Affordable Care Act FAQ's
Since the passage of the Affordable Care Act, there have been many questions and concerns from individuals and employers on how this law affects their families and their businesses. Below are some of the common questions that we have been asked:
I have insurance through my employer – do I have to register with the Exchange?
No, you do not if your employer provides affordable coverage to you; you are fulfilling the individual mandate that the law requires.
If my family doesn’t have coverage, do we still have to pay a fine?
Yes, you do. The law requires every citizen and legal resident to have coverage.
What is the fine?
The fine is calculated off of household income. It will increase to $695 or 2.5% of income in 2016. The government has not issued the fines after that yet. The fine for 2017 will be adjusted for inflation and is yet to be released.
Does paying the fine mean I have insurance?
No. You must carry insurance through your employer, or an individual plan through a private insurance carrier or Nevada Health Link.
Would I qualify for a subsidy through Nevada Health Link if I refuse my employer’s plan?
No if your group insurance plan meets the minimum essential requirements of the law, and if you are an eligible employee, you cannot qualify for a subsidy. Furthermore, since the coverage is considered affordable for you, it is also considered affordable for your family. Therefore, your family members would not qualify for a subsidy.
Who qualifies for a subsidy?
If you do not have affordable coverage through your employer, or if you fall between 138% and 400% of the Federal Poverty Level (depending on size of household), you can qualify for a subsidy.
What is considered affordable coverage?
If the premium that you pay is less than 9.699% of your income for the employee only, then the plan is considered affordable.
How many hours do I have to work in order to be considered an eligible employee?
You have to work 30 hours or more per week in order to be considered full time and eligible for benefits.
What if I am not eligible for benefits?
You can enroll in a plan through Nevada Health Link (the Exchange), and potentially qualify for a subsidy, depending on your family size and taxable household income. Or you can obtain coverage through a private insurance carrier. We are always available to help you with any questions or concerns that you may have. You can reach our benefits department at A and H Insurance at 775-829-2600 or 1-888-791-8579. You can also go onto Nevada Health Link’s website at www.nevadahealthlink.com.