McFarlin Insurance Agency Home Page Contact Us Postheader
Post Header 1 Post Header 2 Post Header 3

PPACA

Aka: ACA or Obamacare

Patient Protection and “Affordable” Care Act

Overview- Passed March 23, 2010 and affirmed by Supreme Court June 28, 2012.  This law creates many provisions to regulate the insurance companies, employers, and individuals for the purpose to ensure everyone has affordable health insurance.  Provisions of the law have various dates of compliance, many of which have already been enacted.   

Highlights- http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act

                     http://www.healthcare.gov/law/index.html

 

  1. HHS- Creation of Health and Human Services, CMS and many related entities that are charged with “filling in the details” of the law.
  2. Individual Mandate- that insurance must be purchased either through an employer, personal policy, government coverage, or through an exchange.
  3. Exchanges- the requirement for each state to create and run a health insurance purchase exchange to begin on Jan. 1, 2014. These policies will be offered with “guaranteed issue” or with no pre-existing condition exclusions and be required to have a minimum level of coverage established by each state.
    1. Individuals
    2. Small businesses up to 50 employees
    3. States can create their own or participate in a federal exchange
    4. States can allow purchases on and off the exchange or on the exchange only (DC and VT).
    5. Navigators- currently expected that non profit organizations will be set up to “guide” individuals to health insurance plans offered on the exchange.
    6. Brokers- may or may not be eligible to “sell” on the exchange depending on the state.
    7. MD – brokers will be able to offer both “on and off” exchange purchasing of health insurance for individuals and businesses
  4. Subsidies – offered if purchased from the exchanges- based on a graduating scale of income, both subsidies and maximum premiums are required.  These IRS subsidies are to be offset by larger employers (50 FTE’s- full time equivalent employees) paying $2000 penalties for any employees who receive subsidies from the exchange.
  5. Minor provisions-
    1. Up to age 26 dependents- employment, student nor existing health insurance status does not restrict from going onto their parent or guardian’s plan.
    2. Contraceptive Mandate- free condoms
    3. Free preventive care- all plans- certain drugs and procedures were added to the “preventive” list of coverages.
    4. Medical Loss Ratio- requirements of carriers to issue credits back to business and individuals for “overpayment of premiums” for claims not made
    5. Unlimited Lifetime Benefits- this removed the insurance companies higher level limits of coverage.
    6. Monthly Income Reporting-Employers must report employee income monthly to establish subsidy amounts and taxes.

Disclaimer:  Please note the purpose of this outline is to provide a general, and broad, overview for the above referenced topic and is not intended to be used for outside distribution or reference.  Please contact your health insurance advisor or local government authority for additional materials and information. 

Share |


No Comments


Post a Comment
Name
Required
E-Mail
Required (Not Displayed)
Comment
Required


All comments are moderated and stripped of HTML.
Submission Validation
Required
CAPTCHA
Change the CAPTCHA codeSpeak the CAPTCHA code
 
Enter the Validation Code from above.
NOTICE: This blog and website are made available by the publisher for educational and informational purposes only. It is not be used as a substitute for competent insurance, legal, or tax advice from a licensed professional in your state. By using this blog site you understand that there is no broker client relationship between you and the blog and website publisher.
Blog Archive


View Mobile Version
Site Links Insurance Types Contact Information   Get Social
Home Page
About Us
Get A Quote
Claims
Newletter
Read Our Blog
Our Partners
Services
Contact Us
Business Insurance
Life & Health Insurance
Personal Insurance
More Insurance Types
McFarlin Insurance Agency, LLP.
8325 Guilford Rd, Suite A
Columbia, MD 21046

Phone Number: (410) 312-7800
Fax Number: (410) 312-7808

© Copyright 2010 All rights reserved by McFarlin Insurance Agency, LLP.