What You Need to Know About Healthcare Reform
- Your patients may qualify for financial help with their insurance coverage.
- The Affordable Care Act mandates a three-month grace period.
- You may be affected as an employer.
1. Your patients may qualify for financial help with their insurance coverage.
Almost everyone needs to have healthcare coverage or pay a penalty. To help more people afford high-quality health coverage, the government is assisting with the cost of coverage for people at certain household income levels. To get financial help, they must:
Two types of financial assistance are available:
- Tax credits – People whose household income is between 100 percent and 400 percent of the federal poverty level may qualify for a tax credit. Learn more about the premium tax credit.
- Cost-sharing reductions – For people whose household income is between 100 percent and 250 percent of the federal poverty level (up to 300 percent for Native Americans), the government may also help pay part of copays, coinsurance, and deductibles. Learn more about the cost-sharing reduction program.
2. The Affordable Care Act mandates a three-month grace period.
This grace period applies to individual members who receive a premium subsidy from the government and are delinquent in paying their portion of premiums. It only applies to individuals who meet all of the following:
- Enroll through HealthSource RI (or their state’s health insurance marketplace/exchange).
- Receive a premium subsidy in the form of a tax credit and/or cost-sharing reduction.
- Have paid for at least one month of coverage.
For more information on how the grace period will be handled, please see the Provider FAQs.
3. You may be affected as an employer.
Many providers are also small business owners, so the Affordable Care Act may affect any health coverage you offer your employees. If you have fewer than 50 full-time or full-time equivalent employees, you are not required to offer coverage. To learn about how your plan benefits may change, and your options for buying coverage, please see the small employer page. You may also want to read the information for all employers.