HEALTH CARE REFORM

Health Care Reform, most commonly known as the Affordable Health Care Act (ACA) or ObamaCare, is a complicated and ever-changing law that is difficult to navigate. Here are some of the most common questions we receive, and as health care specialists, can answer with confidence.

  • “Am I in compliance?”
  • “What happens if I’m not?”
  • “Do I have to define if my plan meets minimum value?”
  • “Do I have to distribute notice of insurance marketplace availability?”

What it means for you

The ACA involves everyone. The law says that individuals, insurance companies, and doctors and hospitals all have a role to play. The following is a quick overview:

  • Individuals — Applies to everyone who is a citizen of the United States. It requires individuals to purchase a qualified health plan starting in 2014 or pay a penalty.
  • Employers — Large employers, those with 50 or more full-time equivalent employees, must offer affordable and minimum-value plans or pay a penalty.
  • Insurance Companies — Moving forward, there are strict rules for insurance companies to follow. Insurance companies cannot deny anyone coverage, cannot raise rates without government review and approval, and must spend $.80 to $.85 of every dollar collected in premiums on actual medical claims or pay the money back.
  • Doctors and Hospitals — Provider payments will now be focused on outcomes rather then by service. This encourages providers to focus on giving care that helps individuals get well and stay healthy.

While many firms were waiting to see if the ACA would indeed be enacted, Rose Street Advisors had already started preparing. Our team of benefits specialists has been on top of the ACA law since day one and can lead you through the maze. To discuss your health care reform needs, contact us at: info@rosestreetadvisors.com.