Health Care Reform: The Basics for Individuals November 4, 2013 Sponsored Post individual mandate, Marsh, health care reform, Mercer 0 Beginning January 1, 2014, new regulations provide most Americans access to affordable health insurance that covers essential care. The regulations that facilitate this include: Individual Mandate—Most individuals are required to have and maintain health insurance effective January 1, 2014. There are exceptions for certain individuals. Penalty—If you elect not to purchase coverage, you are required to pay a penalty - in 2014: the greater of $95/individual (3 per family), or 1% of income - In 2015: the greater of $325/individual (3 per family), or 2% of income - In 2016: the greater of $695/individual (3 per family), or 2.5% of income Guaranteed issue—Insurance companies must sell coverage to everyone, regardless of pre-existing conditions, and can’t charge more based on health or gender. Health Insurance Exchange—Individuals without access to affordable, employer-sponsored plans that provide qualifying coverage can enroll in plans offered either through the individual insurance market or through Covered California with coverage beginning January 1, 2014. Subsidies—Individuals and families may qualify for federal tax credits and benefit subsidies only through the exchange. Tax credits are available to those who meet certain income requirements and do not have access to affordable health insurance that meets minimum coverage standards offered through their employer or another government program. Eligibility for tax credits is based on family income and size. Premiums—Premiums can only vary by age, geography and family composition. They may not vary by gender or health conditions. Annual or lifetime limits—Individual and group plans may not impose limits on essential benefits. Out of Pocket expenses—Limits out-of-pocket expenses for co-pays, co-insurance, deductibles, etc. to $6,350 per individual to a maximum of $12,700/family annually. This is a sponsored post from Mercer, a partner of the San Francisco Medical Society. Mercer is a global consulting leader in talent, health, retirement, and investments. Mercer helps clients around the world advance the health, wealth, and performance of their most vital asset— their people. Mercer is a wholly owned subsidiary of Marsh & McLennan Companies (NYSE: MMC), a global team of professional services companies offering clients advice and solutions in the areas of risk, strategy, and human capital. SFMS members enjoy exclusive discounts on a variety of insurance premiums, including Worker's Compensation, and one-on-one assistance with their insurance needs. For more information, contact a Mercer client advisor at (800) 842-3761 or click here for more information. Comments are closed.
