A ROCKY START

A ROCKY START

 

 

The October 1, 2013 open enrollment period for the Affordable Healthcare Act in to the Nevada Health Link exchange got off to a rocky start with computer glitches preventive people anxious to see what types of health insurance coverage’s are available to them and how much is it going to cost. Officials of the Nevada Health Link have been working tirelessly to fix these computer program problems so perspective shoppers can apply for coverage. I anticipate next week will be a tab bit smoother than the opening week.

However another type of glitch has come to light in the last week; the “Family Glitch”.

Expert analysts are saying that nationwide as many as 500,000 children might be left without insurance coverage because of this glitch. What is the family glitch?

The Affordable Healthcare Act defines affordable as the cost of insurance not costing more than 9.5% of a persons or families adjusted annual income. For full time employees that are insured through an employer group plan and they pay no more that 9.5% of the employee’s adjusted gross income means his/hers coverage is affordable and cannot apply for coverage through a government run exchange and obtain a subsidy for their health insurance premium. Now there is the glitch; if the employee has dependents and is not insuring them on the group health insurance plan because of the high premiums, the dependents cannot obtain a subsidy through the exchange either as they are eligible for an “affordable” group health plan.

How can this happen? It’s the way the law was written. This is what happens when congress passes a bill that is so complicated and rushes into passing it for political reasons. Why can’t congress just change it? I believe it will eventually be fixed but it won’t be anytime soon. The republican controlled house has been trying to defund the ACA (Obamacare) law and this is a perfect opportunity to show off the laws shortfalls. Who suffers; well of course the families that were hoping to find affordable health insurance through a subsidized plan.

This does not mean that dependents cannot purchase plans either in the Nevada Health Link exchange or off exchange, they just cannot realize a subsidy to help pay of it. However the insurance premiums for dependents are extremely high on group health insurance plans and it’s been common practice for workers with the State of Nevada, the Carson, and Douglas, Washoe school districts to waive coverage for their dependent spouses and children and insure them on an individual policy. This will continue and this coverage will continue to be less expensive than group coverage for dependents.

There will be excellent plans offer by Anthem Blue Cross and Blue Shield, Saint Mary’s Health, Health Plan of Nevada. The open enrollment begins October 1st and will run through March 1st, 2014. However enrollment must be completed and initial premium paid for by December 15th in order for coverage to begin January 1, 2014. After January a person can still enroll but the effective date will be delayed by 60 days, if someone enrolls in January the coverage would begin on March 31st.

If someone misses the enrollment period after March 31, 2014 they must wait until the next open enrollment period October 2014. If someone loses their job based coverage they will have a 30-day special enrollment period to enroll in an individual health plan. There is a tax penalty for not having a health insurance plan meeting the standards of the ACA law’s “essential health benefits”. The penalty is 1% of adjusted gross income with a minimum of $95 in 2014, 2% in 2015 and 2.5% in 2015. This penalty is taken right form your tax refund.

This will be a complicated process, call a licensed agent or broker for help as they are the only ones the can legally provide advice in which plan is best for your family’s needs. A Navigator with the Nevada Health Link and merely explain the differences of the plans offered.