ACA Expertise

The consultants at Benefits Planners, Inc. are continually educating themselves to stay abreast of new laws, regulations and legislation within the healthcare and healthcare insurance industries.

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Healthcare Reform, The Affordable Care Act

How it affects everyone.

Benefits Planners, Inc. can keep you informed of all of the latest changes in Healthcare Reform to ensure you are prepared and compliant, especially when it comes to the most recent healthcare reform, the Affordable Care Act (ACA).

The ACA, also known as OBAMA CARE, is currently being implemented and is probably the nation’s most significant change in the laws that govern healthcare.

Below you will find some (but certainly not all) highlights of the new law and how it may impact employers and individuals under 65.

Highlights of the Affordable Care Act

For Individuals and Businesses

Employers who have 50 or more full-time equivalent employees must offer those employees and their families and dependents to age 26, benefits that pays for 60% of the minimum essential benefits, as established by the ACA, or face a potential penalty.

Individuals must now obtain qualifying coverage either through an individual policy or through their employer or face a potential penalty.

Grandfathered and Grandmothered health plans may have some leniency in the ACA tax penalties, but strict rules apply. If you think you may have a Grandmothered or Grandfathered plan, contact us today to get more information.

No pre-existing clause. Insurance companies can no longer increase rates or deny coverage because of a pre-existing condition.

Dependents up to age 26 may be added to an insurance policy for both individuals and employer coverage.

Gender is no longer a factor in determining rates.

Renewal rates are the same as new business rates.

Waiting period should not exceed 90 days.

Individuals must purchase their health insurance during the annual open enrollment period. Failure to do so may result in penalties and having to wait until the next open enrollment to purchase coverage. Employers are able to offer benefits year round or during their normal open enrollment as usual.

To be in compliance with the new healthcare reform laws and avoid costly penalties, you must purchase Insurance coverage that pays at least 60% of the costs of the following “essential benefits.”


Business and Individuals who purchase their health insurance through the new Health Insurance Marketplace and/or SHOP may be eligible for tax credits which are applied as a discount on your monthly insurance premium.