Healthcare Reform Act
The various names it goes by:
Affordable Care Act, Patient Protection Affordable Care Act
Healthcare Reform Act, Obamacare.
Medical Loss Ratio and What it Means to You
Many Americans worry about getting their money’s worth when it comes to health care. The Affordable Care Act requires insurance companies to spend your premium dollars primarily on health care.
The percentage of your premium dollars that an insurance company spends on providing you with health care and improving the quality of your care (as opposed to what it spends on administrative, overhead, and marketing costs) is known as 'medical loss ratio.'
The new law limits how much of your premium dollar your insurer can spend on things other than providing health care and improving its quality. If your insurance company exceeds that limit, it must provide a rebate of the portion of premium dollars that exceeded this limit.
Some Important Details
Highlights of the Healthcare Reform Act
Small Business Tax Credits and Your Organization
The Affordable Care Act helps small businesses and small tax-exempt organizations afford the cost of covering their employees.
If your organization has fewer than 25 employees and provides health insurance, you may qualify for a tax credit of up to 35% (up to 25% for non-profits) to offset the cost of your insurance. This credit will increase in 2014 to 50% (35% for non-profits). This will lower the cost of providing insurance to employees.
Financial Assistance for those that qualify: We are Certified and Authorized to offer plans on the Individual Exchange. Many people will qualify for some type of assistance to meet the objective of providing affordable healthcare. We can help you in determining eligibility and obtaining the right program to meet your needs.
For assistance with your insurance needs, please contact Vincent Reda at (631) 543-5242 or info@mainlineins.com.
vincent@mainlineins.com
Affordable Care Act, Patient Protection Affordable Care Act
Healthcare Reform Act, Obamacare.
Medical Loss Ratio and What it Means to You
Many Americans worry about getting their money’s worth when it comes to health care. The Affordable Care Act requires insurance companies to spend your premium dollars primarily on health care.
The percentage of your premium dollars that an insurance company spends on providing you with health care and improving the quality of your care (as opposed to what it spends on administrative, overhead, and marketing costs) is known as 'medical loss ratio.'
The new law limits how much of your premium dollar your insurer can spend on things other than providing health care and improving its quality. If your insurance company exceeds that limit, it must provide a rebate of the portion of premium dollars that exceeded this limit.
Some Important Details
- The law requires insurers selling policies to individuals or small groups to spend at least 80% of premiums on direct medical care and efforts to improve the quality of care. Insurers selling to large groups (usually 50 or more employees) must spend 85% of premiums on care and quality improvement.
- Your health insurance company must report yearly to the Secretary of Health and Human Services on the share of premium dollars spent on health care services and quality improvement and any rebates required. The first report, covering calendar year 2011, was filed June 1, 2012.
- Insurers made the first round of rebates to consumers in 2012.
Highlights of the Healthcare Reform Act
- Health Insurance Exchange has to be up and running by October 2013 for implementation January 1, 2014
- The mandate requiring Employers with 50+ employees working 28+ hours per week has been lifted by President Obama. This was accomplished by eliminating the penalties for 50+ employee businesses. The mandate for these larger groups will now go into effect in 2015.
- The individual mandate along with its penalties is still part of the Health Care Reform Act effective January 1, 2014.
- The 80/20 Rule is meant to control rising premiums.
- Effective 2013, Flexible Savings Accounts will now be subject to a $2,500 maximum contribution, per plan year.
- Mandatory requirements for most Americans to buy health insurance or be fined will be effective in 2014.
Small Business Tax Credits and Your Organization
The Affordable Care Act helps small businesses and small tax-exempt organizations afford the cost of covering their employees.
If your organization has fewer than 25 employees and provides health insurance, you may qualify for a tax credit of up to 35% (up to 25% for non-profits) to offset the cost of your insurance. This credit will increase in 2014 to 50% (35% for non-profits). This will lower the cost of providing insurance to employees.
Financial Assistance for those that qualify: We are Certified and Authorized to offer plans on the Individual Exchange. Many people will qualify for some type of assistance to meet the objective of providing affordable healthcare. We can help you in determining eligibility and obtaining the right program to meet your needs.
For assistance with your insurance needs, please contact Vincent Reda at (631) 543-5242 or info@mainlineins.com.
vincent@mainlineins.com