Living in Jersey?  You may wonder whether you need to get a health insurance plan in the age of Obamacare.  You may also want to know how much the plan should cover, its costs, how to sign up, and how to get assistance should you need it.

What New Jersey Residents Need to Know About Obamacare

The Affordable Care Act requires you to have health insurance, unless you qualify for an exemption.  You have to report on your tax return if you have other coverage or qualify for an exemption. Although you can’t be arrested or jailed if you do not have health insurance, you may be required to pay a tax penalty if you don’t comply.

If you have an individual insurance plan, whether purchased on your own, through HealthCare.gov, a plan (including COBRA or a retiree plan) provided by your employer, Medicare, Medicaid, Children’s Health Insurance Program (CHIP), TRICARE (coverage from the U.S. military), a veterans health care program, or coverage through the Peace Corps, then you are already qualified for coverage and need not worry about any penalties.

Exempt individuals are those who:

• Are insured for over 3 months of the calendar year
• Prove they cannot afford coverage
• File no federal income tax return due to low income
• Are members of federally recognized Indian tribes, health care sharing ministries, or a recognized religion that objects to health insurance
• Are prisoners or Illegal immigrants in the US

Understanding Obamacare’s Employer Mandate

Obamacare is an employer mandate that will roll out in 2015, 2016, and even after.  It impacts employers with more than 50 full-time-equivalent (FTE) employees, and whose workers average 30 hours per week or 130 hours per month.  Employers are required by law to offer insurance coverage to employees, failing which they must endure an “Employer Shared Responsibility Payment”, which is a tax penalty.  Employers who have more than 100 full-time employees will be required to offer insurance coverage to at least 70% of their eligible workers in 2015. Increases are also set to take place in 2016, with mandated coverage jumps to 95% of eligible employees. However, employers who employ 50 to 99 full-time workers won’t have to follow this law until 2016.

Even if only one employee qualifies for cost-saving premiums when they buy an individual plan, the employer mandate would then apply to the business and the employer will receive a penalty.  If the employer offers affordable care coverage that meets legal requirements, then they would not receive any penalty.  For coverage to be affordable, it must cost no more than 9.5% of the wages the employer reports on each employee’s W-2 form annually.

The health plan offered by employers should meet a minimum value and pay for at least 60% of the covered services. Use a free tool called the minimum value calculator to see if your workplace healthcare plan covers 60% of the costs, as it should.

Tax Penalties for Employers

The amount of the employer’s shared responsibility payment will primarily depend on whether or not they offer any health care coverage at all.

If employers don’t offer health care coverage, then they could suffer an annual penalty of $2,000 per full-time employee, excluding the first 30 employees.  However, if the employer offers coverage that does not meet the requirements, the penalty is $3,000 for each full-time employee who qualifies for lower premiums under Obamacare. Use the Employer Mandate Calculator to calculate what kind of penalty your employer may be required to pay.

Conclusion

If you or someone you know may have questions or concerns about healthcare coverage in the age of Obamacare, please call or write to us.  We will set up a reduced fee initial consultation to assess the facts, interpret the law, and give you an opinion on what you should do.  We also will serve as your legal advocate if you want us to.
Let’s get started with a conversation.  Please call or write to us today.  We will be happy to help you.