WyoHealthExchangePresented by

Personal Financial Solutions, IncAffordable Care Act

The information provided in this document is not intended to advise you on how to comply with any provisions of the referenced legislation or regulations, nor is it otherwise intended to impart any legal advice. If you have any questions about how to comply with this or any other law or regulation, we recommend that you consult with your legal counsel.

ACA –Affordable Care Act

PPACA – Patient Protection & Affordable Care Act

HR 3590

ObamaCare

Enrollment Periods

Initial Open Enrollment Period will be October 1, 2013 – March 31, 2014

January 1, 2014 Effective Date

Sign up 1st thru 15th, effective date 1st of following month.

Sign up 16th to end of month, effective date is month after following month of enrollment

Annual Open Enrollment October 15 through

December 7 - After Initial Enrollment Period

Grandfather Status: Having either Group or Individual Health Insurance that covers the Minimum Essential Coverage (MEC) before March 23, 2010. Which means you comply with the New HealthCare Law and not subject to Penalties.

MEC is NOT: General Liability Ins., Accidental Death and Dismemberment Coverage, Dental or Vision, Long-Term Care, etc..

Grandfathered Plans

Healthcare Reform Laws - Overview

Some Highlights or Basics of the Law:

Pre-Existing Conditions Covered for Children (started 9/23/10)

Pre-Existing Conditions Covered for Adults - starts 2014

Maternity and Newborn Care

Mental Health and Substance Abuse

Preventive Care Services Covered

Pediatric Services, Including Vision, Oral care, and Medically Necessary Orthodontics to Age 19

Healthcare Reform Plan Designs

Catastrophic Plan

Bronze Plan

Silver Plan

Gold Plan

Platinum Plan

Out of Pocket Limit on all plans will be equal to Health Savings Account Law Limit. For 2013 the limits are $6,250 for Individual and $12,500 for Family

Less Coverage Less Expensive

Most Coverage Most Expensive

Healthcare Reform Laws - Overview

What is an Exchange / Marketplace?

A Exchange/Marketplace is a mechanism for organizing Health Insurance options to help Consumers and Small Businesses shop for coverage in a way that permits easy comparison of available plan options based on Price, Benefits, Services, and Quality. Basically it is where you go to determine if you are Eligible for Subsidies

Wyoming will have a Federally Facilitated Exchange/Marketplace

Private exchanges will be ran by Private Entities with no subsidies available

2013 Federal Poverty Level Table

Household Size 100% 133% 150% 200% 300% 400%

1 $11,490 $15,282 $17,235 $22,980 $34,470 $45,960

2 15,510 20,628 23,265 31,020 46,530 62,040

3 19,530 25,975 29,295 39,060 58,590 78,120

4 23,550 31,322 35,325 47,100 70,650 94,200

5 27,570 36,668 41,355 55,140 82,710 110,280

6 31,590 42,015 47,385 63,180 94,770 126,360

For each additional person, add

$4,020 $5,347 $6,030 $8,040 $12,060 $16,080

Penalties

**You are not Required to Buy Insurance, but You may Pay a Penalty for not having it.**

2014: $95.00 + $47.50 per child up to $285 for a family per year; or 1% of income whichever is greater.

2015: $325.00 + $162.50 per child up to $975 for a family per year; or 2% of income whichever is greater

2016: $695.00 + $347.50 per child up to $2085 for a family per year; or 2.5% or income whichever is greater

Additional Information

Small and Large Groups

Call Personal Financial Solutions at 307-778-2881 or toll free 1-877-672-7426 for Detailed information

Summary

Q & A

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1-877-672-7426778-2881