What Employees of Small Businesses Need to Know
Almost everyone will need health coverage
Starting in 2014, almost all Americans must have health insurance or risk paying a federal fine. If you work part-time and need coverage, you can buy health insurance in the marketplace or directly from HMSA. Everyone can get health insurance even if you were denied in the past because of a serious health condition.
Marketplace available in October
Starting October 1, 2013, if you work for a company with up to 50 full-time employees, your employer will have two options to buy employee health plans. Companies can continue to work directly with HMSA or use the state health marketplace, called the Hawai‘i Health Connector. Be sure to check with your employer before October 1, to find out how you will choose your health plan next year.
Premiums are changing
Starting in 2014, health plan premiums will be based on your age. Health plans for older employees may cost more than plans for younger employees.
Also, the federal government will pay for health care reform with new fees and taxes for health insurers nationwide, including HMSA. This will increase health plan premiums.
Benefits are changing
Starting in 2014, your health plan will include these 10 essential health benefits:
- Prescription drugs
- Ambulance service
- Emergency care
- Laboratory services
- Maternity and newborn care
- Mental health and substance use services
- Pediatric oral and vision services
- Rehabilitation and habilitative services
- Services for preventive care, wellness, and chronic disease management
I work part-time and don’t have employer coverage
If you work part time (less than 20 hours a week) and don’t have health insurance, you’ll need to get coverage by January 1, 2014, or pay a fine to the Internal Revenue Service. Health insurance will help keep you healthy and protect you from the high cost of health care. Because of health care reform, you won’t be denied health insurance, even if you couldn’t get coverage in the past because of a serious health condition.
Your employer isn’t required to offer you coverage. You can buy an HMSA individual plan directly from us or in the Hawai‘i Health Connector, the state’s online health insurance marketplace. Depending on your income, you could be eligible for financial help to pay for health insurance if you buy it in the Connector.
Do your spouse and children have health insurance? If not, they’ll need coverage starting in 2014 or will have to pay a fine to the Internal Revenue Service. Health insurance will help keep them healthy and protect them from the high cost of medical care. Check if your employer offers dependent coverage. Young adults could be covered under a family plan until age 26.
If your employer doesn’t offer dependent coverage, your dependents can get an HMSA plan directly from us or in the Hawai‘i Health Connector, the state’s online health insurance marketplace. Depending on their income, they could be eligible for financial help to pay for health insurance if they buy it in the Connector. And because of health care reform, they won’t be denied coverage even if they were turned down for insurance in the past because of a serious health condition.
This information is based on HMSA’s review of the Affordable Care Act (ACA). This overview is intended for educational purposes only and should not be used as tax, legal, or compliance advice.