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How Does the New Federal Healthcare Law Affect Me?

2013 April 1

There are many elements to the new federal healthcare law, known as the Patient Protection and Affordable Care Act (PPACA). Health plans no longer having maximum lifetime benefit limits or mandatory preventative care services The “individual mandate” that went into effect in 2014 is no longer a federal requirement, though some states uphold this law (MA, NJ, VT, CA, RI, and DC). This requires consumers subject to this law to purchase health insurance which meets a benefit standard set by the federal government or be subject to a tax penalty.

If your employer provides group health insurance benefits, it is likely that your plan will meet the mandate requirement since there are guidelines that employers must follow that are based on benefit design and affordability (or they, too, would be subject to penalties). If your employer does not provide health insurance and you live in a state that upholds the individual mandate, you must purchase a plan and provide proof of coverage to avoid penalties. Your employer is also required, if offering a health plan, to have the employee contribution for single coverage not to exceed 9.5% of their wages or they could be subject to penalties.

Insurance companies can no longer limit, exclude, or deny coverage or charge higher premiums for pre-existing health conditions, expanding your access to plans if you have any such conditions. In addition, PPACA has established subsidies to help individuals and families afford this expense. The subsidies vary by income level and are intended to help within certain poverty level limits reduce their costs to 3-9% of their adjusted gross income.

Visit HealthCare.gov for the most up-to-date information on policy changes and enrollment.