Affordable Care Act FAQ
FHCP understands that you may have many questions about the Affordable
Care Act ("ACA" and how it may affect you. Listed below are
some frequently asked questions that may help you better understand these
new laws. If you still have questions, please contact us at 1-855-Go2FHCP
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What is the health insurance marketplace (a/k/a exchange)?
The Health Insurance Marketplace is an internet “hub” or website
where people who are uninsured or who buy insurance on their own can go
to buy health care coverage in the future. They will be able to compare
plans and insurance carriers. They will also be able to find out if they
are eligible for financial assistance (a/k/a subsidy or APTC). There will
also be a Small Business health Options Program (SHOP) website where small
group employers can also shop and purchase health coverage to offer to
Do I have to buy from the marketplace?
No. The Health Insurance Marketplace is just one of the ways you can shop
for health coverage. You can still purchase through your employer or directly
from FHCP. However, in order to receive any financial assistance, you
must purchase through the Marketplace. To find out if you may qualify
for financial assistance (subsidy) or not, please click
click here to be taken to a calculator that will
estimate the amount of financial assistance you
may qualify for. Keep in mind this is just an estimate and the actual amount
of financial assistance is dependent upon many factors to include your
age, where you live, the plan you purchase, and your total household income.
How can I be exempted from having to buy insurance?
The ACA requires
most US citizens and legal immigrants to have insurance starting January 1,
2014. People with certain religious beliefs, members of Native American
tribes, undocumented immigrants and individuals in prison are exempted.
Also, individuals below a certain level of income are also not required
to purchase insurance.
What do I do if I don’t think I can afford to buy insurance?
You and your dependents may be eligible for financial assistance (called
subsidy) to help you pay for your insurance. This will be determined by
the Health Insurance Marketplace, beginning in October 2013. Below is
an example of the income ranges that may qualify for assistance.
- Between $15,282 and $45,960 if you are SINGLE with NO dependents.
- Between $20,628 and $62,040 if you are MARRIED with NO dependents.
- Between $31,322 and $94,200 if you are a FAMILY of four.
What will happen if I don’t buy insurance in 2014?
You will be charged a tax by the government. The 2014 tax is the GREATER
of $95 or 1% of your household income. If you are single and make $30,000
annually, your tax would be $300.
If I’m currently undergoing treatment and have to change plans, how
will that affect me?
You can purchase one of the new 2014 plans even if you are currently sick
or have any pre-existing conditions. Everyone who applies for coverage
is guaranteed to receive coverage. Once your coverage begins, it cannot
be canceled due to your health status.
Will my insurance premium go up?
As the new law goes into effect, the amount you pay for your insurance
may change. There are many reasons for this, including:
- The type of insurance you choose to purchase
- The number of family members you choose to cover
- Whether or not you qualify for financial assistance (subsidy or APTC)
- Whether or not you are a smoker
- Whether you are purchasing individual coverage through your employment or not
What new plans will fhcp be offering in 2014?
We cannot sell our new plans until open enrollment, which begins on October
1, 2014. We have many different plan options that will offer you flexibility
in coverage. You can choose a plan with free access to over 40 gyms or
forgo that option for a lower premium plan. We will also have plans that
include dental for children and those without as well.
What are the different “metal” level plans what does that mean to me?
FHCP will offer plans in all four metals levels. The metal levels are:
- Bronze - minimum 60% actuarial value - which pays for 60% of all medical costs.
- Silver - minimum 70% actuarial value - which pays for 70% of all medical costs.
- Gold - minimum 80% actuarial value - which pays for 80% of all medical costs.
- Platinum - minimum 90% actuarial value - which pays for 90% of all medical costs.
One other option for individuals under age 30 is called a Catastrophic
Plan. These plans primarily cover preventative benefits and have higher
deductibles for those times that you are sick and require more services.