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ACA – Individual Mandate January 1, 2014

It’s been a while since we’ve blogged and for good reason: Health Care Reform is keeping us super busy!

The Affordable Care Act (ACA) or as you may be more familiar, Obamacare, is in full swing. October 1st brought the beginning of open enrollment for the Exchanges. Here in California, our exchange or marketplace is called Covered California.  Employers were required to give ALL employees a model exchange notice announcing the health insurance marketplace and information about the health coverage offered by the employer.

One of the most highly discussed items is the subsidy.  The salary requirements to qualify for the subsidy at quick glance are as follows:

Household of one – Less than $45,960

Household of two – Less then $62,040

Household of three – Less than $78,120

Household of four – Less then $94,200

Household of five – Less then $110,280

Individual Mandate -  beginning January 1, 2014

Come January 1, 2014 most U.S. citizens and legal residents have to be enrolled in a health insurance plan that meets minimum essential coverage.  If you are already enrolled in a plan through an employer – they likely meet the requirement.  Do check with your HR department.   The same goes for those who are enrolled in programs like Medicare, Medicaid, and TRICARE.

There are a few select groups who are exempt from the Individual Mandate:

- people who qualify for religious exemptions

- people who have an income that is below the threshold required for filing taxes

- people who would have to pay more than 8% of their income for health insurance

- undocumented immigrants

- incarcerated people

- federally recognized American Indians & Alaska natives (These members may enroll in or change existing coverage in Covered California Health Plans one time per month.)

If you do not fall into one of the above-mentioned categories and you do not have health coverage as of January 1, 2014 – you will be subject to a penalty.  The penalties for not having medical coverage are as follows:


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