Can Self Employed get Obamacare?

If you are currently self-employed (work for yourself), you probably are familiar with the challenges of getting affordable health insurance on the open market. Even when you do find one, the cost can be prohibitive and sometimes, you are not sure what exactly is covered under the plan you purchased. With all the noise about Obamacare, you may be wondering – Can Self Employed Get Obamacare? The answer is YES. One of the benefits of the Affordable Care Act (ACA) is that self employed individuals can now get affordable health coverage through the health exchanges. Starting October 1, 2013, you can use the Marketplace to find health coverage that fits your budget and meets your needs. You can compare important features of several plans side-by-side. All the plans available to you will offer a full package.

One of the great features introduced by the ACA is that you cannot be denied coverage or charged more because of a pre-existing condition. Click here to sign up. To learn more about applying for Obamacare and how to sign up (including what documents you need to complete the application process), click here.

If you currently have individual insurance that you purchased yourself on the open market (not the kind you get through an employer), you may be able to change to a Marketplace plan. Click here to learn more about changing individual insurance plans.

Self-employed Definition under the ACA
You are considered self-employed if you run an income-generating business with no employees. You’re still classified as self-employed even if you hire independent contractors to do some work.

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Obamacare Individual Mandate

The Individual Mandate is one of the major pillars of the Affordable Care Act (ACA), otherwise called Obamacare. The mandate requires most people to obtain health insurance or pay a penalty for noncompliance. Specifically, the mandate requires individuals to maintain minimum essential health insurance coverage for themselves and their dependents by January 2014 or face a penalty. Some individuals will be exempt from the mandate while others who qualify may receive subsidies to help them pay for the cost of their heath insurance.

Who does the Obamacare Individual Mandate Affect?

Whether you are affected by the Affordable Care Act individual mandate depends on whether you currently have health insurance coverage that meets the “Minimum Essential Coverage” as required by law. Those who currently have insurance coverage through their employer or through the government (like medicare or medicaid) do not fall under the individual mandate and have nothing to worry about. The mandate is aimed at the 57 million people under the age of 65 who do not have health insurance. Click here to learn more.

What is Minimum Essential Coverage?

Under the Affordable Care Act, Minimum Essential Coverage is defined as having insurance coverage under one of the following categories:

  • Coverage under certain government-sponsored plans
  • Employer-sponsored plans, with respect to any employee
  • Plans in the individual market,
  • Grandfathered health plans; and
  • Any other health benefits coverage, such as a state health benefits risk pool, as recognized by the HHS Secretary.

How Do I comply with the Mandate?

If you do not currently have health insurance or if you purchased health insurance from the open market and are thinking of switching, you can purchase insurance through the online exchanges set up in each state (also called the Health Insurance Marketplace). Each state has their own health insurance marketplace where individuals, families and small business can shop for affordable health insurance. Click here to learn more about how to apply for insurance through the exchange. Here is a good video explaining the Individual Mandate and how to comply.

What if I cannot afford to buy Health Insurance?

You may qualify for a government subsidies to help you buy health insurance on the exchange if your income is less than 400% of the federal poverty level (which in 2013 stood at $45,960 for an individual and $94,200 for a family of 4). To learn more about whether you qualify for subsidies to buy health insurance, click here.

What happens if I refuse to buy insurance?

If you do not buy the minimum level of insurance required under the Individual Mandate, and you do not qualify for the Individual Mandate exemptions, then you will have to pay a penalty to the Internal Revenue Service (IRS).

How Much is the Obamacare Individual Mandate Penalty?

If you fall under the individual mandate but fail to buy the minimum level of health insurance coverage required, you will have to pay a penalty of $95 (for each adult) and $47.50 (for each child). The penalty must be paid at the end of the tax year to the IRS. The penalty goes up from 2016 and beyond to $695 for each adult and $347 per child (up to $2,085 per family) or 2.5% of family income whichever is greater. Click here to see IRS guidelines on the penalty. See the table below for details about the penalties:

"Obamacare Individual Penalties"

Obamacare Individual Mandate

Note: The penalty assessed is based on the number of months in a given year an individual or their dependent is without “minimal essential coverage” or an exemption.

Who is Exempted from the Individual Mandate?

There are 9 different groups/categories that are exempted from the Obamacare Individual Mandate requirements. These group of people will not face any penalty for noncompliance with Obamacare. They are:

  • Individuals who cannot afford coverage
  • Individuals with household income below the filing threshold
  • Members of federally recognized Indian tribes
  • Individuals who experience a hardship
  • Individuals who experience a short coverage gap
  • Members of certain religious sects
  • Members of a health care sharing ministry
  • Incarcerated individuals
  • Individuals who are not lawfully present in the United States

For a details explanation on each of these groups and how to apply for an exemption, click here. Also, here is a great article on 5 Myths of the Individual Mandate.

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How Obamacare Affects Small Businesses

When it comes to Obamacare small businesses want to know what it means for them. How does the law impact them and what are the requirements they must comply with. We have all the answers.

To understand how Obamacare affects small business, you first have to understand what the Obamacare Employer Mandate is about. The the small business requirements under the Affordable Care Act (ACA) – also called Obamacare depends on whether you are affected by the employer mandate or not.

"How Obamacare Affects Small Businesses"

How Obamacare Affects Small Businesses

How Obamacare Affects Small Businesses

Businesses with more than 50 Employees

The employer mandate under the ACA requires that businesses with more than 50 employees provide health insurance coverage to their employees or face a penalty of $2,000 per employee. However, when you look at the data provided by the census bureau, only 10,000 business, out of the 5.7 million surveyed will be directly impacted by the employer manage. The reason is that more than 95% of businesses with more than 50 employees already offer health insurance coverage. For a more detailed analysis of the employer mandate, click here and here.

 Businesses with 50 or fewer Employees

If your business has 50 or fewer employees, then you are not required under Obamacare to provide health insurance to your employees. Howver, you are required to inform your employees of their health insurance options. They can enroll under your employer provided plan or they can choose to buy insurance directly from the healthcare insurance exchange through the state.

If you have 25 or fewer employees and an average wage of $50,000, you can apply and receive tax credits to help you cover some of the cost of providing health insurance for your employees. To learn more about Obamacare for Small Businesses, watch the video below or visit this website.

Self Employed

If you are self employed (work for yourself) with no employees, visit our Self Employed Obamacare page for details on how the Affordable Care Act applies to you.

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Obamacare Employer Mandate

In this article, we want to provide a summary of the often discussed but misunderstood Obamacare Employer Mandate. In the Affordable Care Act (ACA), otherwise known as Obamacare, there is an Individual Mandate, which has requirements for individuals, and there is the Employer mandate, which has requirements for businesses (employers).

Employer Mandate Summary

The employer mandate requires businesses to provide health insurance for their employers. Specifically, businesses with over 50 full time employees must provide health insurance for their employees or face a tax penalty of $2,000 per employee. Small businesses with 50 or less employees are not subject to the mandate and WILL NOT pay a fine for not providing health insurance to their employees. In addition, small businesses with less than 25 employees can get tax credits of up to 50% of their employee premium costs to purchase insurance via their State’s Health Insurance Marketplace.

How Many Businesses are Directly Affected By the Employer Mandate?

According to the census bureau, only 3.6% of businesses in the United States employ 50 or more workers. That’s 210,000 business out of the 5.7 million surveyed by the Census Bureau in 2010. However, of the businesses that have 50 or more employees, 94% of those with 50 – 199 employees already provide healthcare coverage to their employees, while 98% businesses with 200 or more employees already offer healthcare coverage to their employees. Therefore the individual mandate and penalty will directly affect about 10,000 businesses out of the 5.7 million surveyed by the Census bureau. So, as you can see, the mandate is directed at only a very small fraction of businesses.

Employer Mandate Delay

The employer mandate was originally set to begin in January 2014, but the Obama Administration has delayed it’s implementation by a year, which mean that the employer mandate and penalty will begin to be applied beginning in January 2015.

Small business and the Employer Mandate

The Affordable Care Act affects all businesses. Under the law, only employers with more than 50 full time employees are required to provide health insurance. However, there are provision that affects businesses of all sizes. For the purposes of the law, businesses are divided into three (3) categories. We look at each business category below and the elements of Obamacare that apply.

1. Self Employed

Under Obamacare, you are considered self-employed if you run an income-generating business with no employees. You’re still classified as self-employed even if you hire independent contractors to do some work. If you call under this category, you have to purchase insurance through your state’s healthcare exchange. Starting October 1, 2013, you can use the Marketplace to find health coverage that fits your budget and meets your needs. If you currently have individual insurance that you purchased yourself on the open market (not the kind you get through an employer), you may be able to change to a Marketplace plan. Click here to see our detailed post on Obamacare for the Self Employed.

2. Small Business with 50 Employees or Less

If you are a small business and have 50 or fewer employees, then you are required under the ACA to inform your employees about their health insurance options. Your employees can either choose to participate in your employer provided health plan or they can purchase insurance directly through the health insurance marketplace in their state of residence.

If you are a small businesses with 25 or fewer employees and an average wage of $50,000, you can apply and receive tax credits to help you cover some of the cost of providing health insurance for your employees (which can be purchased through your state’s health insurance marketplace). Click here to learn more or watch the video below for a detailed explanation.

3. Businesses with more than 50 Employees

Businesses with more than 50 employees are required to offer health insurance to their employees or face a penalty of $2,000 per employee with the first 30 employees exempted. If a company with 60 employees is subject to the penalty, its annual liability would be $60,000 (60 employees: 30 employees x $2,000 = $60,000). For a detailed look at the employer mandate penalty and what it means for businesses, click here.

As stated above, the employer mandate has been delayed and will begin in January 2015.

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Obamacare Summary – Affordable Care Act Explained

"Obamacare summary"

What is Obamacare?

The Affordable Care Act (ACA), popularly known as Obamacare is a national healthcare law passed in 2010. The law has two main purposes:

1) To make health insurance better for people who already have it, and

2) Provide the more than 60 million people without health insurance the opportunity to get coverage.

To achieve the two goals stated above, the ACA includes new rules for  for private insurers (like Aetna and BlueCross/BlueShield), public insurers (like Medicaid), employers, and everyday citizens. The basic framework for Obamacare was first implemented in the state of Massachusetts in 2006 under then-Gov. Mitt Romney. President Barack Obama adopted that plan as the basis for the Affordable Care Act. The video below from Kaiser Family Foundation does a great job of explaining what the Affordable Care Act is all about. The ACA law is about 1,000 pages and this video is a great summary. It breaks down the law and looks at how it will affect you, how much it will cost, and what lies ahead. It will be worth your while watching it.

How Does Obamacare Affect Me?
According to a recent story by the Washington Post, most people will not be directly impacted by Obamacare and here is why:

"How will Obamacare affect me?"
Source: Washington Post

As the image above shows, around 80% of Americans get their health insurance through their employer or the government. These people will not have to sign up under Obamacare (unless something changes with their employer). However, they could still be affected by other parts of the law, including efforts to improve care quality or cut health-care costs.

Obamacare is mostly focused on the 20 percent of Americans shown in the image above who are either uninsured or get insurance on the individual market. If you fall under that category, then you can sign up for Obamacare through the Insurance Marketplace established for your state. If you make more than the federal poverty line, but less than four times the poverty line ($94,200 for a family of four), you can buy subsidized insurance on the marketplaces. Those making less than 133 percent of the poverty line, and living in a state that has accepted the Medicaid expansion, can get Medicaid.

If you already have insurance through the government or your employer, then you do not have to sign up for Obamacare.

When Does Obamacare Begin?
The first important date on the Obamacare launch calendar is October 1, 2013. That is when the Health Insurance Marketplaces established under the ACA will officially open. The Marketplace is a new way for Individuals, Families and Small Businesses to find quality health coverage. The marketplace is also for those who don’t have coverage or those who currently have coverage but want to find something better or want to see what other options are out there that can meet their needs.

Each state has its own marketplace. Some states run their own marketplace while the federal government runs the marketplace for states that declined to run their own. To sign up for Obamacare, visit your state’s Insurance Marketplace. All you have to do is fill out one application and you will then find out if you can get lower costs based on your income. You can also compare your coverage options side-by-side, and enroll in a plan of your choice. The enrollment perioed for Obamacare runs from October 1, 2013 to March 31st, 2014. Coverage for plans begin as early as January 1, 2014. For detailed instructions on how to sign up for Obamacare, click here.

I don’t have Health Insurance but don’t want Obamacare. What will happen?
If you are eligible for health insurance under the Affordable Care Act and do not sign up by April 2014, you will have to pay a fine. The fine for the first year is only about $100 (though it will increase over the years). However, if the policy costs more than 10 percent of your annual income or you don’t pay any federal taxes, you won’t have to pay a penalty. Whether the government will enforce the penalty or not is another matter. We have to wait and see.

We hope this Obamacare Summary helpful.

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How will Obamacare Affect Me?

There is no getting around the fact that the Affordable Care Act (popularly known as Obamacare) has become a political football. But, behind all the politics, the government is moving full steam ahead to implement Obamacare . The biggest question about the Affordable Care Act is this – How will Obamacare Affect Me? If I already have insurance, do I have to do anything? If I don’t have insurance, what are my options? We have the answer for you below:

According to a recent story by the Washington Post, most people will not be directly impacted by Obamacare and here is why:

As the image above shows, around 80% of Americans get their health insurance through their employer or the government. These people will not have to sign up under Obamacare (unless something changes with their employer). However, they could still be affected by other parts of the law, including efforts to improve care quality or cut health-care costs.

Obamacare is mostly focused on the 20 percent of Americans shown in the image above who are either uninsured or get their insurance from the open market. If you fall under that category, then you can sign up for Obamacare through the Insurance Marketplace established for your state. If you make more than the federal poverty line, but less than four times the poverty line ($94,200 for a family of four), you can buy subsidized insurance on the marketplaces. Those making less than 133 percent of the poverty line, and living in a state that has accepted the Medicaid expansion, can get Medicaid.

If you already have insurance through the government or your employer, then you do not have to sign up for Obamacare. To sign up for Obamacare, click here to learn more

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Welcome to Obamacare Facts

With all the political storm around the Affordable Healthcare Act (ACA), otherwise known as Obamacare, there is a lot of confusion out there about what the law will and will not do. A recent Kaiser Health Tracking poll showed that just 15 percent of the general public, and only 12 percent of the working-age uninsured, knew ACA Healthcare exchanges were launching in October. It is this kind of lack of awareness our website – Obamacare Facts Help seeks to tackle in our own small way. We will present the facts to you – no spin.

"Obamacare facts"

Obamacare Facts

On October 1, the exchanges are going in effect and will be open for the uninsured to start signing up. Given the threat of a government shutdown around the same time over defunding Obamacare, the news about the exchanges may not be getting through. But with polls showing the public does not want the government to shutdown over the ACA, hopefully the news will focus back on getting the word out for people to sign up.

We plan to bring you a comprehensive list with links and phone numbers from each state – so that you know where to go to sign up. We also plan to add more content about cost, comparing plans choices and latest data available about how the sign up process for the exchanges are going.

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