Affordable Care Act
Mike Goodwin No Comments

The Affordable Care Act is entering it’s 5th year in the USA. Open enrollment for these plans are November 1- Dec 15 for a Jan 1 coverage date for 48 states. The other 2 states CA-CO have a little longer enrollment periods. There have been some changes that will effect many people. In December of 2017, the House of Representatives voted to eliminate the much scorned “TAX PENALTY” for individuals who chose not to have an ACA approved plan. The elimination of this penalty will now give more flexibility to individuals to choose non compliant plans that may better suit their individual needs at a much lower cost. In 2019 , Individuals who choose not to purchase health coverage or purchase a non compliant ACA- (AKA)- ( Non- Obamacare plan) will not be penalized the $695 per person or 2.5% (whichever is greater) of their taxable income any longer. 

The Affordable Care Act plans can offer a tax credit-subsidy for individuals and families that have a Federal Poverty Level percentage between 100%-400% income. The insureds monthly premium is based on the household taxable income and size of household. People who fall within those Federal Poverty level percentages may benefit financially on their premiums. The people who earn above those amounts would pay the full cost for their plans. The cost of these plans can be very expensive for the individual who makes over the 400% FPL. 

The most affordable plan within the ACA is the Bronze plan. The Bronze plan has a $7350 deductible per person x 2 for a family. In 2019 the deductible will be raised to $7900. All Adult and Children’s wellness visits are covered at 100%. Individuals who have major preexisting conditions can not be declined.  There are ZERO PPO plans available with the ACA. HMO and EPO plans are available to purchase, and this means that an insured must go to a Doctor in their area that is in network. These networks have been known to be limited on what providers will accept their insurance. 

The self employed and employees whose employers do not offer health coverage may have more options to choose from without financial penalties to be concerned about come tax time. The non compliant plans come in a couple different options. There are the so called Short Term PPO plans that individuals can purchase that have common deductibles to choose from. These plans are generally PPO networks, which means they have greater flexibility vs. ACA plans as to where they can get services in network. These type of plans generally do not cover maternity and all people applying must medically qualify. So, if someone has recent major health issues like Heart disease, Type 1 diabetes and Cancer, they may not qualify for this type of plan. Up to now, these plans were available to keep up to 6 months to 1 year, depending on state of residence. The USA government recently announced they will be extending the option to carry these Short Term plans for up to 36 months,  without having to shop for a new plan. This new law should be enacted in October 2018. 

There area also several Fixed Indemnity PPO plans that offer a fixed benefit for services provided. These plans offer greater flexibility as to where an insured can receive services. The Fixed Indemnity plans usually do not cover maternity and one must medically qualify. This is an option for the individuals who are generally in good health and that do not want to pay the Affordable Care Act premiums they may be subject to. 

If you have any questions regarding Health & Life insurance you may reach me, Mike Goodwin at 303-884-1333 or email at

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