed by the Patient Protection and Affordable Care Act (PPACA), or Obamacare as many people know it.  While the law is a political hot button, college age students can benefit greatly from the legislation.

How Does Obamacare Help College Students?

Health insurance for college students is addressed in couple of ways by the Affordable Care Act.  First, the law allows dependent children to remain on their parent’s plan until the child reaches age 26.  For many people, this gets them through the college years with access to health insurance.

Second, the law provides two avenues to help pay for medical expenses  – expanded Medicaid and the health insurance exchanges, or marketplaces.  Medicaid has been expanded to include adults that make less than 133% of the poverty level.  Medicaid is administered by the states, and not all states are going to expand Medicaid, so make sure to check with your state’s eligibility.

The health insurance marketplace, then, is a great option of health insurance for college students.

Why is the Exchange Good for College Students?

If a student in college needs to purchase insurance on their own, there is a good chance that they will be making this sort of purchase for the first time.  The exchanges are online locations where available plans are laid out side-by-side to make it easy to compare the health insurance options, both by plan design and premium.  This will make the purchase easy to wade through and understand.  If the student needs assistance, they can contact customer service representatives, called navigators, to help them through the process.

But perhaps the best thing for college students is that PPACA allows for tax credits for purchases through the marketplace if the individual makes less than 400% of the poverty level.  The calculation for this credit is done online.  Since many people in school make less than this threshold, health insurance for college students is much more affordable than before the Affordable Care Act.

Like Medicaid, the exchanges are administered through the states.  Some states do not have their own exchange.  In that case, residents will go through the federal marketplace.  You can find your state’s marketplace here.

Filing Tax Returns

One thing to be aware of if a college student purchases a medical plan through the exchange is that he or she will have to file a tax return, even if there would otherwise be no reason to file.  So while health insurance for college students is available for a low cost on the exchange, make sure to actually get the credit you were promised.

The Affordable Care Act is a controversial piece of legislation.  The effects, both good and bad, will be felt for years.  But one thing for sure is that the availability and affordability of health insurance for college students was helped by PPACA.

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