Health Care Reform

The landscape of the health insurance industry has seen dramatic changes as a result of the Affordable Care Act being signed into law on March 23rd, 2010. Since then, we've seen several changes that affect your coverage, benefits and eligibility. In 2014, we were introduced to the individual mandate that requires every American to have health insurance or face a penalty. Assistance in the form of tax credits is available to those between 100% and 400% of the Federal Poverty Line. Additional assistance, in the form of reduced deductibles and out-of-pocket maximums, is also made available to those below 250% of FPL. Open enrollment windows and qualifying life events limit when and how often you can enroll in and switch plans. Pre-existing conditions are a thing of the past and all plans are guaranteed issue and guaranteed renewable. 

Health plans are now grouped into metal levels (e.g. Bronze, Silver, Gold and Platinum) according to their actuarial value. Preventive services have been expanded to include many benefits at no charge. Those benefits include things like annual exams, colonoscopies, mammograms, childhood immunizations and exams, screenings for diseases, and many other benefits. These are just a few of the changes that have and will continue to impact individuals and businesses through the coming years.
 
The open enrollment window for the 2017 plan year starts on November 1st, 2016 and goes through January 31st, 2017. This is your opportunity to switch plans or possible enroll for the first time. We're expecting substantial rate increases, so this will be an excellent opportunity to review your coverage and look at alternative options. Those enrolling by December 15th, 2016, will have coverage as of January 1st, 2017. If you enroll between December 16th and January 15th, your coverage will be effective on February 1st, 2017. If you enroll between January 16th and January 31st, your coverage will be effective on March 1st, 2017. Don't miss your opportunity to sign up for coverage. The 2016 penalty for not having minimum essential coverage is $695 or 2.5% of your household income (whichever is greater). The 2017 penalty is equal to the 2016 penalty plu an additional adjustment for inflation.       
 
EMPLOYERS TAKE NOTE: Businesses with 50 or more full-time or full-time equivalent (FTE) employees are required to offer health insurance or face a penalty. The plan must be affordable and it must meet minimum value standards. The employee's cost of employee-only coverage cannot be more than 9.5% of the employee's total household income. The minimum value standards require the plan to have an average cost sharing of 60%. The penalty for non-compliance is generally $2,000 per FTE, minus the first 30 employees. ACA Reporting requirements have also been shifted to employers. IRS Section 6055 requires those employers with 50 or more full-time or full-time equivalent (FTE) employees to prove they're providing minimum essential coverage to their full time employees by submitting 1094-B and 1095-B forms. 
 
At JS Sherman & Associates, we know the importance of understanding the changing landscape and putting ourselves in a position to help our clients comprehend and navigate Health Care Reform. We've put a considerable amount of time into learning the law and being able to disseminate that knowledge amongst our client base. We even conduct seminars on Health Care Reform. In fact, we're the designated Health Care Reform instructor for the Orlando Regional Realtor Association (ORRA). ORRA is one of the largest local trade associations in the state of Florida, with more than 9,000 members throughout Central Florida. 
 
To learn more about Health Care Reform or to inquire about a speaking engagement for your organization, please fill out the following form.
 

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