Obamacare will soon to be fully implemented and many Americans, employees and employers are still learning about what is coming down the road. To this end, Tonda Soisson-Lawson, employee benefits manager at Brown & Brown insurance of Florida Inc., told business leaders who are members of the Greater Lehigh Acres Chamber of Commerce in her healthcare reform update to them that last week she was going to speak primarily about government updates and regulations concerning small businesses, or those with under 50 employees.
"There are certain things to know for Jan. 1 of 2014," Soisson-Lawson said.
She went about to list six important elements of the Obama healthcare law, also known as the Affordable Care Act.
She told business owners that the "Individual Mandate" goes into effect on January 1, which means everyone must either have group medical insurance through their employer, an individual policy or a federal marketplace policy in order to not pay the penalty for non-coverage.
"The penalty in 2014 is the greater of 1 percent of family income or $95 per adults and 50 percent for dependents/family max of $208,
"And in 2015, the penalty raises to greater of 2 percent of family income or $325 per adults and 50 percent for dependents/family max $2,085," she said.
Soisson-Lawson spends much of her time working more than 40 hours a week in an attempt to explain what is ahead in Obamacare.
On individual coverage, she said subsidies through the federal marketplace and how they work - a subsidy is only available to qualified individuals purchasing individual coverage through the exchange.
"Individuals with family incomes between $100 percent to $400 percent of the federal poverty level are eligible for a subsidy of an undetermined amount at this time. If you get a subsidy inappropriately, there will be tax consequences," she said.
And Number 3, Soisson-Lawson said that if you are eligible through a family member for any type of affordable coverage from these four sources - Medicare, Medicaid, Tricare or Employer coverage, then you are not eligible for a subsidy through the federal marketplace.
She said the term "Family Glitch" is in the news in response to Americans discovering that PPACA only concerns itself with the affordable nature of the employee only line of coverage and not family coverage, which could leave millions uninsured.
"The Kaiser Family Foundation reports that employee coverage cost an individual approximately $5,600 per year; however, family coverage is over $15,000.
"Therefore, if an employer is offering affordable coverage then the employer and employees are both good; however, if the employee cannot afford to pay 100 percent of the dependent coverage, his or her family cannot go to the federal exchange for a subsidy. In addition, the IRS has just stated that those spouses and families not being able to obtain insurance because of the family glitch would not have to pay the penalty for non-coverage.
She noted that federal exchanges notices are required to be sent out to all full-time, part-time seasonal, variable hours, COBRA, and disabled employees by employers in small and large groups. Model notices are on the Department of Labor website.
She told business leaders that employers who are offering insurance may want to look into using a defined contribution amount for employees instead of a percentage of the employee only coverage to allow employees to decide how to spend their contribution based on their family needs.
While the whole subject of Obamacare may be confusing because of the changes being made from time to time, Soisson-Lawson said she is available to answer questions and provide more information. Those interested can email her at: email@example.com or call 239-274-1446.
Her presentation was in conjunction with the Greater Lehigh Acres Chamber of Commerce's August meeting. She is a member of the Lehigh chamber and a community activist in Lehigh.