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The Artists Health Insurance Resource Center www.ahirc.org 

A program of The Actors Fund www.actorsfund.org 

Dan Kitowski, Director of Health Services - Western Region

323 330-2432 / dkitowski@actorsfund.org 

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Children under age 19 with pre-existingconditions can’t be denied coverage. 

Young adults up to age 26 can stay on or enrollin their parents’ coverage. 

Insurers can’t retroactively cancel the policiesof people who get sick.

Insurers can’t impose lifetime dollar limits on

medical benefits. All new plans must cover certain preventive

services, such as mammograms and tetanusshots, for free.

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Uninsured people with pre-existingconditions may be eligible for coveragethrough PCIP.

Pre-Existing Condition Insurance Plan

www.wship.org/PCIP-WA 

Help for the uninsured with pre-existing medical conditions thru atemporary high-risk pool until January, 2014 

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Insurers can’t refuse coverage to anyone.  Most people will be mandated to have coverage or

pay a penalty.

New insurance marketplaces, called Exchanges, will

offer insurance to those who don’t get it elsewhere.  Subsidies will be available to people who buy

insurance through an exchange with income lessthan 400% of the Federal Poverty Level. ($43,320)

Employers with 50 or more employees who don’toffer insurance will be fined.

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All new plans will offer at a minimum anessential benefits package which limits out-of-pocket medical expenses.

Including: Ambulatory care

Emergency care and Hospitalization

Maternity and newborn care

Mental health and substance abuse Prescription drugs

Preventive and wellness services

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If your income is $10,830 - $43,320 (single),you will receive a subsidy to buy insurancethrough an exchange.

Subsidies will cap the amount you spend onpremiums in relation to your total income.

Subsidies will also cap your annual out-of-pocket medical costs.

Example: a person who makes $21,000/yr will have their premiums capped at 6.3% of their income, and their annual out-of-pocket medical costs will be limited to $1,983/yr (excluding premiums). 

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Under age 30: high-deductible plan option(2014). Prevention benefits and 3 primarycare visits are exempt from deductible.

Under age 26: can stay on or enroll inparents’ plan. Applies regardless of livingsituation, marital status, student status, or

financial dependence. Exclusion: if you have access to insurance through an employer.

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If you have a new policy that began on or after9/23/2010, you can get certain preventiveservices for free:

Blood pressure, diabetes & cholesterol testsBreast, colon & cervical cancer screenings

Vaccines, immunizations & flu shots

HIV & STD testing

Screenings for healthy pregnancies

Well-child visits

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Available beginning 2010 tax year

Employers with fewer than 25 FTE’s employees withaverage wages of less than $50,000 that purchase

health insurance for employees are eligible for thetax credit

To be eligible, employer must offer a group healthplan & contribute at least 50% of premium cost

2010-2013: credit max is 35% of employercontribution (25% for tax exempt/non-profits); willincrease to 50% (35% for non-profits) in 2014

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Small business will file Form 8941when they file income tax returns

Tax exempt organizations will claim the taxcredit on a revised Form 990-T

www.irs.gov/newsroom/article/0,,id=223666,00.html 

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Artists Health Insurance Resource Center:www.ahirc.org 

Office of Consumer Information and Insurance

Oversight: www.hhs.gov/ociio  Federal health care reform website:

www.healthcare.gov 

Kaiser Family Foundation: www.kff.org 

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Rights & Protections – right to receive care in alife-threatening emergency at any hospital

regardless of insurance status.

Words to Know – HMO, PPO, High DeductiblePlan or Catastrophic Coverage.

Choose a carrier & type of policy to meetyour needs and your budget.

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 ◦ Colleges & Universities – Alumni Associations

◦ Associations Plans

◦ Chamber of Commerce

www.seattlechamber.com 

Internet brokers◦ www.ehealthinsurance.com 

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Medicaid◦ Comprehensive◦ Very low income AND fit one of these

categories: pregnant, blind, disabled, 65 orover, 18 or under, or be a parent living withchild 18 or under

◦ No premiums◦ As part of health care reform, income will be

the ONLY eligibility requirement in 2014. www.dshs.wa.gov 

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Free, sliding scale, lower cost clinics Washington Association of Community &

Migrant Health Centers◦ 25 community health centers for low income and

uninsured populations

◦ www.wacmhc.org 

Qliance◦ Primary and preventive care for a monthly fee

◦ www.qliance.com 

Sliding-scale clinics◦ Bureau of Primary Care: ask.hrsa.gov/pc 

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Dental discount plans and dental insurance

Dental schools◦ University of Washington, School of Dentistry

Negotiate with your dentist

Many of the Community Clinics have low-cost or free dental clinics for people withlow incomes.