Woman got her $450/month coverage dropped because they cut her hours -29hrs.
She went to the 'exchange' and was able to get the 'minimum' coverage for $700/month....why?.....cause she has a pre-existing condition.....TRUE STORY!!!

My God....what have they done to us????

Quoted from bumblethru

Woman got her $450/month coverage dropped because they cut her hours -29hrs.
She went to the 'exchange' and was able to get the 'minimum' coverage for $700/month....why?.....cause she has a pre-existing condition.....TRUE STORY!!!

My God....what have they done to us????

subsidized us...just like the farmers....the only thing is we don't have cattle or wheat to sell...we can only sell our bodies
and minds

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New Features For ACA Requirements

OnShift Introduces Predictive Analytics To Support Affordable Care Act Requirements

Your mix of part-time and full-time employees is in the spotlight – like never before – with new health coverage requirements in the Affordable Care Act.

OnShift’s new predictive analytics and proactive capabilities help manage part-time/full-time employee hours – so you avoid unplanned penalties and comply with your Affordable Care Act policies.

Predict, track and alert managers of potential overages before an employee is assigned a shift, so the overage can be avoided
Indicate employees who are designated part-time or full-time when creating and managing schedules.
Enhance open shift management with visibility into part-time employees and hours worked, so overages can be avoided when selecting the best fit replacement.
Report employees over work-hour thresholds so appropriate adjustments can be made.

http://www.onshift.com/products/aca/

I kept telling everybody, no one would listen. A lot of people don't understand what 'deductible' means, but they are going to find out. And much of her
$700 bucks is going to a private company that provides no 'care' at all. This is immoral. BTW, from what I read, the SC did not say the individual mandate was constitutional. That's okay, this isn't going to hurt really poor people, or rich people, or union members, or government employees.

This woman will be eligible for a subsidy, but she will still be forced to spend some of her meager wages on a private company's product, and she will still have a high deductible to deal with. The subsidy will come from free government money.
There are a lot of new taxes just coming to light, to pay for provisions in Obamacare that nobody knew were there. Such as, in NYC there is a new tax on taxis. This is the biggest tax increase on the middle class in American History, and it was never voted on as a tax, as required by law. The Law of the Land only matters when it fits in with our dictator's plans.

Thousands get health insurance cancellation notices

Anna Gorman and Julie Appleby,  Kaiser Health News

Oct. 18, 2013 at 2:55 PM ET

Health plans are sending hundreds of thousands of cancellation letters to people who buy their own coverage, frustrating some consumers who want to keep what they have and forcing others to buy more costly policies.

The main reason insurers offer is that the policies fall short of what the Affordable Care Act requires starting Jan. 1. Most are ending policies sold after the law passed in March 2010. At least a few are canceling plans sold to people with pre-existing medical conditions.

By all accounts, the new policies will offer consumers better coverage, in some cases, for comparable cost -- especially after the inclusion of federal subsidies for those who qualify. The law requires policies sold in the individual market to cover 10 “essential” benefits, such as prescription drugs, mental health treatment and maternity care. In addition, insurers cannot reject people with medical problems or charge them higher prices. The policies must also cap consumers’ annual expenses at levels lower than many plans sold before the new rules.

But the cancellation notices, which began arriving in August, have shocked many consumers in light of President Barack Obama’s promise that people could keep their plans if they liked them.

“I don’t feel like I need to change, but I have to,” said Jeff Learned, a television editor in Los Angeles, who must find a new plan for his teenage daughter, who has a health condition that has required multiple surgeries.

An estimated 14 million people purchase their own coverage because they don’t get it through their jobs. Calls to insurers in several states showed that many have sent notices.

Florida Blue, for example, is terminating about 300,000 policies, about 80 percent of its individual policies in the state. Kaiser Permanente in California has sent notices to 160,000 people – about half of its individual business in the state. Insurer Highmark in Pittsburgh is dropping about 20 percent of its individual market customers, while Independence Blue Cross, the major insurer in Philadelphia, is dropping about 45 percent.

http://www.cdphp.com/en/Health-Care-Reform/~/media/Files/exchange/individual-brochure.ashx


For plan years beginning on or after January 1, 2014, annual OOP maximums for ALL
plans can be no higher than $6,350 for self coverage and $12,700 for family coverage.
These amounts are subject to change every year as determined by the IRS. All benefits
contribute to the OOP maximum, including prescription benefits.

why unions want opt out...

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Obama Administration Delays Large Employer Mandate

Beginning in 2015, the Affordable Care Act will require “applicable large employers” (those with 50 or more full-time equivalent employees) to either offer affordable group health insurance coverage that meets “minimum value” standards to their full-time employees or pay a fine. This requirement was originally scheduled to take effect in 2014 but was delayed on account of feedback received by the Obama administration from businesses across the country.

In 2016, it is proposed that “applicable large employers” will be defined as those with 101 or more FTE employees. This rule is called the Employer-Shared Responsibility provision and is also known as the “employer mandate” or the “pay-or-play” requirements. While the delay affects the “pay or play” reporting and penalties, large group product changes that were required as part of the ACA should not be impacted.

When the mandate rules are issued, the administration plans to work with employers, insurers, and other reporting entities to encourage them to voluntarily implement the reporting in 2014 in preparation for the provisions in 2015. CDPHP will keep you updated on the latest developments in health care reform, including changes to the employer mandate, as they are announced.

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Eligible Employer-Sponsored Plans

If an applicable large employer decides to offer coverage that’s deemed an eligible employer-sponsored plan, the health plan it chooses to offer must meet specific requirements. The plan must be offered to substantially all (95 percent) of full-time employees (not including part-time employees) and their dependents and must be considered “affordable” and of “minimum value.”

Minimum value = A plan that has at least 60 percent actuarial value.
“Affordable” to all full-time employees, meaning they cannot contribute more than 9.5 percent of their household income to the premium
Note: “Dependents” includes the employee’s children, but does not include a spouse
The provision states that an employee’s contribution to the health insurance premium cost can be no more than 9.5 percent of his/her gross income. According to the IRS, household income for purposes of this provision is defined as the modified adjusted gross income of the employee, as reported in box 1 of their W-2 form. For more information, view the Affordability section in the IRS notice.

Determining Minimum Value and Affordability
The proposed ACA regulation describes how minimum value and affordability are determined for employer-sponsored plans, including the treatment of health savings account (HSA) and health reimbursement arrangement (HRA) contributions, as well as incentives through a wellness program.

Wellness incentives: Because certain individuals won’t be able to participate in wellness programs, the proposed regulation does not consider reduced cost-sharing in wellness programs as counting toward minimum value, with one exception: Minimum value may be calculated for a nondiscriminatory smoking prevention/cessation program.

Employer HRA/HSA Contributions: Under currently proposed IRS regulations, HRA and HSA contributions for a current plan year do not count toward minimum value or affordability

and your value is.........??????????????????

Basic Penalty Structure

Penalties for the large group Employer-Shared Responsibility mandate will be collected through an IRS process.

When calculating penalties, use only full-time employees and not full-time equivalents
Full-time equivalents are only used in the classification of an “applicable large employer”
Basic Penalty Structure

For additional assistance with determining whether your business will be subject to a penalty, follow this flowchart.


http://www.cdphp.com/Health-Care-Reform/large-business/mandate/basic-penalty-structure

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Subsidies: Making Coverage More Affordable

If you purchase health coverage through NY State of Health, you may be eligible for subsidies that can assist with the cost of health coverage. There are two types of subsidies: the Advanced Premium Tax Credit, also known as an individual subsidy, which lowers the monthly premium, and cost-sharing assistance, which limits the maximum out-of-pocket costs.

Individual Subsidy
The Individual Subsidy
When enrollment in NY State of Health starts in October 2013, you may be eligible for an Advanced Premium Tax Credit, also known as an individual subsidy, that can be used to lower what you pay for your monthly health plan premiums. The amount of the subsidy you are eligible for will be based on the cost of plans offered in the Exchange and will be set on a sliding scale according to your income. You will be able to apply this subsidy to reduce the premium amount you pay each month, or you can choose to receive the subsidy when you file your federal tax return.

Eligibility Requirements
Individuals and families with incomes between 133 percent and 400 percent of the federal poverty level are eligible for federal subsidies that will offset the cost of health insurance premiums in a health insurance marketplace, or exchange (see chart).

Cost-Sharing Subsidy
Individuals and families under 250 percent of the federal poverty level (FPL) may be eligible for a subsidy that lowers the cap on their out-of-pocket maximums when they purchase a silver plan. To find out if you qualify for this type of subsidy, visit NY State of Health.

Are You Eligible For A Subsidy?
Use a calculator to see if you may be eligible for a subsidy. This calculator should only be used to estimate eligibility. It does not guarantee subsidy benefits.

http://www.cdphp.com/Health-Care-Reform/individuals-and-families/exchange/individual-subsidy

A New Way to Shop for Insurance

A health insurance marketplace, also known as an exchange, is an organized marketplace designed to help people purchase and enroll in health insurance coverage. In New York, there will be two separate exchanges: the individual exchange, which is open to individuals and their families, and the Small Business Health Options Program (SHOP), which will be open to small groups with two to 50 members. Both exchanges will help consumers compare commercial insurance options, calculate costs, and select coverage online, in person, over the phone, or by mail.

Enrollment the NY State of Health marketplace begins October 1, 2013, with coverage starting January 1, 2014. The initial open enrollment period will run for six months and end on March 31, 2014 for individuals.

Get Comprehensive Coverage and More from CDPHP
A physician-founded and guided health plan that’s been a Capital District mainstay for almost 30 years, CDPHP is committed to providing our communities with top-quality health care coverage. Whether you’re an existing member or are exploring your options on and off the Exchange, you can count on CDPHP for affordable benefits, an array of free wellness classes and programs, personalized support, and so much more.

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Many Individuals Will Be Required To Be Insured

The Affordable Care Act requires many U.S. citizens and legal residents to be insured or pay a penalty. This is also known as the “individual mandate.”

The penalty will be phased in beginning in 2014. The annual fees are broken down as follows:

2014: Penalty is $95 per adult and $47.50 per child (up to $285 for a family) or 1.0% of family income, whichever is greater.
2015: Penalty is $325 per adult and $162.50 per child (up to $975 for a family) or 2.0% of family income, whichever is greater.
2016 and beyond: Penalty is $695 per adult and $347.50 per child (up to $2,085 for a family) or 2.5% of family income, whichever is greater.
Penalties for the individual mandate will be collected by the IRS through the income tax process.

Exemptions will be made for a variety of reasons, such as financial hardship or religious objections.

The Kaiser Family Foundation individual mandate flowchart can help you decide whether or not the mandate applies to you.

Lower Your Monthly Health Plan Premiums
When enrollment in the NY State of Health marketplace starts in October 2013, you may be eligible for an Advanced Premium Tax Credit, also known as an individual subsidy, or the Cost-Sharing subsidy, which limits maximum out-of-pocket costs. Both can be used to lower what you pay for your monthly health plan premiums.

Cuts to Medicare Advantage will be
costly for employers
Some employers use the Medicare Advantage (MA)
program — a private health plan option for Medicare
eligible individuals — as a cost-effective way to provide
health coverage for their Medicare eligible retirees. The
ACA freezes MA funding in 2011 at 2010 levels, and in
subsequent years phases in funding cuts. As the federal
government scales back funding for MA, employers will
be forced to offset the funding shortfall by decreasing
benefits or increasing premiums for their retirees.
During the health reform debate, MVP told Congress that
the MA program should not be cut and used as a funding
source for the ACA, especially because it out-performs
traditional Medicare in almost every objective measure.
MVP will continue to work closely with members of
• 3 •Congress to be sure they remain aware ofthe effects of
the funding cuts, andwill urge them to restore funding if
the cuts jeopardize the sustainability of the MA program.