Obamacare Tutorial

VES will try to help you sort through Obamacare by providing some key resources and information.  First, let’s look at California.  Recently, Covered California, California’s health insurance exchange (and the nation’s largest), released its plans and premiums.  But, before you go to their site here are some things you should know, keeping in mind that everyone has different circumstances that will affect details of your coverage and its cost:

  • Everyone has to buy health insurance or be subject to a fine, unless they are eligible for Medicare (over 65), Medicaid/MediCal (below the federal poverty level) or covered by their employer.
  • Just about every state in the US has its own health insurance exchange or access to the Federal exchange. The exchanges in New York and the other states operate pretty much as does Covered California, although there will minor differences from state to state.
  • The monthly premium subsidies only apply if you buy coverage through one of the state public exchanges, and those subsidies can vary depending on your age, the size of your family and your adjusted gross income (line 37 on your 1040 tax return).  Single people with adjusted gross incomes below $47,000 a year and families of four with adjusted gross incomes less than $95,000 will be eligible for subsidies, which will be on a sliding scale. In California, the subsidies are for one particular Covered California plan, the “Silver Plan;” other states vary.  Subsidies range from less than $100 a month to several hundred—the lower your income, the greater the subsidy.  Again, you have to check on your own situation for specifics.
  • If you don’t sign up for the subsidized plan during the initial open enrollment period—October 1, 2013 to March 31, 2014—you will have to wait three years before you can enroll into a subsidized plan unless you have a qualifying event.  Since the law will require you to have coverage, you will need to shop on the open market or at a private exchange.
  • If you are single and your adjusted gross income is over $47,000 or a family of four with an adjusted gross income over $95,000, you get no subsidies, but you will have more choice—you can go with one of the exchange plans anyway, or you can go to other insurance carriers who will have a broad range of options to choose from, or private exchanges (subsidies are not available in private exchanges).  These rates are comparable to current ones.
  • Those of you with small shops need to pay close attention to the changes in the health insurance environment.  They will have a significant impact on small employers, especially those that use short-term workers.  You need to consult with someone who can help walk you through the process and provide expert guidance.

While big states, like California and New York, will offer their own exchanges with pretty comprehensive coverage and lots of choice, smaller states’ exchanges will be more limited, and in some cases, the services will be provided by the Federal exchange.  Just about all the other states are much further behind in planning, and there is limited information at this time on rates and coverage—expect an explosion of announcements this summer.

So, here are some resources.  Some of the links take you directly to the sites of the health insurance exchange; others provide more general information to get you started on researching your individual situation.  We are here to provide as much information and advice as we can, so you may want to start out with VES Benefits Insurance Agency (first link), our broker who has been servicing our members for years, and who is authorized to provide information on Obamacare to individuals:

VES Benefits Insurance Agency
http://ves4mybenefits.biz/
1-877-700-8415

They are authorized to provide information on Obamacare; call them for help with your individual situation.  They can help you with Covered California and the other state exchanges, as well as information on private exchanges and other options.

Covered California
http://www.coveredca.com/

This is the health insurance exchange getting ready to enroll people in California; the other states in the US are not far behind.

New York Health Benefit Exchange
http://www.healthbenefitexchange.ny.gov/

Not as far along as the California exchange, but probably VES’s second largest membership group.

Aetna Tutorial on Obamacare
http://www.aetna.com/health-reform-connection/reform-explained/video-exchanges.html

Good source of general information from a major insurer; be sure to check out the video.

U.S. Dept. of Health & Human Services
http://www.healthcare.gov/
Another good source of general information.

Center for Medicare & Medicaid Services
http://www.cms.gov/cciio/resources/fact-sheets-and-faqs/state-marketplaces.html

Information on how each state is approaching Obamacare’s exchanges.

Kaiser Family Foundation State Health Insurance Marketplace Profiles
http://kff.org/state-health-exchange-profiles/

While this site has a lot of public policy information, it contains links to each state’s exchange, at which point you can get information on rates and policies.

We will keep you posted as things evolve.  Feel free to contact the VES Benefits Insurance Agency with any questions about health insurance or the health insurance exchanges. They can be reached at: http://ves4mybenefits.biz/ or 1-877-700-8415.