By Crystal J. Davis, CJD Consulting Solutions, LLC
For nonprofit organizations, The Affordable Care Act, will impact how these agencies deliver health care services in the community and the people the organizations serve. The National Council of Nonprofits shared important information that I would like to pass along.
HEALTH INSURANCE EXCHANGES
- Every state will have an Affordable Insurance Exchange or‘Marketplace,’ where individuals and small employers can look for and purchase affordable private health insurance. Enrollment through the Exchanges begins October 1, 2013 for coverage effective January 1, 2014. Nonprofits are not requiredto buy insurance for employees through the Exchanges; they can continue with their existing plan. Initially, Exchanges will be open to individuals buying their own coverage and employees of firms with 100 or less workers (50 or less in some states).
- Most U.S. residents will continue receiving their health insurance through their employer, not through Exchanges. For those purchasing through Exchanges, plans are arranged into four categories based on level of coverage/benefits: bronze, silver, gold and platinum; there will also be a young adults’ plan. Costs will vary by type of plan and location. Most people purchasing through the Exchange will be eligible for subsidies; insurers cannot charge more based on gender or health status.
THE SHOP PROGRAM
- For smaller nonprofits: if your organization has less than 50 full-time employees it’s considered a ‘small employer’ and will be eligible to purchase health insurance through state-specific SHOP programs (Small Business Health Options Program) making it easier to secure affordable health plans.
Advantages of SHOP:
- Agencies can offer a single plan for all employees.
- Nonprofits can decide how much they want to contribute towards premiums.
- Nonprofits can collect employees’ share of premiums through payroll deduction.
- Premium contributions can be made with pre-tax dollars.
- Agencies can receive one monthly invoice and make one monthly payment.
INFORMING EMPLOYEES
Employees can begin shopping on October 1. The National Council of Nonprofits suggests the following;
- All plans must cover doctor visits, hospitalizations, maternity/emergency room care, and prescriptions.
- Some employees will be eligible for subsidies to help pay for a health insurance plan.
- Insurance plans cannot deny coverage for employees with pre-existing conditions.
- All plans have to show costs and what’s covered in plain language (no fine print).
- Policies will be sold by private insurance companies that must follow rules and provide high-quality plans.
For more information, call 1-800-706-7893 (Health Insurance Marketplace Small Employer Contact Center). Happy Shopping!
