MARINE CORPS BASE QUANTICO, Va. -- At the start of 2014, the Affordable Care Act’s individual shared responsibility provision will go into effect, requiring all individuals, including children, to have minimum essential health coverage. Those who do not meet the requirement or whose dependents do not have coverage will be required to pay a fee when filing income tax returns, unless they qualify for an exemption.
All federal workers with Federal Employee Health Benefit plans or health insurance plans through the Nonappropriated Fund Health Benefits Program qualify as meeting the coverage requirements. Civil service employees who do not have coverage can enroll for federal health benefits during the annual Federal Benefits Open Season from Nov. 11 through Dec. 9, 2013, while the open season for nonappropriated fund employees runs from Nov. 4 to 29, 2013.
As of Oct. 1, the new Health Insurance Marketplace, where private health insurance options can be compared and purchased, is open, and individuals can enroll during an open season that lasts through March 31. Coverage through the marketplace can begin as early as Jan. 1, 2014, and to have coverage start on the first of the year, customers must enroll by Dec. 15.
However, there is no government or employer contribution to premiums for plans purchased through the marketplace, and, unlike federal health plans, those premiums are paid on an after-tax basis.
The only civil service employees who are not entitled to Federal Employee Health Benefit plans are temporary employees working one year or less, said Susan Galloway, head of Employee/Management Advisory Services. “Well over 90 percent of the workforce is eligible for health insurance.”
Generally, she said, the only people who opt out of it are retired military members in the civilian workforce, who have coverage through Tricare.
On the nonappropriated funds side, only “flex” employees, who have no minimum work hours, do not qualify for health insurance coverage, said Heidi Mauck, human resources and employee benefits specialist with the Human Resources Training Branch of Manpower and Reserve Affairs, adding that all regular part-time and full-time employees are eligible.
All federal employees who purchase plans during their open benefits season will begin to receive coverage Jan. 1, 2014.
A nonappropriated funds employee benefits expo scheduled for Nov. 5, from 10 a.m. to 2 p.m., will feature representatives of all NAF health insurance providers, as well as other health-related organizations. A similar health care fair for civil service employees, featuring all their health insurance providers, will be held all day on Nov. 15. Both events will be at the Clubs at Quantico.
The federal Temporary Continuation of Coverage program also meets the new requirements for coverage, although it may cost more than insurance plans purchased on the Marketplace.
The fee for lacking health insurance will increase year by year. The fee for 2014 is 1 percent of annual income or $95 per person for the year, whichever is higher. By 2016, the fee will be 2.5 percent of income or $695 per person, whichever is higher.
There are certain exemptions to the requirement, for example for members of federally recognized Indian tribes, those whose minimum premiums would cost more than 8 percent of household income or members of religious sects that the Social Security Administration recognizes as conscientiously opposed to accepting any insurance benefits.
Those who purchase insurance on the Marketplace may be eligible for tax credits to help pay for coverage if their household income is between 100 and 400 percent of the federal poverty level. The poverty level for 2013 is $11,490 for an individual or $23,500 for a family of four.
For additional information on the individual shared responsibility provision, visit
www.irs.gov/uac/Questions-and-Answers-on-the-Individual-Shared-Responsibility-Provision. To learn more about health care reform, visit
www.healthcare.gov. For more information about Federal Employee Health Benefits programs, visit
www.opm.gov/insure, and to enroll during open season, visit the Employee Benefits Information System at
www.public.navy.mil/donhr/Benefits/ebis/Pages/Default.aspx or call 888-767-6738. For more on the Nonappropriated Fund Health Benefits Program, visit
www.usmc-mccs.org/employ/benefits.