Affordable Care Act (ACA)

   The Patient Protection and Affordable Care Act (Affordable Care Act) adds many protections related to employment-based group health plans for you and your family.  These include extending dependent coverage up to age 26; prohibiting pre-existing condition exclusions for children under age 19 and for all individuals beginning in 2014; and requiring easy-to-understand summaries of a health plan’s benefits and coverage.

   Additional protections that may apply to your plan include the requirement to provide coverage for certain preventive services (such as blood pressure, diabetes and cholesterol tests, regular well-baby and well-child visits, routine vaccinations and many cancer screenings) without cost-sharing, and coverage of emergency services in an emergency department of a hospital outside your plan’s network without prior approval from your health plan.

   The Affordable Care Act also provides coverage options that allow you to maintain health coverage for you and your family. This page provides information on the Affordable Care Act to help you consider your options and make informed decisions, along with contact information should you have further questions.

   Employers must provide notice to employees of coverage options.  No later than October 1, 2013, employers will be providing these notices to current employees and to new hirees within 14 days. If your employer offers a health plan to some or all employees, you will receive this notice. If your employer does not offer a health plan, you will receive this notice.

Reconcile Advance Payments of the Premium Tax Credit

   You must file a tax return to reconcile any advance  payments of the premium tax credit that were paid on your behalf and to maintain your eligibility for future premium assistance. If you do not file, you will not be eligible for future advance credit payments.

   The Affordable Care Act includes the individual shared responsibility provision and the premium tax credit that may affect your tax return. 

   The individual shared responsibility provision requires you, your spouse, and your dependents to have qualifying health insurance for the entire year, report a health coverage exemption, or make a payment when you file.  In addition, you may be eligible for the premium tax credit if you purchased health coverage through the Health Insurance Marketplace.