About ACA

/About ACA
About ACA2014-10-17T01:35:44-04:00

The Affordable Care Act, also known as, ACA, Healthcare reform or Patient Protection is now a reality. In fact, open enrollment is upon us and to ensure your policy will have an effective January 1st date, your policy must be purchased by December 31st.

Healthcare policies can be purchased from the Government’s Exchange or through private insurance companies.There are four types of plans that can be purchased from the Exchange.

  • Platinum – 90% coverage
  • Gold – 80% coverage
  • Silver – 70% coverage
  • Bronze – 60% coverage

All plans include the following coverage:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity & Newborn care
  • Mental health & substance use
  • Prescription drugs
  • Rehabilitative and habilitative services & devices
  • Laboratory services
  • Preventative & wellness services
  • Pediatric services, including oral and vision care

Policies are based on the following:

  • Age
  • Location (Zip Code)
  • Smoking Status (Y/N, within past 12 months)
  • Cannot exceed 3x the cost of the lowest policy

Exchange plans are based on the following:

  • Affordable, meaning an individual’s share of premium cannot be more than 9.5% of income
  • Premiums based on household income
  • Tax credits are offered to Individuals and families that fall between 133% – 400% of the federal poverty level. Please use the following calculator to determine if you are eligible for tax credits.

Participation is Mandatory

  • EVERYONE must participate or else be subject to penalties, including children
  • The IRS will enforce penalties based on year end taxes
  • Penalty levels
    • 2014 – $95 or 1% of taxable income (whichever is greater)
    • 2015 – $325 or 2% of taxable income (whichever is greater)
    • 2016 – $695 or 2.5% of taxable income (whichever is greater)
    • 2017 and beyond – Annual Adjustments