We offer a full array of ACA health insurance products for your company.

The Affordable Care Act (ACA) is a piece of reformative American healthcare legislation that specifically affects the U.S. health insurance market. The law was written with intent to provide uninsured patients with competitive pricing options, reduce the amount of uninsured Americans and expand healthcare coverage.

Officially known as the Patient Protection and Affordable Care Act, it was first passed as a bill by congress and signed into law by President Barack Obama on March 23, 2010. It is now sometimes referred to as Obamacare. The Supreme Court ruled to uphold the law on June 28, 2012.

The ACA created health insurance exchanges or online marketplaces for patients that don’t receive coverage through an employer to research and apply for an insurance plan that suits them. Some patients that sign up for insurance coverage through an exchange are eligible for premium tax credits that reduce the cost of their coverage. Patients may qualify for lower premiums depending on their household income and if they state in which they reside is expanding its Medicaid coverage.

The law changes the way a number of healthcare services are delivered and how they are covered by insurance companies. For example, people under the age of 26 may be eligible for insurance coverage under their parent’s plan. Also, insurance companies can no longer reduce or deny benefits or charge more to cover patients that have pre-existing conditions.

Patients that enroll in an insurance plan are permitted to choose to be treated by any primary care provider that is part of their insurer’s network. Patients that receive coverage under the ACA must receive a summary of their benefits, written in simple language and a glossary of frequently-used medical terms, given to them by their health plan or insurance provider.

Insurers that sell care policies to small groups or individuals are required to spend a minimum of 80% of the premiums they receive on treating patients or improving their medical care. Also, some preventive care measures are covered under the ACA at no cost to the patient.

Age, family size, geographic location, tobacco use and plan category are the only five factors insurance companies can consider when establishing premium costs under the ACA. Plan categories range from “bronze” to “catastrophic” and are organized by how much of the plan is covered by the participating health plan and how much is paid for by the individual.

Patients that are uninsured or enrolled in an insurance plan that doesn’t meet a minimum coverage standard will pay a fine equal to 2% of their yearly income or $325, whichever is greater. There are hardship exceptions that insured patients can apply for to excuse them from paying a fine.

A Look Ahead: Preparing for the ACA in 2015 and Beyond – October 15, 2014

Our value-add for support of PPACA compliance

There are over six million businesses in the U.S. trying to understand the Patient Protection and Affordable Care Act (PPACA). These employers are looking to their trusted advisors (benefit brokers & CPAs) and support services (payroll providers) for assistance in understanding what strategies to pursue in order to minimize health care reform’s impact on them and their employees.

The delay in the employer mandate is not a reprieve, but rather an opportunity to plan ahead. Employers and their trusted advisors should take this extra time to implement strategic changes that can minimize not only the financial impact of health care reform, but also the organizational impact caused by the changes themselves.