The upcoming year will be a big one in terms of implementing healthcare reform for both businesses and individuals, as key components of the Affordable Care Act go into play.
Individuals will be required to have insurance for themselves and provide it for their families, and no one can be turned down by an insurance company for pre-existing conditions. Employers with 50 or more employees must provide an insurance plan to their workers.
Brad Johnson, Benefit Consultant with Covenant Insurance and Certified Healthcare Reform Specialist, shared these facts and many others at the Chamber of Commerce's monthly luncheon Wednesday. The house was packed. He says a lot of people are in the dark when it comes to what the new law entails.
Johnson says the financial side of the insurance mandate is going to cost employers more money, and will most likely raise individual insurance premiums between 60 and 80 percent. He says hopefully, there will be a return in society for that investment.
The truth is that no one really knows what's going to happen when Obamacare goes into full swing.
Johnson will be holding a more in-depth workshop on the Affordable Care Act next month. Stay tuned to Sheridan Media News to hear more about his return.
Here are a dozen stipulations currently written into the Affordable Care Act:
-The Affordable Care Act provides for cost-sharing subsidies for families at or below 400% of the Federal Poverty Level. That's approximately $80,000 per year for a family of four.
-New Employees must be covered under their employers' insurance plans immediately—there's no 90-day probationary period for insurance.
-The penalty to an employer for not providing sufficient coverage is $2,000 per employee per year.
-If the employer coverage is considered inadequate under federal guidelines, the fine is $3,000 per employee.
-The employee portion of an employer-paid medical insurance plan cannot exceed 9.5 percent of the employee's total pay.
-The individual penalty for not carrying personal insurance is just under $100 per year.
-Women's preventative care, including mammograms and birth control, must be covered under all insurance plans.
-Kids can stay on their parents' medical insurance plan until they're 26 years old.
-Insurance companies must spend 80 to 85 percent of consumers' premiums on direct medical costs. If they don't, consumers get a rebate.
-The maximum legal out-of-pocket expenses for a family under any insurance plan is $12,500.
-Health care premium costs within a small group must be more balanced. This
means premiums for healthy people will cost more and premiums for sick people will cost less.
-Wyoming has opted out of creating a state insurance exchange, so if a person's employer does not provide insurance and the individual cannot afford private insurance on their own, they must participate in the federal exchange or pay the penalty.