Enacted in March 2010, the Affordable Care Act (ACA) provides Americans a way to acquire quality health insurance they can afford.
ACA was designed to take effect in phases with the largest
changes coming in 2014. By law, most Americans will have to
carry health insurance to avoid paying a penalty fee for not
having coverage. The open enrollment period will begin October
1, 2013. Individuals will then be able to review plan options
and sign up using the online Health Insurance Marketplace. Three
important key parts of this reform to remember are:
- Everyone will be eligible for health insurance, regardless of medical condition.
- Most Americans will be required to have health insurance.
- Tax credits and financial assistance will be available to help pay for health insurance, if eligible.
Commonly Asked Questions
What if I am currently eligible to enroll in a Health Plan offered by the City of Riverside?
As a City employee eligible for health insurance coverage, you may not experience changes. Per the ACA, the City will be required to offer health insurance that is both affordable and meets the minimum value requirements. Please note that the City’s health plans meet the affordability and minimum value requirements as set by Federal law. In addition, all benefitted (full-time and part-time) employees who are eligible to enroll in the City’s health plans may consider enrolling in a health plan provided through the Marketplace, however, they may not qualify for the Government provided tax subsidy because the City’s plans meet the affordability and minimum value requirements. Furthermore, if City eligible employees enroll in a health plan through the Marketplace, they will opt-out of the City’s health insurance plan and lose the City’s contribution towards their health premiums.
What if I am currently not eligible to enroll in a Health Plan offered by the City of Riverside?
Per the ACA, starting in 2015 the City will be required to offer health insurance to employees that are considered “full-time” based on hours worked. A “full-time” employee is defined as an employee that works an average of 30 hours per week or more; this includes employees that may not be currently eligible for benefits (non-benefitted). The City will begin a measurement period that will take place in 2013-2014 to measure hours worked for non-benefitted employees and determine eligibility for health insurance. After the initial measurement period, employees that are eligible based on meeting the full-time criteria will be notified by Human Resources and will be given the opportunity to enroll during next year’s Open Enrollment period (November 2014). Starting in 2015, non-benefitted employees found to be eligible to enroll in the City’s health plans may decline the City’s coverage and choose to enroll in a health plan offered through the Marketplace, however, they may not qualify for the Government provided tax subsidy because the City’s plans meet the affordability and minimum value requirements. Starting October 1, 2013 and subsequent years, non-benefitted employees who do not meet the full-time criteria may be eligible to receive the tax subsidy if they purchase health insurance via the Marketplace.
When can I purchase coverage through Covered California?
Enrollment in health plans through Covered California will begin October 1, 2013 and continue until March 31, 2014. Eligible individuals must purchase health insurance during this open enrollment period in order to obtain coverage in 2014. If eligible individuals do not enroll during this period, they will not be assured a health plan will cover them – either through Covered California or in the private market. If individuals have a life-changing event such as the loss of a job, death of a spouse or birth of a child, they are eligible for special enrollment within 60 days of the event. The next open enrollment period begins in October 2014 for coverage in 2015.
What if I currently waive Health Insurance offered by the City of Riverside?
Employees who are currently waiving health insurance coverage may continue to do so provided that they are insured elsewhere or qualify for other insurance coverage such as Medicare. All employees who waive coverage will be required to recertify their option to waive coverage every year during the open enrollment period and provide proof of alternate coverage.