Q&A: Health Insurance Marketplaces Set to Open in October

It’s nearly here! October will bring the unveiling of your state’s health insurance marketplace. There will be no more guessing. You’ll be able to go to the marketplace and find the health coverage that’s right for your family, discover whether you qualify for federal subsidies, and how much insurance might cost for you.

If you have questions or need to know where to look, one place to start is www.healthcare.gov, or call 1.800.318.2596. Now, on to your questions!

I’m a small business owner with less than 50 full-time (or equivalent) employees. I know I’m exempt from the requirement to provide health insurance. Is there anything else I need to know?

Yes! If you have one or more employees and at least $500,000 in revenue, you must inform all employees by a letter that the health insurance marketplaces exist, and that they may be eligible for tax credits. Letters to current employees are required by Oct. 1, 2013, and to new employees within 14 days of their hiring date.

This applies to all employees, full-time or part-time. It’s a simple letter. The Department of Labor has two sample notices, which you can view here if you offer health coverage and here if you do not offer health coverage.

I smoke. Will my insurance cost more?

In a word, yes. The four things an insurance company can look at to determine your premium are your age, family size, location, and tobacco use. With tobacco use, they can charge you up to 50 percent more compared to a non-smoker, and the extra premium cost will not be covered by federal subsidies.

This is because tobacco use has been attributed to many health problems that are costly to treat, such as cancer and emphysema. So if you smoke, you might save thousands of dollars on health insurance by quitting now.

As with any information on insurance forms, it is critical to be honest – if the insurer finds out you intentionally lied, mislead, or excluded information about your tobacco use, they can still cancel your insurance retroactively.

These articles are meant solely to answer questions we receive and provide general information about the Patient Protection and Affordable Care Act. The Center for Rural Affairs does not offer or provide legal advice. CFRA is not an insurance agency, broker, or consultant; does not recommend any health insurance product or policy or provide any advice on the purchasing of health insurance; and does not accept any compensation or consideration from an insurance company, insurance broker, or insurance consultant.

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