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Health Care Reform:

Health Insurance & Affordable Care Act

How Health Care Reform Affects Employer Plans

Health insurance through your workplace might change for 2014. Many employees may have more choices for an affordable health plan. If you already have insurance through your job, health care reform may give you more choices.

How Your Health Insurance Could Change

Depending on the size of the company you work for, you could get insurance through your job for the first time.

If you've been getting health insurance from your employer, you may not see any changes. But you might have a change like one of these:

  • Your company may stop offering health insurance.
  • Your company could decide to cover workers but stop insuring their families.
  • You could decide not to get health insurance through your job and instead buy insurance through your state’s health insuranceMarketplace, also called an Exchange.
  • You might have to pay more for your health insurance.


Why the Size of Your Company May Matter

If you work for a company with fewer than 50 full-time workers, you might be able to get health insurance from your job for the first time. Your company may choose to do this because small businesses can now get a tax break for offering insurance.

But keep in mind that small companies do not have to offer health insurance.  Employers with fewer than 50 employees don't have to pay a penalty for not offering insurance.

If your workplace doesn't offer health insurance, you can buy it through your state's Marketplace.

If your company has 50 to 99 full-time workers, by 2016, it must offer affordable health insurance with at least minimum coverage for you and your dependents. Your dependents are your children up to age 26. Your employer is not required to cover your spouse. If your company doesn't offer this level of insurance it will have to pay a penalty.  Some big companies may choose to pay the fine.

If your company has 100 workers or more, it has to provide insurance coverage to at least 70% of full-time employees in 2015 and 95% in 2016 to avoid tax penalties.

What to Do if Your Job's Insurance Is Too Costly

You do not have to enroll in the insurance offered at your place of work. Instead, you can buy insurance through your state’s health insurance Marketplace.

Through the Marketplace, you'll be able to pick a plan that fits your needs and your budget. You also may get a tax credit to help you pay for the insurance.

You can buy insurance through a Marketplace starting in October 2013.

How You'll Know About Your Choices at Work

Your workplace must tell you in writing about any changes to your insurance. According to the Affordable Care Act:

  • At least 30 days before any changes take place, your employer must give you a letter about your health coverage.
  • The letter must give you information about your state’s Marketplace and tell you how to contact the Marketplace for help.
  • Your employer must tell you in writing if the plan doesn't meet minimum guidelines. The law says the insurance your workplace offers must pay for at least 60% of your covered health care costs. If it doesn't, you can buy insurance through your state's Marketplace, where you may be eligible for financial aid from the government to help you pay part of your premiums if your income is low enough. 
  • Your employer must tell you if a health plan offered is "grandfathered." If your employer still offers a health plan it did on March 23, 2010,  that plan does not have to meet certain protections from the Affordable Care Act. For instance, a grandfathered plan doesn't have to offer free preventive care.
  • Your employer must tell you by late summer/early fall 2013 if you will no longer be getting tax-free financial help from the company to help pay for your health insurance.

The insurance your employer offers must be an affordable health plan. The law says it should not cost more than 9.5% of your family’s income. If it does, you may want to buy coverage through your state Marketplace. There, you may be able to get a tax credit to lower your monthly insurance cost, called the premium. Or you may be eligible for Medicaid .

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