Within slightly more than six months, all Americans will be required to have some form of health insurance and all businesses with more than 50 full-time employees will have to offer coverage to their workers. Following is some information about the rollout:
Q: What if I already have health care coverage?
A: Roughly 85 percent of the public is already covered through employer plans, Medi-Cal, Medicaid or self-insurance. If you already have insurance, or if you run a business that offers health coverage, you don’t need to do anything. On the other hand, especially if you’re self-insured, you may want to check the low-cost insurance plans available through Covered California, the state-run insurance pool, to see if you can get a better rate.
Q: What if I’m among the 6 million Californians who don’t have coverage?
A: By Jan. 1, you are required to obtain insurance. The simplest way to do that is to check out the website of Covered California, healthexchange.ca.gov, during the open enrollment period. The website will provide side-by-side comparisons of insurance plans, allowing consumers to decide which plan best suits them. People with low incomes may qualify for expanded Medi-Cal or Medicaid coverage or subsidized private insurance. Open enrollment for Covered California’s insurance plans begins Oct. 1 and ends Dec. 15.
Q: What if I decide not to buy insurance?
A: If you don’t have coverage by Jan. 1, you may be subject to a fine, which during the first year ranges from $95 to 1 percent of the income you make above the amount required to file a tax return. In later years, the fine will rise to 2.5 percent. For an individual making the San Diego median income of $50,600, minus the minimum income requirement of $9,750, the fine would be $408.50 in the first year, rising as high as $1,021.25 in future years. And you will also be liable for any health care costs you incur during that time.
Q: What steps should I take as a business owner?
A: If you already offer your employees minimum essential health coverage -- or if you run a business with fewer than 50 workers -- there’s no requirement that you do anything.
If you run a business with more than 50 workers and don’t provide coverage, you could be slapped with fines if you don’t buy coverage by Jan. 15. Again, Covered California is a good source for obtaining insurance.
If your business has fewer than 50 workers, you don’t need to buy insurance. But Covered California says it could be a good idea anyway, since providing coverage can help companies recruit and retain top talent, and can reduce absenteeism and increase productivity by keeping small health problems from turning into large and costly ones. Small businesses with less than 25 workers can qualify for tax credits, depending on how much they pay their workers.