eHealth ObamaCare Countdown: Your Second Step to Get Ready for Health Reform This Year

eHealth ObamaCare Countdown: Your Second Step to Get Ready for Health Reform 
This Year 
MOUNTAIN VIEW, CA -- (Marketwired) -- 06/10/13 --  Today eHealth, Inc
(NASDAQ: EHTH), parent company of eHealthInsurance.com
(http://www.ehealthinsurance.com), America's first and largest
private online health insurance exchange, published the second step
in its six step guide to help consumers prepare for health care
reform and this year's new open enrollment period, which begins Oct.
1, 2013.  
Beginning in 2014, individuals and families who do not have major
medical health insurance that meets minimum federal standards will be
subject to a tax penalty, which has been dubbed "the mandate tax."  
In Step One of this six step process, eHealth outlined when an
individual or family that already had health insurance might be
required to enroll in a new plan. In this step, Step 2, eHealth
breaks down the mandate tax, along with the subsidies in Obamacare
that are designed to help make insurance more affordable for lower
income families.  
Individual and family subsidies will be based on the cost of the
second least expensive "silver-level" plan available in a given area.
The benefit and structure of new health insurance plans, including
their Bronze, Silver, Gold and Platinum Level "Actuarial Values,"
will be described in greater detail in Step Three.  
Step 2: June, 2013: Understand the new tax penalties and government
subsidies. 
 Many of the individuals and families who purchase their
own health insurance may be able to qualify for subsidies, or
"premium tax credits," designed to make their health insurance more
affordable. Consumers who understand how the subsidies and tax
penalties work will be better able to make decisions about which
products to purchase and at what price.  
Qualifying for Subsidies
 The law determines whether or not an
individual is eligible for subsidies based on the following criteria: 
1. They live in the United States of America. 
 2. They're a U.S.
citizen, U.S. national or otherwise lawfully present in the United
States. 
 3. They cannot be incarcerated. 
 4. Their combined total
household income is between 133% and 400% of the Federal Poverty
Level (FPL). People with incomes below 133% of FPL will qualify for
Medicaid in most states.  
This table breaks out income levels below 400% of the Federal Poverty
Level (FPL). 


 
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            Income requirements for the Affordable Care Act                 
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 Household Size   2013 Annual Income Above the Federal Poverty Level (FPL)  
                ------------------------------------------------------------
                  100% FPL  133% FPL  150% FPL  200% FPL  300% FPL  400% FPL
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        1          $11,490   $15,282   $17,235   $22,980   $34,470   $45,960
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        2          $15,510   $20,628   $23,265   $31,020   $46,530   $62,040
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        3          $19,530   $25,975   $29,295   $39,060   $58,590   $78,120
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        4          $23,550   $31,322   $35,325   $47,100   $70,650   $94,200
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    For each                                                                
    additional                                                              
    person add     $4,020    $5,347    $6,030    $8,040    $12,060   $16,080
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How Subsidies (Premium Tax Credits) Work
 The subsidies (also called
Premium Tax Credits) will work on a sliding scale that limits an
individual or family's spending on their monthly health insurance
premiums to a fixed percentage of their estimated annual income.
Subsidies will be based off of the second least expensive
"silver-level" plan (a plan that covers 70% of the average cost)
available in the area where the individual lives. 
If the second least expensive silver plan costs more than the fixed
percentage of their estimated annual income, the individual or family
would receive a subsidy in the amount of the difference. They could
then use that subsidy when purchasing a health insurance plan. See
this example. 


 
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                            Subsidy Calculation                            
---------------------------------------------------------------------------
Adult Male (Dave)                                 Annual Income            
non-smoker, age 31                                $2,873 per month /       
                                                  $34,476 per year.        
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Step 1: Determine the cost of 2nd least expensive silver plan              
-- Assume the cost is $500 per month for the purpose of illustration only. 
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Step 2: Determine Individual's Maximum Monthly Premium                     
-- Premiums cannot exceed 9.5% of income                                   
-- 9.5% of $34,476 per year = $3,276 (year) or $273 (month)                
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Step 3: Determine Subsidy Amount                                           
-- Calculate the difference between the 2nd least expensive silver plan    
($500 per month) and 9.5% of income ($273 per month)                       
-- $500 - $273 = $227                                                      
-- The amount of the subsidy would be $227 (per month)                     
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Step 4: Shop for plans using subsidy                                       
-- Dave can use that $227 subsidy to buy a bronze, silver, gold or platinum
plan.                                                                      
-- For simplicity, let's assume "Dave" wants a silver plan and there are   
three to choose from.                                                      
-- He would take his subsidy of $227 and be able to apply it to the cost of
the three silver plans available.                                          
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Silver I Plan             Silver II Plan            Silver III Plan         
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Monthly Premium: $450     Monthly Premium: $500     Monthly Premium: $550   
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Value of Subsidy: $227    Value of Subsidy: $227    Value of Subsidy: $227  
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Cost After Subsidy: $223  Cost After Subsidy: $273  Cost After Subsidy: $323
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The amount of money any individual or family could spend on the 2nd
least expensive silver plan would range from four percent of their
income, to nine-and-a-half percent of their income. Families earning
between 133% and 150% of FPL, would spend no more than four percent
on that plan, while families with incomes between 300% and 400% of
FPL would spend no more than nine-and-a-half percent of their income
on that plan.  
The following table provides a rough outline for the way the
percentage of monthly income is calculated by household size, and the
limitations that the law places on premiums for individuals and
families with incomes below 400% of the Federal Poverty Level (FPL). 


 
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                                2013 Monthly Income Above the               
                                 Federal Poverty Level (FPL)                
                ------------------------------------------------------------
                    133%        150%        200%        300%        400%    
                     FPL         FPL         FPL         FPL         FPL    
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 Monthly Income                                                             
Household Size 1   $1,273      $1,437      $1,915      $2,873      $3,832   
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  ACA Limit on      3% of       4% of      6.3% of     9.5% of     9.5% of  
    Monthly        taxable     taxable     taxable     taxable     taxable  
   Premiums *     income =    income  =   income =    income =    income =  
                    $38*        $57*        $121*       $273*       $364*   
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 Monthly Income                                                             
Household Size 4   $2,610      $2,944      $3,925      $5,888      $7,850   
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  ACA Limit on      3% of       4% of      6.3% of     9.5% of     9.5% of  
    Monthly        taxable     taxable     taxable     taxable     taxable  
   Premiums *     income =    income =    income =    income =    income =  
                    $78*        $118*      $247*        $559*       $746*   
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*For second least expensive silver level plan available in the individual or
family's area.                                                              
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Tax Penalties
 Individuals and families that elect to go without
health insurance for more than three months in a given year may incur
a tax penalty, which would be applied when they file their income
taxes. Penalties are pro-rated by the number of months an individual
goes without coverage. 
Penalties are phased in over three years, beginning in 2014 when the
penalty is 1.0% of income; in 2015 that increases to 2.0% of income;
and by 2016 the penalty is calculated at 2.5% of taxable income. The
maximum tax penalty can't exceed three times the minimum penalty, or
the national average price for a bronze level plan, within a given
year. Pricing for bronze level plans is not available, so for this
table we've used three times the minimum penalty as the maximum.  
This table breaks down how the penalty would be applied each year: 


 
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      Household Size           2013 Annual Income as a Percentage of the    
                                      Federal Poverty Level (FPL)           
                          --------------------------------------------------
                             133%      200%      300%      400%   Above 400%
                              FPL       FPL       FPL       FPL             
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       Family Size 1        $15,282   $22,980   $34,470   $45,960  $45,961+ 
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2014 Yearly Penalty                                                         
- Minimum: $95 per adult,   1.0% =    1.0% =    $285  =   $285 =    $285 =  
$47.50 per child             $153      $230     Maximum   Maximum   Maximum 
- Maximum: $285                                                             
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2015 Yearly Penalty                                                         
- Minimum: $325 per adult,  2.0% =    2.0% =    2.0% =    2.0% =    $975 =  
$162.50 per child            $325      $460      $689      $919     Maximum 
- Maximum: $975            (minimum)                                        
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2016 Yearly Penalty                                                         
- Minimum: $695 per adult,  2.5% =    2.5% =    2.5% =    2.5% =   $2,085 = 
$347.50 per child            $382      $575      $862     $1,149    Maximum 
- Maximum: $2,085                                                           
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       Family Size 4        $31,322   $47,100   $70,650   $94,200   $94,201 
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2014 Yearly Penalty                                                         
- Minimum: $95 per adult,   $285 =    $285 =    $285 =    $285 =    $285 =  
$47.50 per child            Maximum   Maximum   Maximum   Maximum   Maximum 
- Maximum: $285                                                             
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2015 Yearly Penalty                                                         
- Minimum: $325 per adult,  2.0% =    2.0% =    $975 =    $975 =    $975 =  
$162.50 per child            $626      $942     Maximum   Maximum   Maximum 
- Maximum: $975                                                             
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2016 Yearly Penalty                                                         
- Minimum: $695 per adult,  2.5% =    2.5% =    2.5% =   $2,085 =  $2,085 = 
$347.50 per child            $783     $1,178    $1,766    Maximum   Maximum 
- Maximum: $2,085                                                           
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Additional Consumer Resources:  


 
--  Shop for health insurance plans from over 200 of America's leading
    insurers at eHealthInsurance.com
--  Shop for Medicare plans from some of America's leading Medicare
    providers at eHealthMedicare.com
--  Download or request a FREE printed copy of our book, Individual Health
    Insurance For Dummies, Health Care Reform Special Edition, produced in
    cooperation with For Dummies(R), a branded imprint of Wiley, and
    co-authored by eHealthInsurance
--  Follow eHealthInsurance's consumer blog, Get Smart - Get Covered
--  Browse our answers to real-life health insurance questions on Yahoo
    Answers
--  Follow eHealthInsurance on Facebook and Twitter

  
About eHealth
 eHealth, Inc. (NASDAQ: EHTH) is the parent company of
eHealthInsurance, America's first and largest private health
insurance exchange where individuals, families and small businesses
can compare health insurance products from leading insurers side by
side and purchase and enroll in coverage online. eHealthInsurance
offers thousands of individual, family and small business health
plans underwritten by more than 200 of the nation's leading health
insurance companies. eHealthInsurance is licensed to sell health
insurance in all 50 states and the District of Columbia. eHealth,
Inc. also provides powerful online and pharmacy-based tools to help
seniors navigate Medicare health insurance options, choose the right
plan and enroll in select plans online through its wholly-owned
subsidiary, PlanPrescriber.com (www.planprescriber.com) and through
its Medicare website eHealthMedicare.com (www.eHealthMedicare.com).  
For more health insurance news and information, visit the
eHealthInsurance consumer blog: Get Smart - Get Covered. 
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For media inquiries, please contact:  
Sande Drew
eHealth, Inc.
(916) 207-7674
sande.drew@ehealth.com 
Kris Kraves
Cogenta Communications
(805) 527-7733 - direct
kris@cogentacom.com 
 
 
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