What to expect on Affordable Care Act in 2014
• Coverage kicks in: Millions of Americans have been signing up — or attempting to sign up — for a health insurance plan since the exchanges opened on Oct. 1. Those people can take advantage of their health plan and the related federal subsidies.
• Individual mandates get real: The mandate is here and if you’re not enrolled in a qualified health plan either via the individual market or through an employer or other group plan by March 1, you can expect a bill for $95 or 1 percent of your income, whichever is higher, to arrive on your doorstep later this year, unless you fall into one of the exception categories.
• Insurance exchanges: In every state must be up and running. Obviously “up and running” is a loose term.
• Insurance subsidies: Premium tax credits and cost-sharing reductions kick-in for those who are eligible.
• Medicaid expansion begins: The Supreme Court ruled to expand the program. As a result, in 2014 as many as 3.9 million more low-income Americans will have access to the public assistance program.
• Small business tax credit: Small businesses are eligible to apply for a small business tax credit that would help purchase health coverage for their employees. The credit is supposed to expand to more businesses. The “catch” is very few small businesses actually qualify for the credit and now they can only use it to buy Small Business Health Options Program exchange coverage.
• Individuals and businesses: The new national premium tax, which will ultimately be a pass-through fee from the insurer to all consumers of fully-insured individual and group health insurance, goes into effect. The tax will collect $8 billion in 2014, increasing to $14.3 billion in 2018 and increasing based on premium trend thereafter.
• Ninety-day maximum waiting period: This requirement for all employer plans goes into effect.
• Cost-sharing limits: Group health plans, including self-funded plans, may not have out-of-pocket costs that exceed the annual Health Saving Account contribution maximum.
• Annual or lifetime limits are no more.
• Greater wellness discounts: Employers may now offer a discount up to 30 percent for employee participation in a wellness program.
Source: National Association of Health Underwriters