Answers to common questions about Healthcare Reform.

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Dear valued client:

There was a lot of response from my first email about how the Healthcare Reform Act (the Patient Protection and Affordable Care Act of 2010 (PPACA)). There were many questions repeated, so it seems many of you have the same inquiries. I will use this email to hopefully answer many of your questions. (Or maybe these are questions you didn’t think about but when you look this over will say AHA!)

I can’t afford insurance.

How can the Government force me to get it? Households making less than 400% of the Federal Poverty Level (FPL) may be eligible for subsidies to help pay for their health insurance. The Government can’t force you to get health insurance, but the Act allows them to tax you if you don’t get it. In 2014 this tax or penalty is $95 for an adult, $47.50 per child or 1% of household income, whichever is greater. This penalty increases dramatically in 2015.

How do the subsidies work?

The subsidies on health insurance are tax credits. You can wait until you file your taxes for 2014 to get your subsidies as a refund, but many people entitled to these subsidies wouldn’t be able to afford health insurance that way. So the Government has set up Advanced Tax Credits to help pay your health insurance premiums on a monthly basis. For example, let’s say your health insurance premium is $600/month and you are entitled to a subsidy so you only have to pay $200/month. You pay the insurance company $200 each month and the Government, on your behalf, pays the other $400/month.

How am I supposed to know what my household income will be in 2014?

Well, all you can do is estimate. If you get overtime, for example, you may make more than you anticipated. If your hours were cut back you may make less than anticipated. Self-employed people can have wide variations in their income. The final amount will be reconciled when you file your 2014 taxes.

What is the Exchange?

This is the where subsidized health insurance plans are purchased. After five years of calling it the Exchange, in the last few weeks the Government has changed the name to “The Marketplace” because it is a more accurate name and easier for the public to understand what it does.

I don’t want Government insurance!

Health insurance will continue to be provided by private insurance companies. In the Tampa Bay area you will see familiar names on the Marketplace; Aetna, Blue Cross, Cigna, Coventry and Humana. Other companies will be available in other areas of the State.

Can I still work with you as my Agent?

Yes you can! I can help you identify if you qualify for a subsidy. Whether you do or not, I can guide you through the myriad of options.

Should I cancel my current insurance plan and enroll in one of these new plans?

That depends. If you qualify for a subsidy you may want a new plan. (There are situations in which you are better off keeping your current plan even if you qualify for a subsidy.) If you want maternity coverage and your current plan does not offer it, you definitely want to take this option. If you are on a HIPPA plan (also called a Portability Plan) you definitely want to take this option. If you had a big rate up in order to get health insurance, you want to look at this option. If you want to find out more information to see what is the best for you, please click the link below……


When would I be better off avoiding the 2014 plans?

If you don’t qualify for a subsidy, you can anticipate a rate increase on your health insurance of 20 – 70%. If you are a tobacco user, you will get a 50% rate increase above and beyond that. If you are very healthy and just carry catastrophic coverage, you may want to avoid the 2014 plan designs.

What should I do to avoid the 2014 plans?

Please click the link below to contact me so I can weigh your information and guide you in the most appropriate way.


What is your next step?

Click on one of the links above to take you to your options. If unsure of what is the best choice for you, please contact me at paul@wavrock.com If your employer offers health insurance, your options can be significantly different. Contact me to explain how your employers’ group plan can affect you and your family.

Thank you!

Paul Wavrock
About the Author
Paul Wavrock is the founder of Heath Insurance of Florida, a full service Health Insurance brokerage firm, that utilizes several major National and local Insurance providers to assist its clients and their insurance needs.