healthcare reform updates: choices for employers and individuals

The Affordable Care Act – What You Need To Know For 2016

Healthcare Reform Updates: Choices For Employers And Individuals

The President signed the Patient Protection and Affordable Care Act (PPACA) into law on March 23, 2010

Makes significant statutory changes affecting the regulation of and payment for many types of private health insurance – many insurance market reforms

Will require almost all private sector employers to evaluate the health benefits they currently offer and consider whether they are compliant

For those without access to employer coverage, new individual mandate to purchase and maintain minimum coverage

PPACA Background

Am I Required To Offer Coverage?What Is Minimum Coverage?What Is “Affordable” For Employees?Do I Want To Offer Coverage?

Key Questions For Employers

1. Offer Coverage Through The S.H.O.P. Marketplace/Exchange

2. Offer Coverage Directly From An Insurance Company

3. Offer Coverage Through A “Private Exchange”

4. Offer A “Defined Contribution” Plan5. Offer A “Salary Adjustment” In Lieu Of

Health Benefits6. Do Not Offer Coverage

Options For Employers (Fewer Than 50 Employees)

Do Not Offer Coverage – Face Potential Penalties

Offer Coverage Directly From Insurance Carrier

Offer Coverage Through A “Private Exchange”

Self Insure/Self Fund

Options For Employers (Greater Than 50 Employees)

Shop For Coverage In The Marketplace Exchange (Delawareans And Pennsylvanians Have The FFM Marketplace/Exchange; Maryland Residents Have the Maryland Health Connection)

Shop For Coverage Directly From Insurance Carriers

Possibly Qualify For State MedicaidPossibly Qualify For Medicare

Options For Individuals (Including Self Employed And Sole Proprietors)

DeductiblesCopaymentsCoinsuranceNetworks Of Providers (National vs. Local)“Metal” Levels (Bronze, Silver, Gold, and

Platinum)

Insurance Particulars To Consider

Federal NavigatorsState Based Marketplace Guides/AssistersInsurance Agents and Brokers

Assistance Available

Summary and Questions

Nicholas A. Moriello, R.H.U.President and C.E.O.Health Insurance Associates260 Chapman Road, Suite 107Newark, DE 19702302-292-0100 (phone)302-292-1961 (fax)nmoriello@hiaofde.comwww.healthinsuranceassoc.comFFM User ID = nmorielloNPN = 1057116Maryland Consumer Assistance Reference ID = 9000122275

My Contact Info