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The Affordable Care Act (ACA) is taking shape and moving forward very quickly as the Health Insurance Exchanges or Marketplace are expected to be online October 1, 2013. The Marketplace is a place to buy health insurance on the internet and will allow agents and consumers to view plans and pricing for plans with an effective date of January 1, 2014 or later.

Major changes that take effect January 1, 2014 include but are not limited to:

  • No one can be Denied coverage for any Pre-existing Condition
  • No one can be Charged more for any Pre-existing Condition
  • No Condition can be Excluded from Coverage
  • Men and Women of the Same Age will Pay the Same Rate
  • Older adults can not be Charged more than 3 Times than Younger adults
  • All plans must include 10 categories of mandated Essential Health Benefits such as Maternity and Newborn coverage, Mental and Substance Abuse treatment which have not previously been covered
  • Preventative & Wellness care is Covered at No Cost
  • Tax Penalties for those who do Not have a Qualified Health Plan (QHP)
  • Premium Subsidies or Premium Tax Credits from the Government to help Pay for Premiums are available to Individuals and Families with Income under 400% of the Federal Poverty Level (FPL)


What does this mean to you and what do you need to do?

To receive the premium subsides or premium tax credits you must purchase a plan on the Marketplace and your annual income must be under $45,960 for an individual, $62,040 for a couple, $78,120 for an family of 3 and under $94,200 for a family of 4.

I have seen some of the plans and some of the rates from the carriers for next year and there is some Good News and some Bad News. The good news is that the plans will have new benefits that you don’t have now and in many cases lower deductibles and lower maximum out-of-pocket costs. The bad news is that due to more benefits, no one being denied coverage and many other reasons many younger people will see there rates increase if they are above the FPL. Your current health insurance provider may be sending you a letter with an option to renew at the end of the year so you can keep you current plan instead of being forced to take the newer plans.

Please contact me with any questions you have about Healthcare Reform and your options for 2014. Thank you for your continued business.

2013 Federal Poverty Guidelines

48 Contiguous States & DC

Note: The 100% column shows the federal poverty level for each family size, and the percentage columns that follow represent income levels that are commonly used as guidelines for health programs.

Health Insurance

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
7$35,610$47,361
$53,415$71,220$106,830$142,440
8$39,630$52,708
$59,445$79,260$118,890$158,520
For each additional person, add
$4,020$5,347
$6,030$8,040$12,060$16,080