Health Care Reform
Question:
What
is a Health Insurance Marketplace?
Answer:
It's
a set of websites that are all set
up the same way and that the government
regulates. People can buy health insurance
from the marketplaces with government
aid called subsidies. All Health Insurance
Marketplaces must be fully certified
and running by January 1, 2014, by
federal law. Also known as an "Exchange."
Q:
Do
I have to buy from a Health Insurance
Marketplace?
A:
You
can choose to buy insurance from an
insurer like us or from a state or federal
Health Insurance Marketplace. If you
are eligible to get a subsidy and want
to use one, you must buy your plan from
a Health Insurance Marketplace.
Q:
What
are my Health Care Reform plan choices
in 2014?
A:
Under
the new health care law, all new plans
and those that aren't grandfathered
(see definition below) fit in one of
four levels: bronze, silver, gold, or
platinum. These levels make it easier
to compare costs and benefits so you
can choose the right plan for your needs.
- Plan Relative Premium Cost (how
high your cost will be compared
to the other plans) Your Share of
Health Care Costs
- Bronze Lowest 40%
- Silver Average 30%
- Gold Higher 20%
- Platinum Highest 10%
Q:
What
is a grandfathered plan?
A:
A
health insurance plan that was bought
or changed before March 23, 2010. These
plans do not have to follow the new
health care law. That includes, but
is not limited to, benefits for preventive
care at no cost and no lifetime benefit
limit. You cannot add new people to
a grandfathered plan. If you leave a
grandfathered plan for any reason, you
cannot go back to it.
Q:
What
is the Federal Premium Assistance Tax
Credit?
A:
Starting
in 2014, eligible people can use a Federal
Premium Assistance Tax Credit to help
them pay the cost of insurance bought
through a Health Insurance Marketplace.
To be eligible, a person's household
income must be between 100 percent and
400 percent of the federal poverty level,
and the person must either:
- Not be offered minimum essential
coverage (what a person needs to
have to meet the individual responsibility
requirement) by an employer, or
- Be offered minimum essential coverage
by an employer, but (i) the cost
of the employer's coverage is more
than 9.5 percent of the employee's
household income, or (ii) the employer
pays less than 60 percent of the
plan's total allowed costs of benefits.
General Health Insurance
Q:
Do
I have to meet my deductible (the amount
you must pay for health care services)
before my benefits start?
A:
It
depends on the type of plan you choose.
Preventive care benefits start as soon
as you enroll. Some plans also cover
a specific number of office visits before
the deductible is met, so you only pay
a copay.
Q:
What
is preventive care?
A:
It's
the care that helps you stay healthy.
You get it in every bronze, silver,
gold and platinum plan - as well as
many grandfathered plans - at no extra
cost. It includes:
- Yearly checkups
- Flu shots
- Routine shots (vaccinations)
- Mammograms
- Screenings, like cholesterol tests
- Vision exams for kids
Q:
What's
a provider network?
A:
It's
a group of doctors, hospitals and other
health care providers that agree to
accept lower rates for covered services
from a health plan. You save money by
choosing providers in your plan's network.
Q:
Are
the monthly premium amounts per person
or for the family?
A:
The
amount you will pay is for all members
listed in the quoting tool. If you meet
certain criteria, you may be able to
get a government subsidy and /or tax
credit to lower the premium. The amount
of financial help you could get depends
on your income, family size and health
care costs where you live. You can use
our Subsidy Calculator to find out if
you qualify for a credit.
Plans
Q:
I
already have an Individual and Family
plan (not one sponsored by an employer)
with you. Do I need to do anything?
A:
You
will need to move to a qualified health
plan starting January 1, 2014. Log in
to the secure Member Portal to see a
comparison of the coverage you have
now with the qualified health plan we
recommend for you.
Q:
What
if I want specific benefits, like dental
and vision coverage, that aren't part
of a medical plan?
A:
As
part of the new health care laws, dental
and vision benefits for kids will be
either part of your health care plan
or available as a separate policy. We
also offer dental and vision plans for
adults.
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