With the passage and implementation of the Affordable Care Act, accessing health insurance and health care is changing. Dancers’ Group will continue to update this page as resources and information become available.
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The Affordable Care Act aims to expand health coverage through a series of provisions that include:
- Individual Mandate: Mandates all Americans, with some exceptions, to maintain a minimum level of health coverage or face a tax.
- Insurance Exchanges: Creates health insurance Exchanges and provides premium tax credits to assist eligible individuals with the purchase of coverage.
- Medicaid Expansion: Allows state to expand Medicaid up to 138% of federal poverty level.
- Employer Mandate: Mandates employers with 50 or more full-time equivalents to offer coverage to full-time employees and their dependents (applicable only to children, not spouses) or pay taxes if an employee obtains Exchange coverage and a premium tax credit.
- June 2013: Centers for Medicare and Medicaid Services opens a 24-hour call center to field questions about Exchanges and coverage options. Healthcare.gov is re-launched.
- October 1, 2013: Exchanges begin open enrollment period; employers must begin providing Fair Labor Standards Act coverage notices to employees by October 1 and to new hires beginning October 1.
- January 1, 2014: Medicaid expansion and availability of premium tax credits for Exchange coverage begins. Beginning one-year transition period for employer penalties and information reporting requirements.
- January 1, 2015: Employers generally must be in compliance with coverage requirements. (Note: The Administration provided a transition period for employer tax penalties. This does not delay implementation, but penalties will not apply until 2015.)
FAQs about Covered California:
When can I buy health insurance in Covered California, California’s health insurance marketplace?
Starting on October 1st, you can shop for, compare and purchase health insurance all in one place. It’s your health care, made simple. With your new coverage, you can access health care providers starting January 1, 2014.
Which health insurance providers can I choose from?
Each region of the state has different providers to choose from. For example, as a San Franciscan, you may select amongst the following proven health insurance providers: Anthem, Blue Shield, Chinese Community Health Plan, Health Net, and Kaiser Permanente. All will offer the essential levels of coverage and consumer protections that you deserve.
What different plans are available?
Covered California’s plans are designed to fit your needs and your budget. Plans will be offered at four levels of coverage: Bronze, Silver, Gold and Platinum. The plans vary in monthly payments and the amount of health care-related costs they will cover. A Bronze plan will lower monthly payments for you and your family, but increase the amount you pay for a doctor visit or a necessary procedure. Platinum plans will have a higher monthly payment, but that will translate into lower costs when you need medical coverage the most. For more information about the levels of coverage, please click here.
How much will the plans cost?
For individuals with the lowest income levels, coverage will be completely free in Medi-Cal, California’s Medicaid program. For other incomes, discounts may apply. For example, individuals making up to $45,960 and families earning up to $94,200 may qualify for tax credits that will pay a portion of the health insurance plan you select. With these tax credits, a single parent with two kids, making $40,000 annually, could pay as little as $216 a month for a Silver plan covering the whole family. To determine how affordable your coverage will be or if you or your family qualifies for a discount, please click here.
Am I eligible for free health care?
Two million more Californians will have access to free health care in 2014, thanks to the expansion of Medi-Cal, California’s Medicaid program. Those eligible include people under the age of 65, including those with disabilities with an income of less than $15,000 for an individual and $31,180 for a family of four.
What If I am on Medicare?
If you are already on Medicare, you will simply continue to keep your current coverage. But that doesn’t mean you will not benefit from health care reform. Thanks to the Affordable Care Act, the life of the Medicare Trust Fund has been extended by ten years. Additionally, according to the Department of Health and Human Services, more than 6.6 million seniors in the Medicare Part D “donut hole” coverage gap have already saved over $7 billion.
What if I am undocumented?
If you live in San Francisco and are undocumented, you will continue to be eligible for care through Healthy San Francisco. Only legal residents of California will be eligible to purchase health insurance through Covered California.
What if I own a small business?
Under the Affordable Care Act, it is completely optional for small businesses to choose to offer employee coverage. If you choose to do so, offering affordable health coverage to your employees just got easier. On October 1st, your small business can enroll in the Small Business Health Options Program (SHOP) for coverage that begins in 2014. The SHOP marketplace will make it simple for small business owners and workers to pool their buying power and carry out one-stop shopping for affordable plans.
Additionally, your business may qualify for a small business tax credit that could cover up to half of your premium costs for covering your employees. This tax credit is only available for plans purchased through SHOP.
What qualifies as a small business?
Covered California’s small-business program is designed for any business or organization with up to 50 eligible employees. You must have at least one employee other than yourself who receives a W-2 tax form at the end of the year. If you are self-employed without any employees, you are not eligible for the small-business program but should look into the individual marketplace operated by Covered California. Similarly, if those who do work with you receive 1099 tax forms at the end of the year, they are not considered “employees” and therefore should look into the individual marketplace.
What if I am on Healthy San Francisco?
Getting affordable health insurance means you are covered when you need it the most. The health insurance provided under Covered California or Medi-Cal will be much more comprehensive than Healthy San Francisco. Your Healthy SF Application Assistor will help you choose the right health insurance program for you and your family through Covered California or Medi-Cal. For more information, visit here.