You can switch plans mid-treatment but cost sharing doesn’t carry over from plan to plan so in most cases you should stick with the plan you are on until the end of the policy period.
When calculating the fee for the employer mandate you would subtract 30 full-time employees from full-time employees (with each 30 FTE hours counting as one employee for purposes of the mandate).
When COBRA ends it triggers a 60 day special enrollment window to enroll in HealthCare.Gov or your state’s Marketplace. Enroll before COBRA ends to avoid gaps in coverage.
Measurement periods are used by employers to determine full-time status for new-hires and existing employees in regard offering health coverage under the ACA’s employer mandate.
If an employee works at least an average of 30 hours a week, or 130 hours a month, they are considered full-time and large employers must offer health insurance to them under the law.
Out-of-network emergency care is covered under all insurance plans sold after March 23rd, 2010 as part of Ten Essential Benefits under the Affordable Care Act.
If a family member wasn’t added to a family plan during open enrollment they won’t be able to be added until next open enrollment unless they qualify for special enrollment.
Health insurance can only drop you during your policy year for non-payment, fraud, or misrepresentation. You can appeal any insurer decision.
If you estimated your income to qualify for subsidies, but didn’t make enough, you don’t owe back any money and can keep the tax credits you got in advance.
If a dependent has access to affordable employer sponsored coverage they can’t get ObamaCare’s cost assistance, but can qualify for Medicaid / CHIP.
ObamaCare counts income that counts as household income, that is your Modified Adjusted Gross income (MAGI) and the AGI of dependents.
The free preventive visit under ObamaCare covers routine wellness and prevention, it may not cover discussion of existing conditions and other asides.
The Affordable Care Act (ObamaCare) bans insurers from denying coverage or charging more for coverage for preexisting conditions like epilepsy.
Losing coverage that doesn’t count as minimum essential coverage, like short term health insurance, won’t qualify you for special enrollment.
You have a 60 day special enrollment period starting the moment your baby is born to add your child to a Marketplace family plan or to switch to a family plan.
If the cheapest employer plan available to you is 9.56% of MAGI for self only coverage you can get ObamaCare’s cost assistance.
Pregnancy, ability to become pregnant, and gender have no affect on health insurance premiums. However, the ACA does provide improved benefits and some free services to pregnant mothers and women.
Death benefits received from life insurance are typically non-taxable and thus won’t impact the household MAGI ObamaCare’s subsidies are based on.
If an employer plan would cost more than 9.5% of household MAGI for self only coverage, after employer contribution, then it qualifies you for ACA coverage.
During a 90 day or less waiting period for employer health insurance you should keep your current insurance, get COBRA, or get a Marketplace plan.
Health insurance can only be obtained during open enrollment. This applies to coverage inside and outside of ObamaCare’s Health Insurance Marketplace.
Under the ACA you can be charged a tobacco surcharge for smoking of up to 50% of your premium after subsidies, regardless of where you get coverage. Typically won’t be charged the full amount and some insurers may not charge anything at all.
Unmarried domestic partners may be able to share health coverage (domestic partner benefits) depending upon the state, employer, and filing status.
If you have an income above 400% of the Federal Poverty Level then you can’t get cost assistance, but can buy a plan on ObamaCare’s Marketplace.