The Affordable Care Act is Coming Soon! Terms you Need to Understand

Affordable Insurance Exchange – The health insurance marketplace where individuals and small businesses can purchase affordable and qualified health benefit plans. Ohio has received $1,000,000 in grants for research, planning, information technology development, and implementation of Affordable Insurance Exchanges. This grant provides Ohio the resources to conduct the research and planning necessary to build a health insurance marketplace and determine how its exchange will be operated and governed.

Small Business Health Options Program (SHOP) - The SHOP exchange offers small businesses a variety of Qualified Health Plans (QHPs) that allows employers and employees to choose insurance that meets their budgets.

Full-Time Equivalent employee (FTE) - An employee who is employed an average of 30 or more hours per week.

Employer Shared Responsibility – Although employers are not required to provide health coverage to their employees under the Affordable Care Act, employers of a certain size will be subject to the Employer Shared Responsibility payment under the law.

Essential Health Benefits – Essential health benefits must include services within at least ten core categories among them emergency services, maternity, and new born care, prescription drugs and preventive and wellness services. The Affordable Health Care Act ensures that health plans offered in the individual and small group markets both inside and outside of the health insurance marketplace offer a comprehensive package of items and services.

Individual Shard Responsibility – The provision of the law that applies to the self-employed and requires that each individual beginning in January 2014 have basic health insurance coverage (know as minimum essential coverage) for each month, qualify for an exemption, or make a payment when filing a federal income tax return starting in 2015. Individuals will not have to make a payment under these rules if coverage is unaffordable; they spend less than three consecutive months without coverage; or qualify for an exemption for several other reasons including hardship and religious beliefs.

Wellness Programs - Programs intended to improve and promote the health and fitness typically offered through the workplace, although insurance plans can offer them directly to their enrollees. The program allows employers or plans to offer employees premium discounts, cash rewards, gym memberships, and other incentive to participate. The Affordable Care Act creates new incentives to promoted employer wellness programs and encourage opportunities to support healthy workplaces.

Cynthia Schick | 06/25/2013

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The Affordable Care Act is Coming Soon! Terms you Need to Understand