The Affordable Care Act (ACA) has the potential to help millions of Americans secure health insurance. Many individuals are still confused about what the law does and how it will affect them. Let’s have a look at what the ACA means for individuals, families, and businesses.


5 Important Facts about the ACA

  • The ACA is a fairly new law that requires all Americans or legal residents to have health insurance or have a coverage exemption. The law created change in the health insurance industry by preventing insurers from dropping individuals or failing to provide coverage because of certain health conditions.
  • All health plans must provide minimum essential coverage. They also must offer preventative services at no cost.
  • The law does not make health insurance free, but it allows for tax credits that offset the cost for some individuals.
  • Created under the law, the health insurance Marketplace opens for a limited time and offers health care options to most individuals. This includes individuals who already have health insurance and want to compare costs.
  • By 2016, businesses with 50 or more employees will be required to offer employee coverage options.


How the ACA Affects You and Your Family

You must have health insurance or have a coverage exemption, or you will pay a penalty. You can keep your current health insurance plan, but if it is not a qualifying health plan, you may face a penalty. If certain services are excluded from your current insurance plan, research the minimum essential coverage that you must have to avoid a penalty on your taxes. For families with children, dependents can remain on their parents’ health insurance until age 26. Individuals can purchase health insurance even if they may have preexisting health conditions. If you have private insurance and are switching to Marketplace insurance, you can check with your in-network doctor to make sure that Marketplace insurance is accepted.

The Marketplace offers competitive pricing on insurance plans. Plan options can be viewed at Enrollment in Marketplace insurance opens once a year. For the 2014 tax year, the Marketplace will be open from November 15, 2014 to February 15, 2015. The deadline is extended for individuals who encounter a life change, such as marriage or the birth of a child. If you are enrolled in Marketplace insurance and encounter a life change during the year, such as an increase or decrease in income, you must report this change in the Marketplace. Your tax credit will be adjusted accordingly. If you want your health coverage to begin on January 1, 2015, you must enroll by December 15, 2014.


How Businesses Are Affected by the ACA

Businesses with more than 100 full-time employees are required to provide employees with insurance coverage for the 2015 tax year. Businesses that do not offer employees insurance coverage could face a tax penalty. Beginning in the 2016 tax year, this will apply to companies with more than 50 full-time employees. Smaller businesses, or businesses that do not meet the threshold requirement for full-time employees, are not required to offer employees health insurance. If a smaller company wants to offer employees insurance, coverage can be purchased in the SHOP Marketplace and tax credits will help offset the insurance costs for the company.


For more information, you may contact our ACA hotline at 1-800-673-8600.