Open enrollment for 2015 health insurance coverage from the government marketplace is proposed to begin Nov. 15. People who plan to shop healthcare.gov should understand the rules or risk facing serious consequences down the road.
Granted, the rules were confusing to begin with and have been changed and re-arranged with little public explanation or education. Additionally, policies available through HealthCare.gov have been marketed as providing better coverage at lower subsidized prices than what’s available to most individuals shopping privately or covered through employer-sponsored programs.
Many policies purchased through the Health Care Act websites also qualify for government subsidies for the purchaser. Those subsidies are not available for policies purchased through other means.
That allure, and the public’s failure to understand the rules, is leading many to inadvertently break them, which may result in stiff penalties for individuals and families down the road.
Under the law, employers with 50 employees or more must offer policies that meet or exceed the new Health Care Act rules which, for instance, require certain preventative measures to be 100% covered. Some employees, unhappy with their companies’ offers, are instead purchasing through the marketplace in hopes of a better deal.
That’s a violation of the rules.
The IRS has been collecting data from all employers about who has access to an employer health plan. The IRS, according to information publicly available at this time, will not act on database comparisons that show which individuals with access to employer plans have instead purchased a plan through Obamacare.
That means those individuals will not get an early warning that they’ve violated the rules.
The result may be an IRS financial nightmare for those individuals, with the potential for fines, penalties, interest and having to return to the employer policy.
Before you sign up for a policy, ask an accountant, licensed insurance professional, or other person who understands the rules for a personal review and opinion of your specific circumstances. Each person will have a different set of issues that may determine which course of action is proper for your family.
Richard B. Alman is the principal and chief career/employment strategist of Recruiter Media Inc., which offers recruiters, employers and job seekers a smarter alternative to “universal” employment websites. Alman has worked in all aspects of recruiting and career/employment strategies with corporations such as General Motors and UBS and privately owned multi-national companies.
