Every day since the launch of the website on October 1 to sign up for the Affordable Care Act, Positively Naperville’s inbox has been flooded with press releases, advice and suggestions regarding the best ways to acquire new health insurance plans.
For many months prior and now weeks since, separating the scams and spams from confusing allegations and legitimate information has been challenging indeed. After much ado and reading until our heads were spinning, a recent newsletter from The Gierach Law Firm appeared to have straight-forward, practical information.
With the Naperville attorney’s permission, we have re-printed items from the newsletter here to try to provide an objective view about the new law with penalties that were ruled to be a tax by the Supreme Court ruling on June 28, 2012.
Note that the “Affordable Care Act” (originally called the Patient Protection and Affordable Care Act) and “ObamaCare” mean the same thing and the two terms are used interchangeably.
Two common mistakes businesses make with the new health care law…
In all the confusion over the launch of “Obamacare” this fall, we have found two common misperceptions among business owners regarding the law. It is unclear at this point whether businesses will be fined $2,000 if they don’t follow the requirements, but you’ll be better off making sure you are in compliance.
Misperception #1: The Affordable Care Act requires only businesses with 50 employees or more to have provided information by Oct. 1, 2013, to employees about the type of health care coverage the business offers.
Fact: All businesses, regardless of the number of employees, must notify their employees about the type of health insurance that is provided. Furthermore, if you are a business with one or more employees and at least $500,000 in annual revenue, you must notify your employees of the new health care exchanges. According to the law, each state was supposed to have health care insurance exchanges up and running by Oct. 1.
Misperception #2: The Affordable Care Act requires large businesses to provide health insurance or face a fine, but since that requirement was delayed until 2015, so was the notification requirement.
Fact: The Oct. 1, 2013, notification deadline is still in effect.
There are several standard notices at the Department of Labor website that employers can download.
One is for employers who offer a health plan to some or all employees and the other covers employers who do not. If you presently have a group health insurance plan, your administrator may provide you with the proper forms to fill out and many will fill them out for you.
It is a good idea to keep a copy of the signed notice in each employee’s personnel file to prove that notice was properly and timely given. There was some suggestion that the Department of Labor would fine companies for failing to give such notice, but another government agency, SBA, stated that there would be no fine at this time.
Look forward to more deadlines ahead.
And one common mistake individuals are making…
Individuals are confused about the start of affordable care
Because the Obama administration delayed until 2015 the rule that businesses with 40 or more employees must provide health care insurance to workers or face a fine, many individuals think the rest of Affordable Care Act is also on hold. This is not true.
Fact: All individuals and their dependents must have minimum health insurance coverage by Jan. 1, 2014.
The coverage can be obtained in one of three ways: from an employer, through a state exchange or marketplace, or through a federal program such as Medicare or Medicaid.
Before the new law, many Americans chose not to purchase insurance or were unable to do so due to pre-existing conditions. Starting in 2014, everyone is required to participate. This ensures that everyone is covered in case of illness or accident, and creates a larger pool of cash from which those who need insurance may draw. It is similar to paying taxes to support police and fire services, even if an individual never has an emergency.
However, some low-income individuals are exempt from the new health insurance mandate.
Those individuals whose share of premiums may exceed 8 percent of the household’s adjusted gross income and those who are ineligible for employer coverage if the cost of a basic bronze level plan (less any federal tax credit) still exceeds 8 percent of the household’s adjusted gross income.
Those individuals who are uninsured after the start of 2014 face a penalty of the higher of: $95 per person plus $47.50 for each family member under age 18, with a ceiling of $285; or, 1 percent of the excess of the taxpayer’s household’s adjusted gross income over the amount of income that is necessary to be required to file a tax return. The penalty is paid annually on the Federal Form 1040 filed by the individual.
Some, including the Supreme Court, refer to this penalty as a tax, but no matter what it’s called, it is scheduled to be significantly larger in 2015 and 2016.
The one year postponement of the employer mandate means employer reporting is voluntary in 2014. The IRS may not have the information to be able to enforce the individual penalty.
Currently the IRS has limited ability to enforce the law. It cannot file a lien, levy a person’s assets or charge interest on the amount owed. It can only offset the penalty amount against a tax refund.
This law has been controversial and caused much disagreement. But one thing almost everyone can agree on is that it is extremely complex.
—Denice A. Gierach, The Gierarch Law Firm
For more information, visit GierachLawFirm.com.
In our view… A little history with a reminder to pay attention to changes going forward
On March 23, 2010, President Barack Obama signed an expansive health reform bill into law to engage all Americans. This all- encompassing law that governs a projected one-sixth to one-eighth of the nation’s economy over the next decade at first promised to help families find affordable, reliable health coverage. Proponents said that coverage would cost less, cover pre-existing conditions and would not disappear if individuals lost a job or got sick.
Will the promises of this health care insurance reform be met? More than three years after the President signed the historic law, all those promises have become a complex part of the big debatable question.
Editorials expressing the pros and cons of the Affordable Care Act began appearing more than four years ago. Certainly, no one we know thinks anyone should go without needed health care. Everybody agrees that healthcare costs as well as health insurance costs are high and at issue. Most people advocate for stronger, better American health care for patients as well as health-care professionals.
The web site launch
This post has been ready to go for more than week. PN waited to see how the website launch would go. Since the launch of available sign-up opportunities began on Oct. 1, 2013, the Chicago Tribune and Investors Business Daily have shed light on the roll-out across the nation and why the concept of simple sign-up is reported to be stressful and challenging.
A report on the front page of the weekend edition of USA Today on Oct. 18, 2013, says that HealthCare.gov was built with 10-year-old technology. Confusion also has been expressed from applicants with privacy concerns regarding who will see the input of data. Confidence continues to be rocky when it’s time to hit “submit” or “accept.” Plus, plenty of assumptions have been made that everyone has an e-mail and/or is Internet savvy enough to be comfortable and trusting to enroll online.
On Oct. 18, a forwarded post from the White House showed some success stories.
A Google search for more success stories revealed repeated reports that say 7 million Americans must be signed up by the end of March and 2.7 million of them need to healthy young people to cover the costs of the sick and older people.
An Oct. 20, 2013, story in the Daily Herald taken from the Washington Post includes a Q&A with Robert Laszewski, president of Health Policy and Strategy Associates, that also provides insights into ups and downs of the ACA website.
Patience and time will tell if it can be fixed.
A few ways to sign up in Illinois
Health Insurance Market is available here.
Health Care Reform in Illinois is feature here.
Many insurance providers such as Humana invite clients to find out more about ACA via their websites.
Direct Phone Line Available to Call Centers: 1-800-318-2596.
This year, as in every year, individuals will make important decisions for themselves and their families about health care. They can apply for coverage through the Marketplace: Online at Health care.gov; Over the phone by calling the 24/7 customer service center (1-800-318-2596, TTY 1-855-889-4325); Working with a trained person in their local community (Find Local Help); or by submitting a paper application my mail.
According to a news release received on Oct. 24 from Kathleen Sebelius, Secretary of Health and Human Services, the six-month enrollment period has just begun. She wrote, “And unlike a sale on Black Friday, coverage will not run out; it will not get more expensive. Sign up by December 15, 2013 for coverage starting as early as January 1, 2014. Open enrollment continues until March 31, 2014.
“To read more about the how the Affordable Care Act addresses the unique needs of women, visit: http://www.hhs.gov/healthcare/facts/blog/2013/08/womens-health-needs.html.”
Again, constant messaging says that Dec. 15, 2013, is the deadline to complete the ACA Enrollment Process. Illinois residents can go to www.getcoveredillinois.gov to start the process and assure coverage starting Jan. 1, 2014. Pay attention.
This post has been updated.
