The Affordable Care Act (ObamaCare) in a Nutshell*
- EVERY Legal Resident of the United States, including children must have Minimum essential coverage starting in 2014 and on, or else face a penalty. Click here for the requirements of Minimum Essential coverage?
- No more pre-existing conditions or exclusions
-This means that no one can be turned down for Medical Insurance for any reason, and there will no longer be waiting periods on claims for pre-existing conditions. If you have a pre-existing condition, it will be covered as any other illness.
- Dependents are allowed on plans up to the age of 26
- Every Child up to and through the age of 18 must have Dental coverage and preventive vision/screening.
- It is possible to receive Premium subsidies and/or Out-of-Pocket Assistance to help you pay for your coverage depending on your income. Learn more about Income Requirements Here
- Covered California is California’s Exchange/Marketplace where Individuals, Families and Small Businesses can go to Purchase Medical insurance with the possibility of receiving Premium subsidies and/or Out-of-Pocket Assistance, as well as Tax Credits for Small Businesses.
*The Affordable Care Act is an Extensive law and there are many different variables that can affect how this law applies to you, your family and businesses. It is Always advisable to seek the help of a Professional Insurance Agent that can help you One-on-One to ensure that you are properly complying with this law.
What are the Penalties if I do not have Coverage?
Under the Affordable Care Act it Americans that do not have Minimum Essential Coverage will be penalized with a fine/tax in a completely new box on your taxes.
Learn About Penalties here...
What about Employer Coverage?
Large Employers with 50 or more Full-time Equivalent Employees, must offer “Affordable” Minimum essential coverage to Employees. and their Dependent Children*
- Affordability is calculated for the Employees wage only.
-What is Affordability and how do I figure out what my Affordability is? Click here to find out.
-*large Employers are not required to contribute to the dependent children
-Large Employers are also NOT required to offer coverage, or contribute to Spouses
-If your Large employer does not offer coverage to your spouse or dependents, they may go to Covered California to see if they qualify for assistance.
What about Small Employers that employ less than 50 Employees?
- According to the Affordable Care Act, Small Employers are NOT required to offer coverage to their employees, If they do offer coverage the Employer does not have to adhere to the “Affordability” requirements.
- If they do offer you coverage you may elect to take your employer’s plan, but you are not obligated to take that plan if the plan is not “Affordable.”
- HOWEVER, if the coverage offered happens to be “Affordable” you may NOT go to Covered California to receive assistance.
- For your spouses and dependents; if they are offered coverage by your employer even though the employer may not contribute to them. They WILL NOT be able to go to Covered California to apply for Financial assistance. But they may still purchase an “UN-subsidized” plan from Covered California or “Off-Exchange”
- What is affordability, and how do I figure out my affordability. Click here to find out.
My Employer DOES NOT offer Me or my Family Insurance. Do I have to go to Covered California?
Or, Can I get my Insurance from somewhere else?
Of course not! Coverage can be purchased directly with carriers “Off-Exchange” or “On-Exchange” through Covered California. But remember, Covered California is the only place to apply for Advanced Premium Tax Credits, and Cost Sharing Reductions.
So how do you get help?
Contact Us! Let us help you make an informed decision about your Family’s Healthcare and Insurance needs, “ON or OFF-Exchange.”