Affordable Care Act In A Nutshell

You might as yourself; if Sora Global provides health insurance for the international community, why is he talking about the Affordable Care Act (or Obamacare, as most people call it)?  And no, this is not a political opinion blog.  I will not be offering my wisdom on whether it’s going to work or not, that’s for another time.  Anyway, regardless of my personal opinion on the subject, on January 1st of 2014 we will all be affected by this law in one way or the other.  Well, maybe not all; if you are the President or a member of congress you will be spared, but since most of us are neither we need to be aware so that we don’t get caught with our… whatever, down.

This blog will be very brief, I will only be offering the bare bones facts about the program, if you want to find out any more on the subject, you can call or email me and I will be glad to give you a more detailed account.

We can start by saying that we will all fit into one of three categories:

An employee of a company of 50 employees or more, where the employer will be required to offer you, not your family health insurance.  In this scenario, in order to qualify for your company’s health program you must be a full time employee (30 hours) or more.  The company may elect not to pay for your insurance in one of two ways: 1) Buy reducing your hours to less than 30 (a company is not obligated to pay for part time employees), or 2) By simply denying you, the employee coverage.  If the company opts for option 2, then the company is penalized by the government for a set amount per employee.  Your are now on your own to find affordable healthcare. Mind you, the company can opt to subsidize some of your healthcare cost by including a certain amount extra on your paycheck.  This possible subsidy, offered by the company, could create a positive tax advantage for the employer which could possibly offset the penalties set by the government.

A company employing  less than 50 employees, the employer is not required to offer you health insurance, and will not be penalized for doing so.  In the event that the employer does offer its employees health insurance, the employer can chose the company, how much of the premium is paid by you and if your dependents can be covered, or not.  If this employer decides to offer his employees coverage and said employees are earning within the poverty level, the employer may be eligible for a tax discount.   The drawback for you, the employee, is that if your health insurance is obtained through your employer you will not be eligible for possible premium discounts.  I’ll explain about these discounts when I talk about the individual or family policies.

So, let’s talk about what is going to be the bulk of us, those who are unemployed, self-employed, or whose employer has decided not to offer coverage; what’s going to happen to us?

We, and I mean we, I fit into one of those categories, are probably the most fortunate, we get to go online and chose to our heart’s desire.  The Federal Government and some States, Florida not being one of them, has set up what is called Marketplaces (In will speak in depth on this subject in my next blog).  A Marketplace has been referred to as Exchanges, and all that it is is a portal in the internet where you and I can go find our insurance coverage.  It’s that simple, huh! No, not quite that simple, that’s why you have and need me, but I’ll talk about that later on.

As of October 1st, 2013 the Federal Marketplace, for individuals as well as for small companies will go online.  At which time any of us can access it to find out our eligibility for discounts and costs.  Those are the discounts I spoke about in the last paragraph.  If you are within a certain income range and your family size is of a certain number, you may be eligible for an immediate discount on your monthly premiums.  How do you know if your eligible for the discount, simple, the Marketplace will take your data, cross-reference it with the IRS and “Bingo” you will be given a yes or no answer, and if the answer is yes, you will also be given a dollar amount.  Given you annual income and the size of your family you may also be eligible for a tax discount.

Who is eligible for the Affordable Care Act?  Well, anyone who is under 65 years of age, a legal US resident, is not in jail, and can afford to pay the premiums.

I know I made it sound simple, but I fear that it will not be as much.  That is why people such as myself, who are licensed insurance agents and have gone through the Marketplace and SHOP certifications are here to help you.

My next blog will speak to the Marketplace and Marketplace SHOP.  I will be offering more information as to eligibility, penalties and such.

In the meantime if you feel the need to ask questions, please feel free to do so at info.soraglobal.com and we will be very glad to answer to the best of our ability.

As of October 1st, when the Marketplace goes online I will be able to offer more specific assistance and even get you started on your way to your new health insurance.

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