Obamacare, Ready or Not...

I am in a closed networking group which I would highly recommend to any to any business owner.   My group is Network For Success which meets weekly here in the Cumming, GA area.   As a new business owner, I truly love to hear the detailed presentations given by the members, as I get a chance to learn not only about their business offerings, but about the people and processes behind the store-front.

One of the group members I really respect is Peter Clavijo.   Peter co-owns Employee Benefits of Atlanta, and is educating our group on what to expect with the all-encompassing changes of Obamacare, or as they call it – “The Affordable Care Act”.    While I’m not so sure how affordable it will be in the end for either the employer or the employed, here are a few great pieces of information that he has shared with us, and has allowed me to share on my blog (all comments are strictly my own).   This information came to Employee Benefits of Atlanta via one of their partners, Kaiser Permanente.

Will you qualify for a federal subsidy to help pay your health premiums?

Here is a link to a Subsidy calculator.   http://healthreform.kff.org/subsidycalculator.aspx

This calculator illustrates the premiums and subsidies for people purchasing insurance on their own in new health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act.  Beginning in October 2013, middle-income people under age 65, who are not eligible for coverage through their employer, Medicaid, or Medicare, can apply for tax credit subsidies available through state-based exchanges.

Additionally, states have the option to expand their Medicaid programs to cover all people making up to 138% of the federal poverty level (which is about $33,000 for a family of four).  In states that opt out of expanding Medicaid, some people making below this amount will still be eligible for Medicaid, some will be eligible for subsidized coverage through Marketplaces, and others will not be eligible for subsidies.

Using this tool, you can enter different income levels, ages, and family sizes to get an estimate of your eligibility for subsidies and how much you could spend on health insurance. As premiums and eligibility requirements may vary, contact your state’s Medicaid office or exchange with enrollment questions.

What are the Individual Penalties for not having insurance in 2014?

Click this link (PPACA Individual Mandate Penalty) to view a flow chart to see if you will have to pay a penalty for not purchasing insurance beginning in 2014.  The estimated penalty per adult goes from $94/year in 2014 to $700/year in 2016.   Purchasing health insurance through an exchange would vary by age, but is estimated to be around $5,000/year for an adult in 2016.

Good news though… if you’re in jail or an illegal immigrant, you don’t have to either purchase insurance or pay a penalty! 

What are the Employers’ Penalties for not providing insurance in 2014?

Click this link (employer__penalty_flowchart_1) to view another flow chart, showing the penalties that Employers must pay if they do not offer insurance under Obamacare.    The good news for very small businesses (for now) seems to be that if you have fewer than 50 FTE employees, whose average wages are under $50,000, you will not have to pay a penalty.  Note though that this is for 50 full-time equivalent employees.   One full-time employee, according to Obamacare, equates to 30 hours per week.

Keep in mind that this piece of legislation is still evolving and is undoubtedly extremely complicated.  Make sure to contact your insurance professional to get a better understanding of all the requirements.    Employee Benefits of Atlanta provides individualized guidance and a whole host of benefit products such as life, health, vision and dental for large and small businesses, as well as for individuals and families.  They also customize Executive Bonus and Deferred Compensation plans for valued employees, and have just added identity protection services as well as Pet Care Insurance!

If you have questions or want to know more, contact Peter.

Peter Clavijo, Employee Benefits of Atlanta