healthcare reform updates: choices for employers and individuals
TRANSCRIPT
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)[email protected] User ID = nmorielloNPN = 1057116Maryland Consumer Assistance Reference ID = 9000122275
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