HEALTH CARE REFORM UPDATE FOR AVOYELLES PARISH SCHOOL BOARD

EMPLOYEESPrepared by: APSB Finance Department

Introduction

The Patient Protection And Affordable Health Care Act, (known as Obamacare) has made recent headlines upon the Obama Administration’s decision to delay a key provision—the requirement that all but smallest employers offer medical coverage or pay a fine. Meanwhile, other parts of the law remain on track for implementation next year, according to officials.

The following is an update as to how the Act will effect your health benefit as an employee of the Avoyelles Parish School Board.

Health Care Reform and the Individual Mandate

Current Status-Individual Mandate

January 1, 2014 the Acts individual mandate takes effect. (This is different from the employer mandate which has been delayed until January 2015).

The individual mandate requires most individuals to obtain health insurance or pay a penalty. The penalty is applicable to you and your dependents.

In general, penalties start at $95 (per adult) in 2014 and rise to $695 (per adult) in subsequent years. (There are also possible penalties for family dependents). Please go to www.healthcare.gov for more details.

QUESTION: Does being a member of the Office of Group Benefits /Blue Cross Health Plans qualify to meet the individual mandate?

Does being a member of the OGB/Blue Cross Health Plans qualify to meet the individual mandate?

GOOD NEWS: OGB(Office of Group Benefits/Blue Cross) Group Health Plans coverage meets the requirements of the individual mandate.

ANOTHER QUESTION – How will you know if you want to:

• 1- Purchase coverage on the government’s Healthcare Marketplace Exchange?

• 2- Purchase your own private insurance?

• 3- Enroll in one of the OGB Plans?

DUE TO THE INDIVIDUAL MANDATE, YOU WILL HAVE 3 OPTIONS FOR HEALTH CARE COVERAGE BEGINNING IN 2014

Let’s start with #1:

1. The Government’s Healthcare Marketplace Exchange

2. Your own private insurance.

3. Office of Group Benefits/Blue Cross Health Plans.

Government’s Healthcare Marketplace Exchange

The law requires each state to provide public insurance marketplaces/exchanges to provide you with another source to compare health insurances based on price, benefit and quality. This gives you the opportunity to compare available plan options based on price,

benefits, and quality.

Since Louisiana is not prepared to operate a marketplace by January 2014, the federal government intends to operate the marketplace for the state’s residents.

Depending on your individual income level you may be eligible for a tax credit or subsidy when shopping at the public Government Health Marketplace.

You should reserve all of your options.

Please visit www.healthcare.gov for more information.

Explaining The Health Insurance Marketplace

Enrollment in state and federal exchanges is scheduled to begin October 1. Here’s what you need to know.

While some provisions of the Affordable Care Act (ACA) have been delayed another year, the Health Insurance Marketplace is still scheduled to go into effect in January 2014. Starting in October 2013, the Marketplace will allow individuals to look for and compare private health plans, get answers to questions about health coverage options, and enroll in a health plan.

Employers who offer health insurance are required to provide their plan members with information on the services and tax credits they may be eligible for through the exchange. Common questions about your OGB plan are answered below.

Explaining The Health Insurance Marketplace

Can I Get Health Insurance from the Marketplace?

While you may be able to get health insurance through the Marketplace, your OGB plan meets the standards required by the ACA. Because of that, you probably won’t be able to save money on your monthly premiums or out-of-pocket costs through a Marketplace plan. You can find out for sure at healthcare.gov.

Will I Have to Pay a Fee if I Don’t Get a Plan Through the Marketplace?

No, you don’t need to change to a Marketplace plan in order to avoid the fee that uninsured people may have to pay for 2014. Your OGB health plan meets the standards required by the ACA.

Explaining The Health Insurance Marketplace

Could I Save Money With a Marketplace Plan?

Probably not. Most people who get health insurance through their employer will not save money by moving to a Marketplace plan. Whether that’s true for you depends on your household size and income.

Explaining The Health Insurance Marketplace

Because OGB’s plan offerings meet the standards required by the ACA, you’re not eligible for subsidized coverage through the Marketplace. However, if the cost of the OGB plan that covers you (and not any other members of your family) is more than 9.5% of your household income for the year, you may be eligible for a tax credit. If you buy a policy from the exchange without meeting the 9.5% rule, you may have to repay any subsidies or credits received.

Explaining The Health Insurance Marketplace

As you’re considering your options, be aware that because the plans OGB offer meet ACA requirements, you may not qualify for lower costs on your monthly premiums and out-of-pocket costs, even if your income would qualify you otherwise. Also keep in mind that the State currently pays a portion of your premiums. If you choose a Marketplace plan instead, the State will no longer make a contribution to your premiums.

Explaining The Health Insurance Marketplace

Resources

Healthcare.gov

Run by the federal government, this site offers a comparison tool, answers to frequently asked questions, and the opportunity to enroll in insurance through the exchanges.

LHEC.net

The Louisiana Healthcare Education Coalition, led by Blue Cross Blue Shield of Louisiana, provides this site with information about the ACA, healthcare exchanges, and links to articles and resources that can help you understand the new option.

KFF.org/health-reform

The Kaiser Family Foundation site provides a calculator that estimates how a Marketplace plan could impact your family.

DUE TO THE INDIVIDUAL MANDATE, YOU WILL HAVE 3 OPTIONS FOR HEALTH CARE COVERAGE BEGINNING IN 2014

1. The Government’s Healthcare Marketplace Exchange.

2. Your own private insurance.

3. Office of Group Benefits/Blue Cross Health Plans

PURCHASE YOUR OWN PRIVATE POLICY

As it is today, you will have various sources to purchase private health insurance. Traditionally this has been the most expensive vehicle for having health coverage. It’s important that you compare rates and coverage when considering this option.

Be sure the policy you are considering to purchase meets the qualifications for the individual mandate. Details of these requirements can be found at www.healthcare.gov.

DUE TO THE INDIVIDUAL MANDATE, YOU WILL HAVE 3 OPTIONS FOR HEALTH CARE COVERAGE BEGINNING IN 2014

1. The Government’s Healthcare Marketplace Exchange.

2. Your own private insurance.

3. Office of Group Benefits/Blue Cross Health Plans

Annual Enrollment 2014

Health plans being offered effective January 1, 2014:

Blue Cross PPO (nationwide plan)

Blue Cross HMO (nationwide plan)

Blue Cross High Deductible with HSA (nationwide plan)

Vantage Health (not available in all regions)

There are no expected changes in any of the plans for 2014.

Premiums are expected to remain the same as August 2013(next slide).

Office of Group Benefits Information

OGB/Blue Cross health benefit plan annual open enrollment is October 1-31, 2013 for effective date of coverage to begin January 2014. Any changes made during open enrollment will be effective January 1, 2014.

Possible changes would be:

Apply for health insurance

Change to a different health plan

Add or remove dependents

Address or marital status change

If NO CHANGES are necessary with your policy, NO ACTION IS REQUIRED.

WHAT YOU NEED TO DO NEXT

CONSIDER THE CHANGES New healthcare reform begins on January 1, 2014.

You must have health care coverage or pay an Individual Mandate penalty.

You can choose to obtain health insurance from the Government Marketplace Exchanges, purchase your own private policy, or enroll in the OGB/Blue Cross Plan.

APSB will have a health care package available to eligible employees (in October 2013) that should exempt you from these penalties.

Ask questions if you have doubt:

About the APSB plan, visit www.groupbenefits.org

Or contact the APSB Finance Office at 318-240-0227.

ATTENTION: THOSE EMPLOYEES WHO ARE COVERED WITH HEALTH INSURANCE OTHER THAN THE AVOYELLES PARISH SCHOOL BOARD

As your employer we will offer you health insurance, however, if you currently have health coverage, proof must provided.

During the annual enrollment period (October 1-31, 2013) you will be required to complete a document declining coverage with us.

THE NEXT BIG STEP

KEY MILESTONES

Further Government guidelines about the Healthcare Act to be released in late September 2013.

Health care reform begins on January 1, 2014.

Remember, you must have health insurance coverage. If not, there will be individual mandate penalties!!

TO SUM UP

New Health Care Reform goes live on January 1, 2014.

You can apply for marketplace coverage as early as October 1, 2013.

You must have health care coverage or there will be individual Mandate penalties

You have to choose between OGB/Blue Cross Health Care Benefits, government health insurance or a private policy

ONE BIG REMINDER!!!

AS WE HAVE ALREADY SEEN, THE GOVERNMENT MAY CHANGE THE DATES, DEADLINES, CRITERIA,

ELIGILIBILITY AND OTHER ELEMENTS OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT…

ALTHOUGH APSB INTENDS TO KEEP YOU ABREAST OF SUCH CHANGES AND INFORMATION, IT IS YOUR

RESPONSIBILITY TO STAY CURRENT WITH THE LAW AND WHAT IT MAY MEAN TO YOUR CHOICES AND DECISION

FOR HEALTHCARE.