How does ACA handle intermittent health care coverage?

[Humanist_Activist]

This is something I never experienced myself, but something I encounter on a near daily basis as part of my job, but many people work at jobs where you have to meet a certain threshold in hours to qualify for benefits for the next month or months. Mostly this seems to affect union contractors, electricians, ironworkers, carpenters, etc.

Some months they will have full health insurance, others it will be suspended or termed until they get their hours back up, so I was wondering if the ACA has a provision on that.

[SunsetDreams]

1. If you are talking about the penalty

If a person does not satisfy the individual mandate, she will owe a financial penalty, known as
the shared responsibility payment. The financial penalty will be a percentage of household income
subject to a floor and capped at the price of the forgone insurance coverage, assessed and collected by
the IRS and reported on federal income tax returns. Certain individuals are exempt from the financial
penalty, including people for whom annual insurance premiums would exceed 8% of their household
adjusted gross income, members of American Indian tribes, people who receive financial hardship
waivers, people with incomes below the tax filing threshold, and people who lacked insurance for less
than three months during a year.

http://www.kff.org/healthreform/upload/8270-2.pdf

You might find helpful information here as well
ACA Mandate Myths & How the Affordable Care Law Affects You
http://www.democraticunderground.com/1002888920

[Humanist_Activist]

8. Actually I was talking about coverage, I figured they better be exempt...

but this doesn't happen in blocks, should they have to pay the penalty if, 4 months out of the year(not necessarily consecutive), they don't qualify for their Union's/Employer's health benefits?

And as another person in this thread posted, for some Unions, Employers and plans, this is assessed weekly to determine if you are eligible for coverage. A loss of coverage one week per month would be enough to have to pay the penalty, which seems to be an extra burden on people getting cut hours.

[marybourg]

2. This might be handled under the

provision where if your coverage is deemed "inadequate" or doesn't meet certain standards, you can buy insurance from an "exchange" and if you qualify for a subsidy, your employer will be charged a penalty to compensate taxpayers for the subsidy.

[Ruby the Liberal]

3. For now, COBRA should be an option.

I am in the same boat as a 1099 person. October 2013 is when the first enrollment window is supposed to open for the Exchanges (through Feb 2014). Personally can't wait to see what they come up with for that. Until then, I guess we all just hang tight with whatever we have.

[NiteOwll]

4. I'm wondering about this, too.

My husband is union. If he doesn't get a certain amount of work each week, we lose insurance for that week. Of course, we have the option to purchase the insurance for those weeks (or months), but it's hard to afford the $250+ cost per week when you've only got part-time hours and don't know how long it will last. If he is laid off (never with any notice,) we lose our insurance immediately that day, unless he has gotten in the minimum hours of work for the week, in which case its terminated the next week. It's very stressful not knowing week to week if you're going to have insurance.

I'm really hoping we will be able to get some sort of affordable "backup" insurance with the ACA, so we will be covered during the slow times and lay offs.

[Ruby the Liberal]

5. The intent is that this won't be a backup,

that you will be able to have a policy that is priced based on your age, region, individual or family (# of people) and tobacco use. No reapplying with medical history, no exclusions or waiting periods.

That way you don't need to worry about work coverage, loss of coverage or COBRA - the plan is yours on an annual contract basis.

Good link someone posted here this weekend that may help: http://101.communitycatalyst.org/aca_provisions/setting_premiums

[NiteOwll]

6. I forgot to add that

we don't pay any premiums for our union insurance right now. Basically, that is in exchange for the hefty pay cut the employees took a few years ago. I'm certainly hoping that they don't get rid of this benefit once the ACA has fully kicked in, but you never know.

[Ruby the Liberal]

7. Yeah - that is a biggie

Keep your eye on what your state (or the feds, if your state declines) comes up with.

Tough situation on being union in that case as y'all wouldn't want to give up union benefits to self-negotiate an intermittent contract.

Hard to fathom, but it is a possibility that they pull health insurance out of the mix all together where you all can just get your own without worrying about those on and off times. That *could* end up working in your favor, but I trust the insurance cabal about as far as I could throw them, so will wait to see. It would really be great if this ended up being something off your plate as opposed to constantly on it.