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Affordable Care Act Notice Letter

You may have wondered how the Affordable Care Act (ACA) will affect your current health insurance plan, or whether you might be able to afford a plan for the first time through a new financial assistance program created under the law.  There is a mountain of information available from a variety of sources, but who has time to sift through all of the publications, and which ones provide the most accurate and up-to-date information?  You might think that you don’t have to do anything until January 2014 when the ACA goes into full force, but there are several steps you need to take now to prepare for life under the Affordable Care Act.

I’ve compiled some information for you after reading articles, technical releases, state guides, insurance company publications, etc.    This information and the noted web sites contained herein may help answer some of your questions about the ACA.  The ACA aims to expand health care coverage through a series of provisions that generally go into effect on January 1, 2014:

  • Individual Mandate: mandates all Americans, with some exceptions, to maintain a minimum level of health coverage or face a tax.
  • Insurance Marketplaces:  Creates health insurance Marketplaces and provides premium tax credits to assist eligible individuals with the purchase of coverage.
  • Medicaid expansion: allows states to expand Medicaid up to 133% of federal poverty level.
  • Employer mandate:  mandates employers with 50 or more full time equivalents to offer coverage to full-time employees and their dependents or pay a penalty if insurance is not offered.  (PLEASE NOTE: The Employer Mandate has been delayed until January 2015.)

Here’s what you need to be aware of:

  1. October 1, 2013: Exchanges begin open enrollment period.
  2. October 1, 2013All employers must supply all current and future employees’ notification about new coverage options available through the Health Insurance Marketplace of Illinois.  Notification must be in writing and the employer  may choose any of the following methods:
  3. Hand deliver to employee
  4. First-class mail
  5. Or electronically, providing electronic disclosure safe harbor requirement are met (generally this means employees can access email from any location, access to email is an integral part of their duties, and the system must furnish a receipt by the employee and notify the employee where they can obtain a hardcopy).

1. Model notice templates  can be found on www.healthcarereform.illinois.gov

2. Notification requires that the employer determine if they will/will not offer health care insurance to their employees so you may want to discuss your options with an insurance provider in advance.

  1. Small businesses may get health coverage in the Small Business Health Options Program (SHOP) Marketplace. For 2014, no employers are required to offer health coverage.
  2. Starting in 2014, businesses with 50 or fewer full-time equivalent (FTE) employees can use SHOP to offer coverage to their employees. This applies to non-profit organizations as well. You control the coverage you offer and how much you pay toward premium costs.
  3. Health coverage through SHOP starts as soon as January 1, 2014.  Open enrollment begins October 1, 2013. You can sign up and begin offering coverage any time during the year.  Additional information about SHOP can be found at:  www.healthcare.gov/marketplace/shop/.

Here are some additional web sites that contain good, up-to-date information:

I hope I’ve helped you sort through the upcoming Affordable Care Act and the many regulations surrounding implementation on January 1, 2014 and 2015.  Please feel free to call me with any questions you may have to help determine your best course of action.

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