Zinser Benefit Service - Small Business Insurance
Individual Insurance, Group Insurance and Employee Benefits, small business insurance
Zinser · · 2 Comments
I’ve been receiving questions about the individual mandate for 2014.
The law states that you may be subject to a fine if you go three consecutive months without medical insurance after March 31, 2014. Â If you go without you may face a penalty on your 2014 federal tax return, only if you’re subject to the mandate.
Here is some information to help you navigate Obamacare.
1 – Does your current health insurance plan need to change?
If you have a grandfathered plan your going to be able to keep your plan (as long as the health insurance company you have your grandfathered plan with allows you to do so).
If you have what they call a “transitional plan” you’ll be able to keep that plan until your renewal date in 2014. Â Once your renewal date hits in 2014, you will then be required to buy a plan that meets all of the essential health benefits.
If you buy a plan with an effective date of January 1, 2014, that plan will meet requirements.
2 – How will you pay for your health insurance in 2014?
Depending on your household income, you may be able to qualify for payment assistance that make insurance more affordable. Â The only way you can obtain assistance, is if you purchase your plan from either the state or federal exchange. Â If you buy a plan “off exchange” you will not received payment assistance or special discounts.
3 – What is the difference between on and off exchange plans?
In my opinion, the only reason you would go to either the state or federal marketplace (the government prefers this word, but it’s the fancy word for exchange) is if you qualify for payment assistance. Â If your income is over the assistance limit, then going off exchange is the way to go. Â I say this because you won’t have to prove your income, and answer all of the questions that the state and federal government require from you.
For example, here in Kentucky, Humana offers some plans that aren’t available on the state exchange. Â These plans have a more comprehensive network, then the current on exchange plans have.
4 – What type of plans are available?
Networks, co-payments, deductibles, and out of pockets differ between all the carriers. Â You must decide for yourself what is most important to you, and then work with an agent or broker (Zinser Benefit Service, Inc. would be one) who should be able to guide you to the right plan.
5 – When can you buy coverage?
The new open enrollment period for a January 1, 2014 effective date started in Oct 2013 and ends on December 23rd 2013. Â Once this date passes, you’ll have dates similar all the way up through March of 2014. Â If you miss during this time, you will have to have a qualifying event in order to enroll in a plan during 2014. Â A qualifying event would be any of the following:
This is just a brief overview. Â I hope it helps!
This was taken from something I received from Humana.
The health insurance tax
The Affordable Coverage Project, a coalition of business groups that includes the U.S. Chamber of Commerce and the National Association of Manufacturers, wants more lawmakers to throw their support behind a House bill that would delay the health insurance tax for two years. The reform law imposes this new tax – or fee – on health insurers beginning in 2014. “With the economy still struggling to recover, small businesses, middle-class families and public program enrollees are not in a position to bear the burden of this tax,” stated a coalition letter urging members of Congress to cosponsor the bipartisan bill.
Meantime, the Department of the Treasury and the Internal Revenue Service (IRS) issued final regulations on the premium tax, and guidance on the timing and manner of health insurer filings. The final regulations and related guidance closely mirror the proposed rule issued on March 1. However, a few minor changes and clarifications were made, including moving up the deadline for insurers to submit their net premiums to the IRS (from May 1 to April 15). The IRS is to send preliminary fee calculations to health plans by June 15; health plans are to send error corrections by July 15; final fee calculations are to be sent to health plans by Aug. 31, and payments to the IRS are due Sept. 30.
This week’s Business First of Louisville had an article about Modified Community Rating. Â Director of Government Relations Lawrence Ford is quoted throughout the article.
Here’s the link:
Mr. Ford does a good job of explaining how this will impact Kentuckians rates. Â He highlights two issues. Â The first is younger people subsidizing the older population. Â Insurance companies aren’t going to bring down older folks rates, they’re going to push the young population up to help offset the older population claims. Â He also talks about the lack of a substantial penalty for those who don’t enroll.
Still something needs to be done about letting individuals buy whenever they get ill. Â The way it’s currently set up that is what could happen. Â I know there are talks about it, but we need something done soon before Jan 1, 2014.
On Friday President Obama held an event to tout the benefits of ACA, specifically to a large group of women. Â The New York Times is also reporting that the administration confirmed that Kathleen Sebelius, the head of the health and human services, has been trying to raise money from the private sector to promote an education and outreach program raising the awareness of the benefits of PPACA. Â Congress has repeatedly refused to fund this outreach program, and that’s why Ms. Sebelius is going to the private sector.
http://www.nytimes.com/2013/05/11/us/politics/obama-to-makes-new-pitch-on-health-care-law.html?ref=us
Speaking just for Kentuckians, I’m really skeptical that we’re going to see a decrease in premiums. Â Just taking into account what the new policies are going to have to cover, that in and of itself will cause an increase in premiums. Â For instance, maternity. Â All policies (even men) will have maternity coverage. Right now, that costs about $100/mo more than a policy that doesn’t cover it.
The second factor that’s going to cause premiums to rise is the guaranteed issue aspect of the law. Â When underwriting is taken away from the insurance companies, healthy individuals are going to be penalized even more than they are today because insurance companies can’t offset the amount on the older and/or sicker population. Â So the older individuals more than likely have their premiums staying roughly the same, it’s the younger generation that’s going to see an increase. Â The same young people that the President is targeting to enroll in this law.
I will give the President this, the individuals and families that receive a subsidy, may see a decrease in what they pay. Â However, I think the insurance will still cost more.
We’re going to just have to wait and see in October when the premiums are made public just how much it will cost.