Q&A with Karen Rieger
Deadlines grow near for some Affordable Care Act mandates
Q: What are some of the major Affordable Care Act deadlines approaching?
A: The obligation of individuals to have insurance coverage still goes into effect in 2014. This coverage may be obtained individually or through an employer. Certain exceptions to this requirement are available, including an exception that permits an individual to remain uncovered for “a continuous period of less than three months.” Thus, an individual who has insurance in place by March 31 and keeps it for the rest of the year will be able to avoid a penalty for 2014. Because of the problems with the federal exchange website, individuals buying through an exchange now have until March 31 to enroll in health coverage through the exchange and still avoid a penalty. That coverage will qualify, even though it won't go into effect until May 1. If individuals buying through an exchange want their coverage to be effective Jan. 1, they need to enroll and pay their first month's premium by Dec. 15.
Q: How will new rules change health insurance for employers?
A: The obligation of certain employers (generally those with 50 or more full time equivalent employees) to offer health insurance coverage to their full time employees or pay a fee to the government, the so-called “pay or play” requirement, has been postponed until Jan. 1, 2015. So, employers have another year to consider this and examine their options. To the extent an employer currently offers health insurance coverage, such coverage can be continued and generally is not required to meet the same standards as insurance plans offered through the insurance exchanges, although some of the exchange plan requirements may apply.
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