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Health & Fitness

Top Ten Most Popular Questions Answered...

These are the answers to the top ten most common questions about Obamacare:

1. The Exchange and upgraded benefits to all plans will not happen on October 1. Beginning October 1 through December 23, you can enroll in the new plans but they will not be effective until January 1, 2014.

 

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2. If you have a grandfathered plan ( a plan that has not been changed prior to March 23, 2010), you will strongly want to consider keeping your plan because they are not required to add all the new essential benefits and have to meet the new plan designs.

 

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3. The primary purpose of the Exchange is provide a place for low income people to get a subsidy from the government to help pay for their premiums. The rates are high inside the Exchange because they are required to be “richer” plans than usual. Costs in the Exchange have gone up most for younger people, although this can be offset by subsidies if income is low.

 

4. Subsidies for individuals vary by age and are supposed to help with incomes up to $45,000,  but I see very small or no subsidies once your income goes over about $35,000

 

5. To calculate your income to see if you are eligible for subsidies, you will need your Modified Adjusted Gross income which is essentially your entire family income from all sources including qualified dividends, ordinary dividends, alimony, business income, pensions, rental income and tax exempt interest to name a few. Essentially you are looking at Line 37 plus Line 8b on your form 1040 tax form.

 

6. If you have a changing income, it is going to be difficult to determine your subsidy and if you earn more than what you provided upon enrollment, you will have to pay the money back. There will be an option to receive the subsidy at the end of the year when you will know what your income was.

 

7. The only payment method upon enrollment into the Exchange is a credit card or an E-check. They are considering other options such as a pre-paid debit card or a money order.

 

8. There are plans inside the exchange and outside the exchange. Contact a broker for a true comparison between plans to see what is your best option.

 

9. If you have a plan at work, it is “minimum essential coverage” and you are not paying more than 9.5% of your salary for your health care, you cannot get a subsidy from the Exchange. If your spouse and children are or are not on the work plan, they will also not be able to get a subsidy because your own coverage is considered “affordable.”

 

10. If you earn too much money to qualify for a subsidy, there would be no point in looking at plans in the Exchange because there are similar and better options from the same insurance companies outside the Exchange and you would not have to provide your tax data and interact with Health and Human Services, IRS, Treasury and Homeland Security

Ken Williams ChFC, CLTC, CLU CHRS is a health insurance broker with 23 years experience in Kirkland. He works with small businesses and individuals. Please feel free to contact him at 425 821 7914 or kenwilliams@sunstreetsecurities.com
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