WASHINGTON STATE OFFICE OF THE INSURANCE COMMISSIONER

The Affordable Care Act What it means for you

Small employers
(1-50 employees)

Individuals and families

Children cant be denied health coverage if theyre sick No out-of-pocket costs for preventive services No cap on lifetime benefits Young adults can stay on their parents plan up to age 26 Seniors prescription drug donut hole closing No out-of-pocket costs for seniors preventive Medicare services Expanded coverage for early retirees

Small businesses are not required to offer health insurance, but if they do, they could get a tax rebate: Up to 35% today Up to 50% in 2014

Large employers
(more than 50 employees)
Large employers will pay a penalty, starting in 2015, if they dont offer meaningful and affordable health insurance to their employees A plan is considered unaffordable if it costs more than 9.5% of the employees household income or if it pays for less than 60% of covered health care expenses Large businesses cant buy coverage through Washingtons Health Benefit Exchange

Coming in 2014:
Most people must have health insurance by 2014 or pay an annual fine of $95 or up to 1% of your income, whichever is greater No one can be denied health coverage if theyre sick You can buy a health plan through Washingtons Healthplanfinder All individual and small employer health plans will cover essential health benefits Theres help if you cant afford coverage: Subsidies for individuals earning up to $45,960 and up to $94,200 for a family of four Medicaid expansion for childless adults who earn less than $15,856

How Washington state is implementing health reform

The Health Benefit Exchanges Washington Healthplanfinder
Washingtons Health Benefit Exchange is creating a new online marketplace called the Washington Healthplanfinder where individuals and families can buy private health insurance. (www.wahealthplanfinder.org) Unbiased advisors, known as in-person-assistors and navigators, will help you compare and select a private health insurance plan thats best for you, for free. All plans sold in the Healthplanfinder will cover 10 categories of essential health benefits More than 477,000 people will qualify for subsidies to help them afford coverage Learn more at: www.wahealthplanfinder.org

Medicaid expansion
Federal money is available to cover approximately 328,000 additional people in Washington state Expanded to cover individuals between the ages of 19 up to 65 (parents, and adults without dependent children) with incomes up to $15,856 (138% of the Federal Poverty Level). Learn more at: www.hca.wa.gov/hcr/me/Pages/index.aspx

Learn more about health reform at

www.insurance.wa.gov/current-issues-reform/health-care-reform

Questions?
Updated 8/21/13

WASHINGTON STATE OFFICE OF THE INSURANCE COMMISSIONER

The Affordable Care Act What it means for you

Email us at AskMike@oic.wa.gov Call us at 1-800-562-6900