Despite a federal government shut down, enrollment for ObamaCare – officially known as the Patient Protection and the Affordable Care Act (ACA) – went live on Oct. 1 and will continue through March 31, 2014. The legislation is groundbreaking for Americans, but the jury is still out on the execution of the program.
The intent is to give more Americans access to affordable, quality health insurance and to reduce the growth in health-care spending. No, it isn't designed to replace private insurance, Medicare or Medicaid.
The new law issues a mandate that most Americans obtain health coverage by the year 2014, obtain an exemption or pay a fee on their taxes for every month they do not have coverage. Most states established specific health insurance marketplaces (also known as exchanges), allowing citizens to shop for health insurance using cost assistance. Since Gov. Bill Haslam chose not to set up a marketplace, the Tennessee exchange was put in place by the federal government.
The exchanges are online price comparison websites where health insurance can be purchased. Those up to four times the federal poverty level (FPL) may qualify for reduced premiums via tax credits or out-of-pocket assistance, or Medicaid for those states implementing Medicaid expansion.
The Community Health Alliance (CHA) is the health insurance co-op for Tennessee. CHA has a promotional enrollment program offering free smartphones to qualified individuals. The smartphones include unlimited talk, texting, 1.2 GB of data and is preloaded with contact information for a CHA representative. The phones can also be used to track the enrollees, and stay connected with them via phone, email or text.
1) Coverage for people with pre-existing conditions;
2) All new insurance plans will cover preventive services, including annual checkups, mental health, maternity care, mammograms, and colonoscopies, for no out-of-pocket costs; and
3) Provisions are included that prevent insurance companies from dropping enrollees when they are sick or if honest mistakes are on the application; prohibit gender discrimination, unjustified rate hikes, life-time and annual limits.
Citizens who currently have access to insurance through their employer or Medicare/Medicaid are encouraged to maintain it. The application will even recommend that citizens apply for Medicare, if they qualify.
How to enroll
Log onto the website www.HealthCare.gov. Choose your state. Create an account by providing basic information, choosing a username, password and security questions. Complete the application. After comparing the eligible plans and programs, pick a plan that suits your needs and budget. Then enroll. The coverage will start January 1, 2014.
The Small Business Health Options Program (SHOP) is a new option to provide coverage to employees under ObamaCare. The benefits of using the plan are:
1) The business can control the coverage offered and how much is pay toward employee premiums.
2) The business can compare health plans online and make an educated informed business decisions.
3) The businesses may qualify for a small business health care tax credit worth up to 50 percent of the premium costs. The balance of the premium costs not covered by the tax credit can be deducted from your taxes. The tax credit is only available for plans purchased through SHOP.
Small businesses with 50 or fewer full time equivalent employees are eligible to obtain coverage for their employees. If a business owner is self employed with no employees, apply under the individual plan rather than under SHOP. If the business offers coverage under SHOP, it must offer coverage to all employees working 30 hours or more on average.
How do businesses enroll?
Businesses also log onto the website www.HealthCare.gov. Choose your state. Create an account by providing basic information, choosing a username, password and security questions. Complete the application. After comparing the eligible plans and programs, pick a plan that suits your needs and budget. Then have the employees enroll. The coverage can start as soon as January 1, 2014. For any questions regarding SHOP, call 1-800-706-7893.
As families strive to provide a good life for their family, employees will undoubtedly take healthcare into consideration when seeking employment or staying with an employer in 2014. So businesses that currently provide no coverage to employees should consider it as an option in an effort to not only maintain current employees and attract new ones, but also because it is the right thing to do if the business can afford it.