The five things you might have missed in ObamaCare

1.  Even though we no longer have pre-existing conditions, you cannot buy insurance just when you need it.

This is the biggest misunderstanding I hear from people.  Everyone thinks they figured out how to work the system and only buy insurance if something big comes up.  Wrong!  Each year there is an open enrollment period.  This year it is October 1, 2013 through March 31, 2014.  Next year it will be from November 15, 2014 through February 15, 2015.  The effective date is January 1.  If you have a Qualifying Event, you can enroll within 30 days of that event.  A Qualifying Event would be divorce, birth, death, or loss of other coverage.  A big medical diagnosis would not be a qualifying event.  Sorry to burst your bubble.  Get more info and details on Qualifying Events on our website here.

2.  The penalty in 2014 is the GREATER of $95 a person or 1% of your household income. 

This is another big misconception.  If you make $10,000/year, your penalty of 1% would be $100.  At that income level, you qualify for Medicaid – free healthcare.  Everyone will be paying more than $95/year if you don’t qualify for Medicaid.  Do the math.

3.  You must use the WA Health Plan Finder (the Exchange) to receive a subsidy.

As difficult as it is, the Exchange works.  You must apply through the website to get a subsidy.  Do you qualify for a subsidy?  If your household of four has an income of less than $92,500, you will qualify for a subsidy of some size.

4.  An employer with less than 50 employees is not required to offer insurance.  If the employer does, there are rules that apply.

No longer can you exclude anyone working more than 30 hours.  Probationary periods cannot exceed 90 days.  Seasonal workers must work less than 120 days.  All requirements start at renewal in 2014.

5.  An employer with 50 or more employees is mandated to offer insurance to all full-time employees as of 1-1-2014.  The penalty of $2,000 per employee has been waived for 2014. 

The definition of a full-time employee has changed.  If you have seasonal or part-time employees (under 30 hours), you must count their hours and divide by 120.  Add the full-time-equivalent employees to your full-time number to reach the number of full-time employees.  If that number is 50 or higher, you are required to offer benefits.