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Managing the Rising Costs of Payroll & HR
The Employer Mandate: ACA Infographic
Join our free employer education series on the impacts of healthcare reform in the year ahead.
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- Evaluate the best technology solutions available to manage the intricacies of ACA compliance and avoid penalties.
New ACA Compliance Calculator
Gain a completely customized view of the calculations, penalties, and suggested course of action to meet rising employer shared responsibility. The impact of ACA is made clear. Your decision to pay or play is made simple.
The Affordable Care Act (ACA), also known as Healthcare Reform, mandates that all resident citizens and legal immigrants of the United States procure and maintain health insurance. For many people, especially those working for corporations or other large businesses, nothing much will change — they are still covered by their employer. Self-employed individuals and those working for businesses with fewer than 50 eligible employees will also need to obtain coverage, but must do so without a large company to help them. Where will they turn for their healthcare plan?
In the past, many insurance carriers have exercised the pre-existing condition clause, meaning that anyone who was new to the plan and had a pre-existing condition, such as cancer, would not have that particular condition covered. Only new diseases, illnesses and conditions would be covered under the new plan. While this may seem harsh, the plans were designed to contain this clause to prevent large cost increases over time. Now, with the Affordable Care Act having so many new regulations beginning in 2014, we can add pre-existing condition exclusion practices to the ever-growing list of items that are prohibited.
A central goal of the Affordable Care Act is to significantly reduce the number of uninsured individuals by providing affordable options through Medicaid and the state health insurance exchanges. The U.S Supreme Court ruled that states could expand Medicaid benefits to all individuals with incomes at or below 133 percent of the Federal Poverty Level. Beginning in 2014, individuals between 19 and 65 years of age will be guaranteed coverage through Medicaid in every state that chooses to opt-in, regardless of whether or not they have children. It is also the intent of the government to have both the Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollment simplified.
As discussed in Individual Mandate Is Coming, the Affordable Care Act (ACA), includes an individual mandate requiring most U.S. citizens and legal residents to purchase and maintain a minimum level of healthcare coverage. To put some teeth into this mandate and encourage compliance, the Act penalizes individuals and families who choose to ignore the requirement.
Effective January 1, 2014, the Affordable Care Act (ACA) will require most individuals to maintain minimum essential health coverage for themselves and their dependents or face penalties. Because the cost for good, quality coverage is expensive, it’s often out of reach for many lower and moderate income families. In an effort to make health insurance more obtainable to families that couldn’t otherwise afford it, ACA provides two options to individuals with household incomes between 100% and 400% of the Federal Poverty Level.