ObamaCare begins Oct. 1: What you need to know - FOX 10 News | fox10phoenix.com

ObamaCare begins Oct. 1: What you need to know

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CHICAGO (FOX 32 News) -

People living in Illinois may start shopping for ObamaCare health insurance next week, but for many, there are still more questions than answers about what it's all about and how much it will cost.

Officials already know what insurance companies plan to charge, as well as other details of the Affordable Care Act. Critics suggest they're waiting until the last minute to reveal it because, for many consumers, it will be expensive bad news.

For now, the emphasis is on those who will clearly benefit.

"For an individual who's not been able to access health care before, I think it's going to be great news," Tom Meier of Blue Cross Blue Shield of Illinois said.

Vice President Tom Meier helped assemble dozens of proposed ObamaCare health insurance policies that Blue Cross Blue Shield of Illinois submitted to regulators. Five other health insurers did, too. Thanks to a series of delays in Washington, though, consumers in Illinois will apparently be among the last to learn what exactly those policies will cost.

Four levels of policies will be available, with Platinum the most expensive, followed by Gold, Silver and Bronze.

Unlike Illinois, Indiana is already posted pricing. Governor Mike Pence, a foe of ObamaCare, said the average cost would be $512 a month. But insurers are charging $294 a month for a low-end Bronze plan for a 47-year-old male non-smoker. Depending on their income, some will pay much less.

"A number of our both existing and future customers are going to have access to subsidies through the Affordable Care Act that they haven't had access to before," Meier explained.

A family of four earning less than $23,550 would be eligible for free coverage through Medicaid. Incomes of up to $94,200 a year would be eligible for a sliding scale of government assistance to pay for their health insurance.

Some may find it cheaper to pay an annual penalty than to buy ObamaCare insurance: Next year $95 per adult or 1% of taxable income.

That penalty would be collected at tax time, by the Internal Revenue Service. Making it easier to ignore the requirement to buy health insurance: Someone who gets a serious illness would be allowed to buy coverage after a relatively brief waiting period.

Rob Wilson, President of Emplyco USA, explains five healthcare changes to plan for in 2014:

  • Under the Affordable Care Act, you will be required to have a minimum level of insurance. If you do not, you will have to pay a penalty.
    • The penalty will be $95 per person or %1 percent of your household income over the income tax filing threshold. The penalty will be greater each year you do not meet the requirement.
    • You do not have to meet the requirement if your income is below the federal income tax filing threshold, if you are in jail, if you have a religious exemption, if you are the member of a Native American tribe or if you are in America illegally.
  • The tax credit minimum will increase from 35% to 50% in 2014, for small businesses with less than 25 employees and average annual wages less than $50,000.
  • State insurance exchanges will become available to individuals and to businesses with less than 101 employees.
    • Exchanges allow for subsidies toward low-wage employees. Lower-income individuals can purchase health coverage through an exchange.
  • New health insurance plans will have a deductible maximum of $2,000 per individual and $4,000 per family. New plans will also have the same out-of-pocket maximum as HAS-compatible plans. They will also be subject to coverage of routine medical costs of clinical trial patients.
  • On Oct. 1, the health insurance industry tax and temporary reinsurance program will begin. You'll have to pay $63 per person, including dependents – but the cost is expected to be passed on to employers through increased premiums.
    • The reinsurance program is supposed to help offset risk for those who enroll in the individual market who are high cost.



  • Individuals will have two-and-half months in which to compare plans and enroll in coverage that begins Jan. 1.
  • The entire enrollment period will last for six months, all the way through March. But to be covered on Jan. 1 of 2014, you need to enroll by Dec. 15.
  • Approximately 1,200 in-person assisters/navigators will be available around the state to help consumers who need it sort through the plans.
  • The Marketplace website, which will be ready for business on Oct. 1, will make it easy for consumers and small businesses to apply for and enroll in comprehensive health coverage, compare private health insurance plans and enroll in the plan that's best for them.
  • Subsidies will be available on a sliding scale for people who earn between 138 percent and 400 percent of the federal poverty level – that's from $15,860 to $45,960 for individuals and $32,500 to $94,200 for a family of four.

For a step-by-step show-and-tell of the online Marketplace application and enrollment process, click here.

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