What Is Minimum Essential Coverage Under Obamacare?


Minimum essential coverage

To avoid the fee in 2014 you need insurance that qualifies as minimum essential coverage. If you’re covered by any of the following in 2014, you’re considered covered and don’t have to pay a penalty:

* Any Marketplace plan, or any individual insurance plan you already have

* Any employer plan (including COBRA), with or without “grandfathered”status. This includes retiree plans

* Medicaid

* The Children’s Health Insurance Program (CHIP)

* TRICARE (for veterans and veteran families)

* Veterans health care programs

* Peace Corps Volunteer plans

             Other plans may also qualify.





The Administrative Simplification provision under Section 1104 of the Patient Protection and Affordable Care Act issued a final rule Aug. 24, 2012 that adopts a 10-digit healthplan identifier (HPID) for health plan entities to use with other entities.  Effective date to comply for small health plans is November 5, 2015.   Currently, the use of HPID is only requred for electronic transactions. 

Certain individual health care providers are to obtain and disclose a national provider identifier (NPI). Effective date is November 5, 2014. 

This is intended to improve the standards for electronic transactions under HIPAA.

“Employee Choice” in Federal SHOP Exchanges Delayed

 “Employee Choice” in Federal SHOP Exchanges Delayed

On March 11, HHS announced it is delaying the “employee choice” option in the Small Business Health Options Program (SHOP) Exchanges from 2014 to 2015. This delay will impact states where the Federal government will run the Exchanges and states that are developing their Exchanges in partnership with the Federal government.

The employee choice option will allow employers to determine how much they will contribute toward the cost of employee coverage and offer their employees a choice of Exchange plans from different carriers at a certain metal level (Bronze, Silver, etc.).

In 2014, small employers in states impacted by this delay will choose an Exchange plan and their employees will decide whether or not to enroll in that plan. Employers will not be able to offer their employees a choice of plans until 2015.

Exchanges being developed by states may choose to offer employee choice in 2014, or they may choose to delay implementation of that feature until 2015. The employee choice option will be available in all SHOP Exchanges for plan years beginning on or after January 1, 2015.

Cigna May 13, 2013

Healthcare Reform Bill Cost

Healthcare Bill — Gross Cost of Medicaid & CHIP Outlays

Cost:   $434,000,000,000

The healthcare bill significantly expanded eligibility for Medicaid and the Children’s Health Insurance Program (CHIP). In March 2010, the Congressional Budget Office (CBO) estimated that under the bill there would be roughly 16 million more enrollees in Medicaid and CHIP than the number projected under the laws in place before the bill was enacted. According to the CBO, the gross cost of Medicaid and CHIP outlays under the bill will be an estimated $434 billion over ten years.

Fox News:  05/07/2013