Affordable Care Act: Questions for a Health Insurance Specialist

By Peggy Jo Goodfellow, Arizona Farm Bureau: We are getting close to the start of a new year of the Affordable Care Act.  You may begin seeing more stories and advertisements about the beginning of the “Annual Election Period,” new plans starting and old plans being discontinued.  In order to help our members stay informed, we sat down with Steve Kammeyer, Vice President of Health Insurance Services with Farm Bureau Financial Services and asked him some questions.

Does the ACA impact me?

If you are under 65 and purchase your own health insurance, the simple answer is yes. Those covered under group plans will get information from their employer. There is little impact on those who are 65 and older who have Medicare coverage and/or a Medicare Supplement policy. 

I am going to focus my comments today on those in the Individual market.

What is the Annual Election Period (AEP) or Open Enrollment Period I keep hearing about?

The AEP is a period of time during which you can purchase a new health insurance policy or change your existing policy without any underwriting, exclusions, or limitations.  This year the AEP runs from November 15, 2014 through February 15, 2015.  In future years, the AEP is scheduled to run from October 1 – December 7, with effective dates of January 1.  Now is a good time to sit down and review your coverage with your agent.

Is this the only time I can buy health insurance?

It is not the only time you can buy, but it is the only time you can buy without a special event.  A special event can make you eligible for a Special Enrollment Period (SEP).  Examples:

  • Loss of coverage through your employer group or other group plan
  • Moving to a new state
  • Certain changes in your income
  • Changes in family size (marriage, divorce, birth of a child)

Outside of the AEP or a special event, you are not able to purchase individual health coverage.

What options do I have?

You may have many plan options to choose from, including, in some instances, staying on your old/current plan.  The best thing to do is to schedule an appointment with your Farm Bureau agent to review your current health insurance plan and make sure you have the proper coverage going into 2015.  They are trained to assist you and identify the best plan for you and your family.

What about people who work for me? My accountant said I need to make some changes in the plan I provide them.  What do I need to do?

There are new rules around how you provide insurance to employees.  The IRS has made it very clear that an employee’s individual premiums cannot be paid by an employer on a tax-free basis either by reimbursement to the employee or paid directly to the carrier.  Those premiums must now be taxable income to your employee.  There are three ways to continue to provide benefits to your employees:

  1. Make group health insurance available to your employees.
  2. There is a safe harbor allowing a small business owner with only one employee to continue to pay individual premiums.
  3. Another option allowing business owners to legally support their employees’ cost of health coverage with individual health insurance premiums is a Choice Incentive Plan (CIP).  A CIP provides a monthly taxable allowance to employees to help lower and offset the employee’s expense of purchasing their own qualifying insurance coverage.  Your agent can help you with setting up this kind of arrangement.

How do I know what is right for me and determine what I need to do?

The best thing to do is to contact your local Farm Bureau agent.  They are trained on the existing plans in place as well as any new plans available.  They can help you sort out your options and make the right decision for you and your family.  If you don’t currently work with a Farm Bureau agent, you can locate one by going to www.fbfs.com and using the agent locator tool.

Source: Farm Bureau Financial Services

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