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The Ever-Changing ACA

The Ever-Changing ACA. Modifications, Revisions, Delays of ACA Provisions In 2013. “Basic Health Plan” (BHP) Delays. Basic Health Plans delayed for one year BHPs are options for States For low income Income too high for Medicaid But close to Medicaid line

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The Ever-Changing ACA

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  1. The Ever-Changing ACA Modifications, Revisions, Delays of ACA Provisions In 2013

  2. “Basic Health Plan” (BHP) Delays • Basic Health Plans delayed for one year • BHPs are options for States • For low income • Income too high for Medicaid • But close to Medicaid line • Earning 138% to 200% of FPL • BHP regulations to be provided to States in 2015

  3. “SHOP Plans” Delay • Small businesses offered only one plan in 2014 • Additional competitive plans to be offered in 2015 • SHOP offers unsubsidized plans to employers w/less than 50 FTEs

  4. “Employer Mandate” Delay • Employers w/ more than 50 FTEs to pay penalties if do not offer “affordable” “minimum value” benefits to all FTEs • Penalties delayed until 2015 • So ‘large’ employers NOT obligated to provide health care benefits until 2015

  5. “Individual Mandate” Delay • Individuals must have health insurance in 2014 • Individuals may purchase a plan by March 31, 2014, and pay no penalty

  6. “Individual Policy” Reinstatement • Insurance carriers are asked to reinstate cancelled insurance policies • Inadequate sub-standard policies had been cancelled for individuals because inadequate • White House asked companies to re-instate these sub-standard policies

  7. National “SHOP Plan” Delayed • SHOP Exchange originally due to open in 2013 for 2014 benefit plan coverage • National SHOP Exchange opening delayed to November, 2014, for 2015 benefits • (California not delayed; just National delayed)

  8. 2014 Open Enrollment for 2015 Delayed • “Open Enrollment” period to enroll for 2015 benefits delayed • Due to open November 1, 2014 • Delayed to November 15, 2014

  9. “Premium Payment Deadline” Delayed • Premiums originally due Jan 1 for January coverage • Premium payment deadline extended to January 10th by carriers

  10. “Coverage for Cancelled” Changed • Individuals had policies cancelled because inadequate • May now be without coverage in 2014 without penalty • Or • May purchase “catastrophic coverage” policies, like under-30’s

  11. More to Come! Stay Tuned! There will be more changes, more delays

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