PPACA-The Individual Mandate

The Patient Protection and Affordable Care Act (PPACA) basically provided that as of the 1st January, 2014 all US residents are required to have “minimum essential” health insurance failing which they will pay a penalty (subject to certain exemptions).

Individual mandate enrollment penalty-cancelled!

Individual subsidies.

Afraid you won’t be able to afford insurance? If you buy on a marketplace(exchange) as an individual or for a family, you may qualify for a subsidy in the form of an advance tax credit if your household income is between 100% and 400% of the federal poverty line(FPL). (The tax system already subsidizes people who have coverage through a job by excluding the cost of their health plan from income taxes.) While those with less than 250% (FPL) will also get subsidies to reduce their out of pocket costs such as deductibles, copayments and coinsurance.

These tax subsidies will cap the cost of health insurance at 2% to 9.5% of household income, if the household income is up to 400% above the FPL.

HOWEVER, individuals are only eligible for tax subsidies if they are NOT offered qualified, affordable group health insurance through an employer

Here is a calculator from the Kaiser Family Foundation to let you know an estimate of what the tax credit for the premium may be if you applied for health insurance coverage on the marketplace/exchange.

PPACA also required the creation of state/federal based marketplaces ( American Health Benefit Exchanges) through which individuals/families can purchase coverage and also a Small Business Health Options Program (SHOP) Exchange through which small businesses can purchase health insurance coverage.

Also, anyone with existing coverage meets that mandatory requirement PROVIDED that it was in place 3/23/2010 when PPACA became law as it is regarded as “grandfathered”.It does not matter if the plans do not meet the “Essential Elements” requirement of the PPACA based plans nor that they may be unaffordable.

So they do not have to do anything at this time or the 1/1/14 because of the grandfathered status.

As of 1st October, 2013 through 3/31/2014 ( Enrollment Period) the health insurance marketplaces will offer Qualified Health Plans (QHPs) that are the same high-quality health plans available on the private market today.
These QHPs will provide the essential levels of coverage and comply with consumer protections set forth in the Affordable Care Act and will include a “catastrophic coverage” designed for people aged up to 30.

There will be people to assist the public to use the marketplaces called “navigators” but they are not qualified or licensed insurance agents/brokers and cannot advise anyone as to the suitability or otherwise of any healthcare insurance plan/coverage!!

For further information including cost/premium estimates contact:

Eric Walters.
Eric Walters Insurance Services,
TeL: (480)-657-8595
FaX: (888)-739-0796
CELL: (602)-616-1660/ Email: ewinsurance@gmail.com / Eric’s WEB site

REMEMBER- the Health Insurance Marketplaces ( the Exchanges) opened October 1, 2013 for enrollment and anyone can use a qualified insurance agent/broker who is authorised to use the marketplaces by CMS to assist them AT NO COST!!.

Eric’s web site

Get your individual/family coverage/quote now: healthcare.gov

Don’t forget to ADD our FMM ID-EWALTERS37 and our NPN- 8594684 when setting up to your account!

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