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Overview of Affordable Care Act

In 2014 individuals can obtain health insurance without employment. Health insurance whether obtained from your employer or the health insurance exchanges is required to cover the following broad categories:


·         Ambulatory patient services

·         Emergency services

·         hospitalization

·         maternity and newborn care

·         mental health

·         substance abuse disorder service

·         behavioral health treatment

·         prescription drugs

·         rehabilitative and habilitative services and devices

·         laboratory services

·         preventive and wellness services

·         chronic disease management

·         pediatric service

Health insurance exchanges are being set up in four major categories:

Bronze Plan – plan will cover 60% of health care costs.

Silver Plan   -- plan will cover 70% of health care costs.

Gold Plan   -- plan will cover 80% of health care costs

Platinum Plan – plan will cover 90% of health care costs

The health insurance exchange premiums are estimated to range between $300 – 600 for the varied plans. Additionally, individuals may qualify for federal subsidies to help pay for insurance.

The individual penalty is the greater of $95 and $47.50 per respective adult and child listed on the 2014 income tax return or 1% of annual income.

For large employers, 50 or more employees, the shared responsibility payment, which is the requirement that the employer offer insurance, has been delayed until 2015.