Healthcare Reform – Affordable Care Act
Health care reform, formally known as the Affordable Care Act (ACA), or “Obamacare” is already here. Many changes have already happened, and there are many more to come. Here are some things that we have already changed, and some future changes that are planned. There are also some other great resources out there for you to review.
Rice has no plans to stop offering health insurance to eligible faculty, staff and students. Health insurance and the resources we provide to keep you happy and healthy are part of faculty and staff total compensation at Rice. We also want our students to be covered, should a health issue arise.
Wondering what is to happen when? Check out this timeline, provided by Aetna.
Rice adopted the new standard of covering dependent children to age 26 effective July 1, 2010. So, this means that any children already covered by our medical plans will not lose Rice health coverage until the end of the month of their 26th birthday. Dental and Life Insurance are available until the end of the month of their 25th birthday.
Effective January 1, 2011, there are some changes to what is an allowable expense under all medical spending accounts. Most over-the-counter medications now require a prescription to be eligible for the medical spending account.
There is also a mandate that all medical spending plans adopt an annual plan limit, for calendar year 2016 the limit is $2,550.
The health care marketplaces are here! What is the "marketplace" (formerly known as the "exchange")? Here is a great article that explains that question, and another article that addresses marketplace questions.
You can register on the Federal Marketplace if you cannot get insurance through an employer or on your own. Everyone is required to have health insurance starting in 2014 (some excemptions may apply) or pay a penalty. Note that the State of Texas has opted-out of creating an exchange, so the Federal Marketplace is the option for Texans.
Here are the links to Rice's notices regarding the marketplace:
Rice will continue to offer health insurance to its faculty and staff, as we feel that we can help you decide on a comprehensive plan at a reasonable price. We will also continue to subsidize this health insurance, as it is of value to our employees.
The Affordable Care Act (ACA) requires a tax form 1095 to be provided to every individual who participates in a medical insurance plan. If you are in a benefits eligible position at Rice during calendar year 2016 you will be mailed a 1095-C form to your home address, whether you participated in one of Rice’s medical insurance plans or not. Rice will send Form 1095-C since the University is self-insured. You may receive another Form 1095-A, B or C if you had coverage outside of Rice at any time during the calendar year.
Form 1095-C is important because it tells the government you had qualifying health coverage, also called minimum essential coverage during the year. Individuals who do not have qualifying coverage for each month or do not qualify for an exemption may be subject to pay a penalty under the shared responsibility provisions of the ACA. The form will include information for you and any eligible dependents enrolled in the plan. The IRS will use the information from these forms and a Form 1094-C that Rice will send directly to the IRS to confirm who had health coverage during the calendar year.
Watch for your forms to arrive in your mailbox by February 1, 2017. Please make sure your address is updated in Esther www.esther.rice.edu.
If you had health insurance through Rice in 2015 you will not need the 1095 form to file your taxes. You’ll just have a copy of the 1095 form to keep with your tax documents. It will serve as proof that you had qualifying health coverage.
Regardless of whether you need the form to file your taxes, you should still check to make sure the information is correct. Review all eligible dependents and for what months during the year they had coverage. Rice has partnered with Tango Health to send out the 1095-C form to employees and a portal will be available for re-prints and to submit correction requests.
With so many changes happening at such a fast pace, we encourage you to visit the following websites to learn about how these changes will affect you — be an educated consumer!
- Rice's Fondren Library has a nice LibGuide with a lot of resources regarding ACA.
- http://kff.org/interactive/subsidy-calculator/ – a calculator to help you determine if you are eligible for a subsidy in the health insurance marketplace.
- http://www.healthcare.gov/ – explains the Federal regulatory changes in a consumer-friendly format.
- http://www.cuidadodesalud.gov – El Mercado de Seguros Médicos comenzará pronto.
- http://www.irs.gov/uac/Affordable-Care-Act-Tax-Provisions-Home – information on the tax provisions for the Affordable Care Act.
- http://www.healthcaretownhall.com/ – A Milliman-sponsored website that addresses controlling health care costs and the government-driven reforms.
- http://www.txhealthpool.org/ – the website for uninsurable Texans.
- http://www.tdi.state.tx.us/consumer/cpmhealthcare.html – the State of Texas' health reform page.