Latest ACA news updates
The latest ACA News Updates can be found by clicking here and scrolling to the ACA News updates section.
This information is for:
- U.S. Expats living overseas
- U.S. Expats visiting the U.S.
- U.S. citizens residing in the U.S.
- U.S. residents residing in the U.S.
- Non – U.S. citizens visiting the U.S.
We have written this information on the new U.S. health laws to help those living overseas and those planning to move or travel overseas understand the new health laws in the United States and how those PPACA/ACA (Affordable Care Act) laws might affect their families and insurance rates. We have broken it down into three major parts below
NOTE: There are NO penalties at this time for expats who currently are on international medical insurance plans (or who buy international insurance) that visit or live in the USA for up to a year, until 1-1-2016.
There are no penalties or fines for those who reside overseas more than 330 days in the calendar year (January 1 – December 31) and have credible overseas coverage. Those who are recognized as bona fide residents of a foreign country are also exempt.
Please see all latest ACA/PPACA updates and latest news at https://www.gninsurance.com/aca-ppaca_how_does_it_affect_me/
PART ONE – For Americans and Expatriates coming to the U.S.
- Your international insurance will be accepted in the USA just as before, up to the limits set by your policy.
- A key ruling has come out that expats who are residing overseas, but visit the U.S. for up to 12 months, will be exempted from the individual/family penalty tax. – UPDATED. Please see ANA News Updates at https://www.gninsurance.com/aca-ppaca_how_does_it_affect_me/ for the latest.
- This is until 1-1-2016
- This ruling has been updated, and that update is located here.
- All you need to do currently is prove/state that you are an expat, have an international address and show your international health coverage.
- Please note that NO International/overseas health insurance plans need to be ACA PPACA-compliant. ONLY U.S. domestic insurance plans (that do not cover overseas) are required to follow the new PPACA/ACA rules. See more here.
Explanations and Definitions used in Part One above
- PPACA = Patient Protection and Affordable Care Act
- ACA = Affordable Care Act (same as above)
- Public Marketplace (also called in the past “public exchanges”) = The only place one can get government subsidies when purchasing U.S. domestic insurance – https://www.gninsurance.com/arizona-individual-family-public-private-marketplace-options/
- The Public marketplace are ALL private health insurance plans, however with the additional option of the U.S. government subsidizing (paying) for a portion of your premium either month-to-month or at year-end based on your income.
- However, if you meet the income qualifications of Medicaid, you are automatically enrolled in Medicaid in the state you are residing.
- You are allowed to use a broker to help you select the best policy for your family and for customer service. However, YOU MUST WRITE DOWN AND FILL IN THE TWO NUMBERS for your broker where requested in the online application.
- Public marketplace does have a smaller amount of insurance plans, usually between 4-6 plans per insurance company.
- Thus, to see all the insurance plans (Such as BlueCross/Blue Shield of Arizona – which has over 20 insurance plans at https://www.gninsurance.com/individual-and-family-health-coverage/) one would have to call a local insurance broker (such as Good Neighbor Insurance register in Phoenix, Arizona and also licensed to sell health insurance for California, Texas, Pennsylvania and Florida) or go to a private carrier.
- Subsidies are based on net income ONLY. (Such as your reported income to the IRS)
- Private Marketplace = You can get quotes for ALL private health insurance plans by going directly to the carriers one-by-one, or by getting competitive quotes from a broker- https://www.gninsurance.com/arizona-individual-family-public-private-marketplace-options/ and here at http://www.gnhealthplan.com/.
- Going to the private marketplace exempts you from government subsidies, but allows you more choice/options. Either way, You may still use a broker to help you select insurance.
- Penalty / tax / fine = money you have to pay to the U.S. government if you reside (not as an expat) in the U.S. and do not have an ACA-qualified health insurance plan starting in 2014 and defined as Individual Shared Responsibility Payment
- If you reside in the U.S., you have up to 90 days before you are expected to have U.S. domestic health insurance and not be taxed/fined/penalized.
- Expats that are covered under international health plans will be considered as having credible coverage through 1-1-2015, whether they are overseas or in the states on furlough /vacation / visit up to 30 days.
- Expatriate = A person temporarily or permanently residing in a country and culture outside of their country of citizenship.
- Sometimes shortened to “expat”
PART TWO – Information for those primarily residing in the U.S.
- Insurance in the U.S. is, and will continue to get more, expensive. By voting for better and expanded coverage, Americans will see higher premiums. Many of the options that used to be in only “higher end” insurance plans are now universal, although networks are not.
- I call the new PPACA laws “the good, the bad, and the ugly.” The good is stronger benefits. The bad is higher premiums. The ugly relates to all the new rules and regulations/regulatory bodies as well as extra taxes.
- What to expect and where to find more information on ACA-related health insurance regulations that might affect you:
- We are constantly adding new information on our health blog on what the new health care laws are about, as well as impact on your family. Please go to these two links:
- Also check out our Arizona health insurance site: https://www.gninsurance.com/
- The new 1-1-2014 rates are located online here at: https://www.gninsurance.com/azhealthinsurance.asp, for those residing in Arizona. Premiums will vary by state and ZIP code.
- You can find more information on the ACA options at https://www.gninsurance.com/affordable_care_act_insurance_options_PPACA/
- OPEN ENROLLMENT – For this year only (Since it is the first year) one may apply for U.S. domestic insurance coverage for 2014, from Oct 1st until mid-February – Valentine’s day, 2014 (for an effective start date of March 1). There is currently debate to extend this date due to enrollment problems. From 1-1-2015 onwards or to change to another insurance plan, Open enrollment will be November 1 of each year to January 1 (to be covered January 1st of the following year) unless you have a qualifying “status change” which include: Adoption, Birth, Change of spouse’s employment/benefits, Death of a dependent, Death of a spouse, Divorce, Gain or loss of employment, Legal separation, Loss of eligibility for coverage as a result of reduction in hours, leave of absence, Marriage, Qualified Medical Child Support Orders (QMCSOs), relocation after living overseas/expatriate.
There are 4 ways to get U.S. domestic health insurance (coverage for the U.S.) in America:
- Group insurance. Through your employer (Just like in the past)
- Straight from an insurance company (like it always has been)
- Through an insurance broker / insurance agent like Good Neighbor Insurance (as in the past, paid for by the insurance carrier, but with additional service and customer support) that offer plans from more than one insurance company.
Premiums on both option #2, option #3, and option #4 – with or without government, the total premium is the same in either private or public/government marketplace.
- Public marketplace (government-administered) also called the public exchange
These are private insurance plans but with fewer options. The amount you are required to pay will be based on your income. The premiums are the same as on the open market, however, the government will offer to pay a portion of that premium (a subsidy to you) depending on your income level, either month to month or at the end of the year in a tax rebate/return.
For example, if the premium for an individual is $300 per month, then the government may elect to pay $50 per month (based on income) and the individual will pay $250 per month. This will be reported on your taxes next year. If you make more than what you reported for next year then you will pay the government “x” amount at tax time. If you made less then what you reported, at tax time the government will refund you money back. The refund and payment to the government is all done through the IRS.
NOTE: The IRS/government can go back ten years (seven years for all other) to audit/collect any monies you owe the government paid on health insurance premiums through the public marketplace.
The Public marketplace is supposed to be similar insurance plans as options (2) and (3) have, shown above. However, we know that networks and other options may differ. Yes, you will have four options from each insurance company and each will have to follow exacting rules like those outside the marketplace. However, over time, there may be less insurance companies involved in the public marketplace (Aetna and UHC for example in some states at this moment have opted out of the exchanges). Another possible and real situation is that there are fewer medical networks (choice of doctors or hospitals) as a part of your health insurance plan. Please be careful to check before signing up for a plan, that a local hospital and/or emergency clinic nearby is included in your plan.
* NOTE: Usually an adult (no dependents or spouse) who makes under $28,000 annually will not be offered an alternative to Medicaid (full government health insurance). Although this may vary from state-to-state.
THE INFORMATION OFFERED ABOVE IS THE MOST ACCURATE AND PUBLIC INFORMATION WE HAVE AT THE MOMENT (OF PUBLICATION) AND IS OFFERED “AS IS” WITHOUT WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED. WE CANNOT GUARANTEE THIS INFORMATION TO BE ERROR-FREE, IN TERMS OF IT’S CORRECTNESS, ACCURACY, RELIABILITY, OR OTHERWISE. WE ENCOURAGE EVERY CLIENT TO DO THEIR OWN DUE DILIGENCE IN REGARDS TO POLICIES, APPLICABLE LAWS, ETC. AS IT AFFECTS THEIR PERSON AND ORGANIZATIONS.
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