What are my options if I lose the health coverage I get at work?
If you lose coverage at work you will have several options. The most common but often expensive is COBRA. Cobra allows you to continue the same coverage offered by your employer for a number of months depending on your situation. Cobra gets expensive for an individual since the employer no longer pays for a portion of the premium. If this is the case you can call one of our specialists and get a quote today for a plan that suits your needs.
For detailed information make sure to check out the United States Department of Labor site at: http://www.dol.gov/ebsa/cobra.html
How will health insurance exchanges work?
Covered California is a new exchange program allowing everyone to enroll for health coverage effective January 2014, regardless of pre-existing conditions! Whether you choose coverage through covered California or directly through the carriers, you will be approved. You may qualify for a subsidy if your income is within the guidelines. Please click on the following link for the income guidelines: http://www.coveredca.com/PDFs/English/Covered_California_Getting_Financial_Help_fact_sheet_English.pdf
Carriers participating in the exchange are: Blue Shield, Health Net, Kaiser, Sharp and a few other smaller carriers. Doctor networks are limited and not equal to plans directly offered through the carriers outside of the exchange.
Will I have to pay taxes on the premiums my employer pays?
No. Reporting health insurance premiums on your W-2 are simply for keeping track of employer contributions.
The individual shared responsibility provision goes into effect in 2014. You will not have to account for coverage or exemptions or to make any payments until you file your 2014 federal income tax return in 2015. Information will be made available later about how the income tax return will take account of coverage and exemptions. Insurers will be required to provide everyone that they cover each year with information that will help them demonstrate they had coverage.
Is it true that I will have to get health insurance coverage or pay a penalty?
Yes, penalty will be 1% or $95 whichever is greater and by 2016 it will be 2.5% of your income or $695. The IRS routinely works with taxpayers who owe amounts they cannot afford to pay. The law prohibits the IRS from using liens or levies to collect any payment you owe related to the individual responsibility provision, if you, your spouse or a dependent included on your tax return does not have minimum essential coverage. However, if you owe a shared responsibility payment, the IRS may offset that liability against any tax refund you may be due.
Why does the law require people to get coverage?
Under the Affordable Care Act, the federal government, state governments, insurers, employers, and individuals are given shared responsibility to reform and improve the availability, quality, and affordability of health insurance coverage in the United States. Starting in 2014, the individual shared responsibility provision calls for each individual to have minimum essential health coverage (known as minimum essential coverage) for each month, qualify for an exemption, or make a payment when filing his or her federal income tax return.
What is considered essential coverage?
Minimum essential coverage includes the following:
- Employer-sponsored coverage (including COBRA coverage and retiree coverage)
- Coverage purchased in the individual market
- Medicare Part A coverage and Medicare Advantage
- Most Medicaid coverage
- Children’s Health Insurance Program (CHIP) coverage
- Certain types of veterans health coverage administered by the Veterans Administration
- TRICARE
- Coverage provided to Peace Corps volunteers
- Coverage under the Non appropriated Fund Health Benefit Program