Overview of “ObamaCare” – Impact in 2013

Many thanks to Brad Johnson, Certified Healthcare Reform Specialist from Covenant Insurance Group, for his overview of “ObamaCare” at last week’s Chamber luncheon. It’s clearly an important topic for all of us, and we had over 125 of you in attendance.

As Brad mentioned, a lot of people are in the dark when it comes to what the new law entails. One general presentation only scratches the surface, but Brad will be coming back to Sheridan on May 31 for a half-day seminar sponsored by the Big Horn Mountain Chapter of the Society for Human Resource Management (SHRM). We’ll be sharing more about that as the time is closer. But you can be planning to attend even now – click here for the training event brochure.

See below for a summary of the presentation.


Overview of PPACA* – Impact in 2013
*Patient Protection and Affordable Care Act, aka ObamaCare

Summary of presentation by Brad Johnson, Certified Healthcare Reform Specialist, Covenant Insurance Group, April 10, 2013
Summary courtesy of Tracee Davis, Sheridan Media, with a few modifications by the Sheridan County Chamber

The upcoming year will be a big one in terms of implementing healthcare reform for both businesses and individuals, as key components of the Affordable Care Act go into play.

Individuals will be required to have insurance for themselves and provide it for their families, and no one can be turned down by an insurance company for pre-existing conditions. Employers with 50 or more employees must provide an insurance plan to their workers.

Brad Johnson, Benefit Consultant with Covenant Insurance and Certified Healthcare Reform Specialist, shared these facts and many others at the Chamber of Commerce’s monthly luncheon. According to Johnson, a lot of people are in the dark when it comes to what the new law entails.

Johnson says the financial side of the insurance mandate is going to cost employers more money, and will most likely raise individual insurance premiums between 60 and 80 percent. He says hopefully, there will be a return in society for that investment.

The truth is that no one really knows what’s going to happen when ObamaCare goes into full swing.


Johnson shared a dozen of the key stipulations currently written into the Affordable Care Act:

– The Affordable Care Act provides for cost-sharing subsidies for families at or below 400% of the Federal Poverty Level. That’s approximately $80,000 per year for a family of four.

– Employers with 50 or more full-time employees are required to provide insurance coverage or pay a penalty. (The employer still has the option to impose a probationary period of up to 90 days for insurance coverage for new employees.)

– The penalty to an employer for not providing sufficient coverage is $2,000 per employee per year.

– If the employer coverage is considered inadequate under federal guidelines, the fine is $3,000 per employee.

– The employee portion of an employer-paid medical insurance plan cannot exceed 9.5 percent of the employee’s total pay.

– The individual penalty for not carrying insurance is just under $100 per year.

– Women’s preventative care, including mammograms and birth control, must be covered under all insurance plans.

– Kids can stay on their parents’ medical insurance plan until they’re 26 years old.

– Insurance companies must spend 80 to 85 percent of consumers’ premiums on direct medical costs. If they don’t, consumers get a rebate.

– The maximum legal out-of-pocket expenses for a family under any insurance plan is $12,500.

– Health care premium costs within a small group must be more balanced. This means premiums for healthy people will cost more and premiums for sick people will cost less.

– Wyoming has opted out of creating a state insurance exchange, so if a person’s employer does not provide insurance and the individual cannot afford private insurance on their own, they must participate in the federal exchange or pay the penalty.



















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