Will I Lose My Coverage at Work?
If you are among the more than half of all Americans who get healthcare coverage through your job, you may be wondering about the future of your coverage. What will happen to your health benefits now that the Affordable Care Act makes it easier for individuals to buy their own coverage? Will your benefits change? Here’s what you need to know.
What the new law does for employees
Under the new law, all newly issued healthcare coverage must include annual preventive check-ups and exams with no copays (there are exemptions for grandfathered coverage). There will be limits on your out-of-pocket costs each year, and there cannot be a cap on the expenses your healthcare company pays for your care.
Under healthcare reform, companies don’t have to offer health coverage. However, beginning in 2015, some companies must pay a penalty for each employee not offered health coverage that meets the requirements of the Affordable Care Act.
The penalty amount, in many cases, is far less than the cost of offering employee health benefits, and smaller companies will face no penalties at all. There may be companies of all sizes that decide it makes financial sense to drop employee health benefits.
There is no way to predict how many employers will drop employer-sponsored healthcare coverage, but it helps to remember there are other incentives for employers offering health coverage. Employee healthcare is tax deductible for the company. It’s also a benefit that helps attract and retain talented workers.
If your job continues to offer health coverage, however, the type of plan you get and what you pay for it could change. As the healthcare market changes, employers might make changes to premiums or types of coverage. Keep in mind, many employers cover part of the premiums for employees’ healthcare coverage. In many cases, this will make sticking with your job-based coverage an easier choice.
What Happens if You Lose Job-Based Coverage
If you lose your job, or start a new job that does not offer healthcare coverage, you have to buy insurance on your own or you may face an annual penalty. You can shop for a plan on state and Federal healthcare coverage comparison sites, known as marketplaces, or go directly to a healthcare coverage carrier like Humana.
Some individuals will qualify for a tax credit that lowers the cost of a plan bought a marketplace. The discounts, called Premium Tax Credits, are generally available to Individuals with incomes below 400% of the Federal poverty line (less than about $94,000 a year on average for a family of four in 2013). There is also a cost-sharing subsidy that may be available to individuals with incomes between 100% and 250% of the Federal poverty line (between around $23,550 and $58,900 for a family of four in 2013).
If you have a plan through work, you may not be eligible for these credits and subsidies. Your employer may be able to provide details on eligibility based on your existing coverage.
Regardless of what your employer does, consider your options carefully before making a decision that works for you.
Have questions? Contact us
This information is only a high-level summary of certain provisions of the health care law. This information does NOT attempt to summarize all provisions of the health care reform law. This information is not and should NOT be used as legal or tax advice; it should not be used as a basis for decisions regarding how the health care reform law will affect you and/or your business. Should you have any questions on how the health care reform law (including the high level summary of certain provisions of health care reform) will affect you and/or your business, you should seek professional advice from attorneys or other advisors.
Insured by Humana Insurance Company, Humana Health Plan, Inc., Humana Health Insurance Company of Florida, Inc., or Humana Health Benefit Plan of Louisiana, Inc. or offered by Humana Medical Plan Inc., Humana Employers Health Plan of Georgia, Inc., or Humana Health Plan of Texas, Inc.
For Arizona residents: Insured by Humana Insurance Company. For Texas residents: Insured by Humana Insurance Company or offered by Humana Health Plan of Texas, Inc.
Our health benefit plans have exclusions and limitations and terms under which the coverage may be continued in force or discontinued. For costs and complete details of the coverage, call or write your Humana insurance agent or broker.