ACA

Which ACA provisions were implemented in 2010

No lifetime dollar limits or annual dollar limits on essential health benefits, no cancellations except for fraud, free preventative care, dependent coverage until age 26, pre-existing conditions must be covered for children under 19

What ACA provisions were implemented in 2014

Pre-Existing conditions must be covered for all, guaranteed issue, no discrimination, community rating rules for premiums, health insurance exchanges or marketplaces, premium tax credits and cost sharing subsidies

The affordable Care act is also known as

Ppaca, Obamacare, healthcare reform

What is a grandfathered health policy

A policy that existed prior to the affordable Care act

A grandfathered health policy is not required to follow what provisions of the affordable Care act

Free preventative services, new protections for appealing claims and coverage denials, any choice of healthcare provider for emergency care

Grandfathered health plans are not required to

Phase out annual dollar limits on essential health benefits, eliminate pre-existing condition exclusions for children under 19

What is the individual mandate

Requires US citizens and legal residents to have qualifying health Care coverage. (Minimum essential coverage) Or pay a tax penalty

What is the current penalty for the individual mandate

$0, or 0%

What plans qualified as minimum essential coverage

Government sponsor programs, employer-sponsored plans, individual market plans, grandfathered health plans, State health benefits

What are the 10 essential health benefits that plans must cover to be ACA qualified

Ambulatory services, emergency services, hospitalization, maternity and newborn, mental health, prescription drug, rehabilitative services, laboratory services, preventative and wellness services, pediatric

How are qhps categorized

Qualified health plans are categorized in four metal tiers

What are the four metal tears that categorize qualified health plans

Bronze silver gold and platinum

What percentage does each metal tier of ACA qhps cover

Bronze-60.

Silver-70

Gold-80

Platinum-90

Since the affordable Care act allows children up to age 26 to be covered under their parents health plan, children can join or remain on their parents plan even if they are

Married, attending school, not financially dependent, eligible to enroll through an employer, not living with the parents

What is a qualified health plan

A plan that is sold on the health insurance marketplace or the health insurance exchange

What are the details for qhp s

Provide ehbs( essential health benefits) only available in exchange, only plan that provides tax credits and cost sharing

If an employer has 50 or fewer full-time employees, they can purchase insurance from

The shop, or small business health options program

Navigators for the ACA are

Call centers

Through the ACA, the employer mandate states

Employers with 50 or more full-time employees must pay a $2,000 penalty per full-time employee if the employer does not offer health insurance