Starting in Jan 2014, people will be needed to have wellness insurance plan protection that enables as minimum important protection or risk paying a tax charge for every month they are without insurance.
When the Cost-effective Proper care Act (ACA) was introduced on Goal 23, 2010, President Obama said that if Americans liked their protection, they could keep it. Therefore, the ACA allows providers to distinguish programs that persisted before to Goal 23, 2010 (Grandfathered Plans) and those that came subsequently (Non-Grandfathered Plans). Since Grandfathered Plans were intended to stay as they persisted as of Goal 23, 2010, they are not subject to many of the ACA’s requirements.
Learn more about Grandfathered Plans and why they are important:
Individuals and families
Small companies (less than 50 employees)
Large company groups (51+ Employees)
The Cost-effective Proper care Act (ACA) creates new ‘marketplaces’ (also known as ‘exchanges’) where people and companies will be able to buy wellness insurance plan protection for protection from 2014. California’s wellness insurance plan protection industry is known as Protected Florida. In addition to buying protection via Protected Florida, people and little company will be able to buy health care the way they do today through brokers and directly through wellness insurance plan protection providers.
Blue Shield is planning to participate on Protected Florida in both the Individual and Small Company marketplaces.
Learn more about Protected California:
Covered Florida for people and families
Covered Florida for companies (less than 50 employees)
October 1, 2013 is the first day people, family members and companies can implement for protection from 2014. This Start Registration interval lasts until Goal 31, 2014.
Individual Start Enrollment
Open-Enrollment for 2014: Registration in wellness programs efficient in 2014 will start on Oct 1, 2013 and end on Goal 31, 2014. In the past, people who were buying their own protection of wellness could implement whenever you want. However, beginning with protection efficient on Jan 1, 2014, applications will generally only be accepted during this open enrollment interval. There are exclusions for “special enrollment” within 60 days of a life-changing event, such as the loss of a job, death of a spouse or birth of a child. This is similar to how Start Registration times work for protection through an company.
Open Registration for 2015 and beyond: Yearly open enrollment times for people and family members buying their own protection of wellness will be held Nov 15 - February 15 of annually with an initial efficient time frame of Jan 1st of one season later.
Small Company Start Enrollment
Small business companies will have a yearly selection interval before to the group’s annual open enrollment interval. For 2014, open enrollment for companies will start on Oct 1, 2013. After that time frame, companies can start participating whenever you want during (rolling enrollment), but workers can only enroll or change programs once a season, unless they qualify for a special enrollment interval.
All non-grandfathered wellness programs provided in the personal and little company marketplaces, both interior and exterior of Protected Florida, will be needed to give you a core package of advantages and solutions known as "essential wellness advantages," which must include protection within at least the following 10 categories:
Ambulatory patient services
Prescription drugs
Emergency services
Rehabilitative and habilitative solutions and devices
Hospitalization
Laboratory services
Maternity and newborn care
Preventive and wellness solutions and chronic disease management
Mental wellness and substance use disorder solutions, such as behavior wellness treatment
Pediatric solutions, such as oral and vision care
Under the Cost-effective Proper care Act, all non-grandfathered, wellness programs provided in the personal and little company marketplaces, both interior and exterior of Protected Florida, will be needed to provide protection at a "metal level" – Jewelry, Silver, Silver and Brown. The steel levels are based on the actuarial value (AV): Brown (60 % AV), Silver (70 % AV), Silver (80 % AV) or Jewelry (90 % AV). What this means is that someone who buys a silver strategy would have to pay 30 % of health care costs, while the strategy covers 70 %.
There is also a disastrous strategy for the personal market only that will cover the fundamental wellness advantages plus three primary care visits annually. The disastrous strategy can only be sold to customers under age 30 and customers who are exempt from the personal require as a result of low earnings or problems.
2014 Individual and Family Metal Stage Plans
Starting in 2014, financial assistance will be available for customers whose annual earnings are between 134% and 400% of the Federal Hardship Stage (FPL) and who meet other applicable guidelines. These cost-sharing reductions and advanced premium tax attributes will lower the price of premiums and out-of-pocket expenses for protection of wellness purchased through Protected Florida. Those with an FPL under 134% may be eligible for Medi-Cal.
Tax attributes will also continue to be available to companies with no more than 25 full-time equivalent workers to help offset the price of providing protection. Discover more about the little company tax credit.
The ACA requires that certain taxation be gathered to fund aspects of the law, such as Protected California—the state-wide healthcare industry (aka the Exchange).
For an overview of taxation beginning Jan 1, 2014, download our ACA tax fact sheet (PDF, 24KB).
Starting on Jan 1, 2014, the Cost-effective Proper care Act (ACA) will require companies over a certain size to provide affordable wellness strategy protection to full-time workers and their children or face a charge if an employee receives federally-subsidized protection from Protected Florida (aka: The Marketplace/Exchange). Discover more about the Play-or-Pay provision.
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