Advanced Insurance Designs Inc

Next Open Enrollment
11/1/2016 - 1/31/2017



Providing solutions for health care reform


AIDI will help you adapt to this changing health care environment by providing up-to-date information and options.


What is reform?


The Patient Protection and Affordable Care Act was signed into law by President Barack Obama on March 23, 2010. Along with the Health Care and Education Reconciliation Act of 2010 (signed March 30), the Act is a product of the health care reform efforts of the Democratic 111th Congress and the Obama administration. The law includes health-related provisions to take effect over four years, including expanding Medicaid eligibility for people making up to 133% of the federal poverty level (FPL), subsidizing insurance premiums for people making up to 400% of the FPL ($88,000 for family of 4 in 2010) so their maximum "out-of-pocket" payment for annual premiums will be from 2% to 9.5% of income, providing incentives for businesses to provide health care benefits, prohibiting denial of coverage and denial of claims based on pre-existing conditions, establishing health insurance exchanges, prohibiting insurers from establishing annual coverage caps, and support for medical research. According to White House and Congressional Budget Office figures, the maximum share of income that enrollees would have to pay for the "silver" healthcare plan would vary depending on their income relative to the federal poverty level, as follows: for families with income 133–150% of FPL will be 3-4% of income, for families with income of 150–200% of FPL will be 4-6.3% of income, for families with income 200–250% of FPL will be 6.3-8.05% of income, for families with income 250-300% of FPL will be 8.05-9.5% of income, for families with income from 300 to 400% of FPL will be 9.5% of income.


The costs of these provisions are offset by a variety of taxes, fees, and cost-saving measures, such as new Medicare taxes for those in high-income brackets, taxes on indoor tanning, cuts to the Medicare Advantage program in favor of traditional Medicare, and fees on medical devices and pharmaceutical companies; there is also a tax penalty for those who do not obtain health insurance, unless they are exempt due to low income or other reasons.


Who has to buy insurance or pay a fine?


The Affordable Care Act does not require small employers to provide health benefits to their workers, but larger employers face penalties starting in 2015 if they don't make affordable coverage available.





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