How Healthcare Will Change Under the Affordable Care Act

Health Insurance Marketplace Q & A
With the health care mandate under the Affordable Care Act (commonly referred to as
“Obamacare”) on the horizon, many questions abound. As of January 1, 2014 most Americans
will be required to carry health insurance or face a penalty. In response, 16 states and the
District of Columbia have set up health insurance exchanges through which eligible individuals
can compare rates and purchase health plans. In the 27 states that elected not to set up
exchanges individuals will be able to purchase insurance through a federal exchange. People
who already have affordable coverage through an employer-sponsored plan will generally not
need to do anything.
Below we address some questions surrounding the health insurance marketplace. This is not an
exhaustive list, but rather provides answers to some of the most common questions.
Who is Eligible to Buy Coverage through the Healthcare Marketplace?
Any American citizen can opt to purchase health insurance through the marketplace, however
not everyone will necessarily qualify for a subsidy to help cover the cost of coverage.
Individuals whose income is less than around $46,000 or $94,200 for a family of four may
qualify for a subsidy.
When Will I Have to Buy Insurance Under the New Law?
Most Americans will be required to have health insurance by January 1, 2014. Exceptions
include seniors on Medicare and those who qualify for state and federal assistance programs
like Medicaid, and others.
When Can I Buy Coverage through the Exchange and When is My First Payment Due?
Enrollment began October 1, 2013 and individuals have until March 31, 2014 to enroll, however
people will need to make their first payment by December 15, 2013 in order to be covered when
the mandate takes effect.
How Do the Plans through the Exchange Compare to My Current/Former Plan?
The plans through the exchange are offered on a tier-based system and include bronze, silver,
gold and platinum level plans. The plans with the higher value metal cover more but have a

higher premium, while the plans with the lower value metal cover less but have a lower
premium. Familiar types of plans such as HMOs and PPOs will be offered through the program.
Insurance companies cannot deny coverage based on pre-existing conditions and all plans
must cover 10 essential health benefits under the law, including emergency and hospital care,
prescription coverage and more.
What is the Penalty If I Don’t Have Insurance?
For 2014 the penalty for not having insurance is $95 per adult and $47.50 per child, or 1 percent
of taxable income, whichever is greater. This will increase as time goes on, eventually maxing
out at 2.5 percent of taxable income.
Where Can I Sign Up?
If your state has set up an exchange you can sign up through the state-run website, or if you live
in a state that did not set up an exchange you’ll need to sign up through healthcare.gov.
Residents of California can sign up through Covered California, or contact an exchange certified
agency. Benefit Packages is exchange certified and our agents are specially trained on the
healthcare mandate. We can help you understand your options for affordable coverage both
inside and outside the exchange, and we work with reputable carriers like Anthem Blue Cross
and Blue Shield of California. There is no time to waste—enrollment began on October 1, 2013.
Contact us today to sign up for coverage before the January 1, 2014 deadline at 1-800-356-
3615 or visit our website.