“Open enrollment” for individual health insurance is currently happening.  You have until February 15th to enroll and pay for coverage during this period.  This is information pertaining to the exchange – www.wahealthplanfinder.org.  The next open enrollment period will be November 15, 2015 – February 15, 2016.

There are other enrollment opportunities through “special enrollment periods” whereas you qualify for the same via moving to our State, losing coverage through a group plan, losing your job, etc.  Additionally, if you qualify for Washington Apple, enrollment is open all year.

For those who elect not to participate in health insurance, without an acceptable “opt out”, will be assessed penalties via the I.R.S., for lack of participating.  The penalty for 2014 will be 1% of your individual &/or family income.  Penalties will increase each year over the next couple of years.

Employer Sponsored Group Medical Plans:

It appears that small and micro group coverage will not be available in the exchanges until January 1, 2015. There will be no magic answer as to the best approach – but one thing for sure – small employers will not be subject to penalties for not providing benefits.  Again, providing benefits for one’s employees is the “right thing to do” but will not be required necessarily.  The exchanges will make sense for those who are considered low income in that government subsidies will only be available to those who apply through the exchanges.

Reform Timeline:

2011 – Dependent coverage to 26, No lifetime dollar limits, Restricted annual dollar limits to 2014, No pre-existing condition limitations for enrollees up to 19 (during open enrollment periods only), No HSA reimbursement for non-prescribed drugs, Increased penalties for non-qualified HSA distributions, Income-based Medicare Part D premiums, Insurers subject to medical loss ratio rules.

2012 – Employers to distribute uniform summary of benefits and coverage to participants, Employers to provide 60-day advance notice of material modifications for mid-year changes, Form W-2 reporting for health coverage (track in 2012 for W-2 form provided early in 2013, Coverage for additional women’s preventative care services bgins (plan years on or after August 1, 2012).

2013 – Employers notify employees about exchanges, Medical device manufacturer’s fees start, Higher medicare payroll tax on wages exceeding $200,000 individual/$250,000 couples, Change in medicare retiree drug subsidy tax treatment takes effect, Exchanges initial open enrollment period to begin, Auto enrollment likely to begin in 2014.

2014 – Health insurance exchanges, Individual coverage mandate, Financial assistance for exchange coverage of lower income individuals, Medicaid expansion, HIPAA wellness limit, Employer shared responsibility, Additional reporting and disclosure, Dependent coverage to age 26 for any covered employee’s child, No annual dollar limits, No pre-existing condition limits, No waiting period over 90 days, Health insurance industry fees begin.

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