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 "New Health Insurance Marketplace Coverage Options and Your Health Coverage"

The Affordable Health Care Act

I’ve heard about the Health Insurance Marketplace.   What is it?

The Health Insurance Marketplace is a new way for individuals, families and small businesses to shop for health insurance plans.   The Marketplace is sometimes referred to as an Exchange.   Beginning October 1, 2013, individuals and families will be able to go online (or call), fill out an application, and compare different insurance plans.   Applying for health insurance through the Marketplace is the only way to qualify for tax credits to help offset the cost of premiums.   This year, annual enrollment for the Marketplace will be from October 1, 2013 to March 31, 2014. 
If I apply for health insurance through the Marketplace, will I be eligible for a tax credit?
If you apply for health insurance through the Marketplace for yourself or your family, your eligibility to receive a tax credit generally depends on your income and the coverage offered by your employer.  Single individuals with household incomes of less than $46,000, and families of four with household incomes of less than $92,400 may qualify for tax type credits if they are not offered health insurance through their employers.    If your employer offers you and your family health insurance, it is unlikely you will qualify for a tax credit.   However, you can still purchase health insurance through the Marketplace even if you are not eligible for a tax credit.

Where can I go to get more information on purchasing health insurance through the Marketplace? 

Please visit for more information about the Marketplace.   There, you can sign up to receive emails with important news and updates about the Marketplace.   By October 1, 2013, you will also receive a notice from your employer providing important information about the Marketplace.  If you begin a new job after October 1, 2013, you will receive this notice shortly after your start date.   It will contain important information about your employer’s health plan that you will need to complete the health insurance application if you decide to purchase health insurance through the Marketplace.  

Will I have to pay a tax if I do not have health insurance for myself and my family?
Yes.   Beginning in 2014, most individuals will either have to purchase health insurance through their employer or the Marketplace, be enrolled in Medicare, Medicaid, or another healthcare program, or pay a tax.   The tax starts off at $95 per person ($47.50 for dependents under age 18), or 1% of household income, whichever is greater.  This tax will increase in the future. 

I do not have health insurance now and need to purchase it to avoid the tax in 2014.   What are my options?
You may enroll in your employer’s health plan.   If you are eligible for your employer’s health insurance plan but are not enrolled, you can enroll at the next annual enrollment.  

You may purchase insurance in the Marketplace.   Annual enrollment for the Marketplace will begin on October 1, 2013.  At that time, you will be able to purchase health insurance through the Marketplace for yourself and/or your family that will be effective on January 1, 2014.   Purchasing coverage through the Marketplace will allow you to avoid the tax for yourself and your dependents. 

If you miss the annual enrollment deadlines for the Marketplace or your employer, you will not be able to enroll in health insurance coverage unless you experience certain life events, such as the birth or adoption of a child, or a termination of employment.  

What if I am sick or I smoke?  Will I still be able to get health insurance in the Marketplace?  
Yes.  Beginning in January 2014, insurance carriers cannot deny health insurance coverage to people with pre-exiting conditions.   However, if you use tobacco, your insurance premiums through the Marketplace may be higher.  

I get my health insurance coverage through my employer.   Will my benefits change in 2014?
Maybe.   Employers are still allowed to change the cost of health insurance for employees, change parts of the plan such as the deductible and co-pays, or change the type or number of plan choices available.