I-ACA Yenza Ukuguqulwa Kwengxenye Okufinyeleleka Okungaphezu Kokufinyeleleka Kwakukhona Kwakukhona
Uma ngabe usuliwe noma uma inkampani yakho ivaliwe, ungase ukhathazeke ngokulahlekelwa izinzuzo zakho eziqashiwe nomqashi, ikakhulukazi umshuwalense wezempilo. Ukungenawo umshuwalense wezempilo kungaba yinto ebesabekayo, ikakhulukazi uma uhlelo lwakho lwezempilo lomqashi luhlinzekela umndeni wakho. Futhi, ungase ukhathazeke kakhulu uma wena noma ilunga lomndeni unesifo esingapheli esidinga ukuvakashelwa njalo nodokotela wakho noma isidingo semithi yokwelapha ebiza kakhulu.
Kubalulekile ukuzama ukuthola uhlobo lomshwalense wezempilo ngesikhathi sakho sokungasebenzi. Uma wena noma ilunga lomndeni lifuna ukunakekelwa ngaphandle kokuthola umshuwalense wezempilo, uzobe unamathela ekukhokheleni konke okusemthethweni. Ungase uthathe ingozi engadingekile yezezimali ngokungenawo umshuwalense wezempilo. Uma ungenawo umshuwalense wezempilo ungase ubonakale ubiza izindleko uma ungenayo noma ungenayo imali encane, kungenzeka ukuthi awukho! Isizathu esiyinhloko sokuqedwa komuntu siqu e-United States yizikweletu nokugula.
Kubalulekile futhi ukuqonda ukuthi i-ACA ibeka isigwebo sezimali uma unesiphakamiso sokubanjwa kwezinyanga ezingaphezu kwezinyanga ezimbili phakathi nonyaka . Ukuze ugweme isijeziso (ngaphandle uma ungakhululwa kuso ), kufanele ugcine ukubhekwa okungenani okubalulekile. Lokhu kungafaka phakathi i-COBRA noma uhlelo oluthengwe emakethe ngayinye (noma ku-exchange exchange ), kodwa alubandakanyi umshuwalense wezempilo wesikhashana .
Ngenhlanhla, uma unikezwa i-slip ebomvu, unamathuba amaningi okuhlala u-insured isikhathi esilandelayo ngemva kokuqedwa kwakho.
Umlingani noma Umshuwalense Wezempilo Ozakwethu
Ukuthola umshwalense wezempilo kumqashi womlingani wakho (noma umlingani wezakhamuzi) kungaba yindlela oyikhethayo kakhulu. Izinhlelo eziningi zomshuwalense wezempilo zomqashi zivumela abasebenzi babo ukuba bangeze amalungu omndeni asebekwe eceleni - oshade naye angakwengeza ohlelweni lwakhe.
Uma umsebenzi wakho unikeze umshuwalense wezempilo kuwo wonke umndeni, oshade naye angase aqalise ukuhanjiswa komndeni, ngoba ukulahlekelwa ukukhokhelwa ngumcimbi ofanelekayo obangela isikhathi sokubhalisa esikhethekile , kungakhathaliseki ukuthi kwenzekani phakathi nonyaka.
Uma ukwazi ukusebenzisa umshuwalense wezempilo womngane wakho womshado , qiniseka ukuthi ungasebenzisa zingakapheli izinsuku ezingu-30 ngokulahlekelwa isabelo sakho sangaphambilini-izinhlelo ezithile zomshuwalense wezempilo ezixhaswe ngumqashi angeke wamukele ukubhaliswa kwakho uma ulinda izinsuku ezingaphezu kwezingu-30.
COBRA
Uma ngabe umqashi wakho wangaphambili unabasebenzi abangu-20 noma ngaphezulu, inkampani iyadingeka ngumthetho wesifundazwe ka-1986 ukukunikeza ithuba lokukhokha ukwandiswa kwemali yomshwalense wakho wezempilo okungenani izinyanga ezingu-18. Lo mthetho uyaziwa ngokuthi i-COBRA, okumelela uMthetho Wokuhlanganiswa Kwemali Yezokuhlaziywa Kwezimali .
Ngesikhathi ususiwe, umqashi wakho kufanele akutshele ngokubhala ngamalungelo akho ngaphansi kwe-COBRA. Usube nezinsuku ezingu-60 kusukela ngosuku lesaziso noma usuku umshwalense wakho wezempilo ophelile ukubhalisa noma ukubhalisela ukuhlinzeka ngaphansi kwe-COBRA. Uma inkampani yakho iphuma ebhizinisini noma ilahlekile, i-COBRA ngeke itholakale.
Uma ubhalisela i-COBRA, uzoqhubeka nomshuwalense wezempilo owodwa owawusebenza ngenkathi usebenza.
Kodwa-ke, kufanele ukhokhe imali ye- premium yomshuwalense wezempilo owawuqashile umqashi wakho wangaphambili, ngaphezu kwama-premium owawakhokhela ngaphambilini nge-payroll deduction. Umqashi angase futhi afake imali engu-2% yokuphatha.
Kuye ngezimo zakho ngabanye, i-COBRA ingabiza kakhulu. Abasebenzi ngokuvamile abaqapheli ukuthi baqashile kangakanani abaqashi babo egameni labo mayelana nama-premiums. Ngokomhlahlandlela we- Kaiser Family Foundation ka- 2016 , umqashi osezingeni eliphezulu ohlinzeka ngezinzuzo zomshuwalense wezempilo ukhokha amaphesenti angu-71 wezindleko eziphelele zemishwalense yomshuwalense wempilo yomndeni, kanti amaphesenti angu-82 wezindleko zezinkokhelo zabasebenzi abangashadile.
Ukushintshela ku-COBRA kusho ukuthi unesibopho sezindleko ezigcwele ngokwakho. Ama-premium aphelele, kufaka phakathi isabelo esikhokhwa ngumsebenzi nomqashi, ama-18,142 ayizigidi ezingu-186 ngo-2016 ukuze kutholakale umndeni, kanye no-$ 6,435 ukuhlinzekwa okukodwa.
Leyo imali eningi futhi cishe okungaphezu kwalokho okulindele ukukhokha, ikakhulukazi uma ulahlekelwe imali yakho futhi uqoqa umshuwalense ongasebenzi. Kwezinye izisebenzi, izinkokhelo ze-COBRA zingaba ngaphezu kwamaphesenti angaba ngu-60 kuya kwangu-70 kokuhlolwa kwabo okungasebenzi kwenyanga. Abasebenzi abaningi abaqashiwe abafanelekile ukuqhubeka nomshwalense wabo wezempilo ngeCOBRA abakwazi ukukwenza lokho.
Uma ungeke ukwazi ukukhokhela i-COBRA, kungenzeka kube nezinye izinketho zomshuwalense wezempilo ezizohlinzeka ngezinzuzo zokuthola impilo oyidingayo wena nomndeni wakho. Lokhu kuyiqiniso ikakhulukazi manje ukuthi i-ACA iguqule imakethe yempilo yomshwalense ngamunye.
I-COBRA ilawulwa yi-US Department of Labor. Iwebhusayithi yomnyango ine uhlu lwemibuzo evame ukubuzwa mayelana ne-COBRA. Futhi ungashayela u-866-444-3272 ngolwazi noma usizo.
Qaphela: I-COBRA ayizange ishintshe ngendlela ye-Care Affordable Act
Umshwalense Wempilo Eyimfihlo: Ukuze Ufinyelele Izibonelelo, Qala Ngokushintshanisa Embusweni Wakho
Ungathenga umshuwalense wezempilo ngokushintshanisa esifundeni sakho (phawula ukuthi lena yindawo kuphela lapho izinsizakalo ze-premium nezinsizakalo zokwabelana ngezindleko zitholakala khona), ngokuqondile kwinkampani yomshuwalense wezempilo, njenge-Blue Cross, noma ngomthengisi womshuwalense obamele izinkampani eziningi zomshuwalense.
Kumele uthathe ukubonisana nomthengisi womshuwalensi onesilayisensi ongakwazi ukukusiza ukuthi uthole uhlelo lomshuwalense wezempilo olungabizi kakhulu kune-COBRA futhi uhambisana nezidingo zakho. Uzofuna ukuqinisekisa ukuthi umthengisi uvumelekile ukushintshanisa kuhulumeni wakho, ukuze angakusiza ukuba ubhalise nge-exchange uma imali yakho ingakuthola ukuthi ufaneleke ukuthola izinsizakalo zokukhokha izindleko zokufaka kwakho, futhi kungenzeka izindleko zakho zokuphuma ngaphandle.
Ungakwazi ukuqhathanisa kalula amaphrimiyamu nezinzuzo zezempilo ku-intanethi, ikakhulukazi uma usebenzisa iwebhusayithi yokushintshanisa (qala ku-HealthCare.gov, futhi izokuqondisa esiteshini esisebenzayo uma isimo sakho sihamba nesikhulumi saso sokubhalisa). Izinkampani zomshuwalense wezempilo ziyahlukahluka kuhlobo luni lwezinhlelo zempilo abazihlinzekayo futhi ngokuthenga ezungezile ungakwazi ukulondoloza imali. Ngokwesibonelo:
- UJohn Skillset, oneminyaka engu-36 ubudala, wabekwa eceleni kwesimo esiphathelene nokuphatha ebhange lokutshala izimali. Umndeni wakhe uhlanganisa i-COBRA yi-$ 1450 ngenyanga. Wakwazi ukuthola ukutholakala okwanele emndenini wakhe kusuka kwenkampani yomshuwalense ongeyona inzuzo ye $ 785 ngenyanga. Nakuba le nqubo idinga ukuba akhokhele izindleko zezokwelapha zokuqala ezingu-$ 3000 (i-deductible), umndeni wakhe uphilile futhi uye waba nezindleko eziphansi zezokwelapha esikhathini esidlule.
- UJenny Techwhiz, oneminyaka engu-24 ubudala, waqedwa ngesikhathi sokunciphisa inkampani yekhompyutha. Ukutholakala kwakhe ngabanye ngeCOBRA kungu- $ 390 ngenyanga. Ukwazi ukuthola uhlelo olukhethekile oluvela eBlue Cross kubantu abaneminyaka engu-18-26 kuya ku-$ 280 ngenyanga.
I-Obamacare Futhi Iqede Izivimbelo Zokubhalisa Kubantu abanezimo eziPhambi kwesikhathi
Isivikelo Sokubekezela Nokunakekelwa Kwezinkinga (ACA) sashintsha isimo sezwe ngokufinyelela komshwalense ngamunye wempilo yomshuwalense. Ngaphambi kuka-2014, umshwalense wempilo yamakethe ngamunye (uhlobo oluthengayo ngokwakho, ngokumelene nokuthola kumqashi) lwalubhalwe phansi kwezokwelapha emazweni amaningi. Lokhu kusho ukuthi abantu abanezimo ezikhona ngaphambili babekhokhiswa amaphrimiamu aphezulu, aphikisiwe ukukhokhelwa, noma ahlinzekwa izinhlelo ezingafaki imibandela yabo ekhona ngaphambili.
Kubantu ababekwe eceleni futhi babe nemibandela ekhona ngaphambili, lokhu kwakusho ukuthi i-COBRA yiyona ndlela yokwenza okuyiyo kuphela, naphezu kwethegi elibiza kakhulu.
Kodwa kusukela ngo-2014, umshuwalense wezempilo ngamunye kuwo wonke umbuso waba nesiqiniseko; abanikazi bomshuwalense abasavunyelwe ukubeka noma yikuphi ukulinganiselwa kwesimo esandulele . Ukubhalisa sekukhawulelwe ngendlela efanayo ukuthi kunqunyelwe izinhlelo ezixhaswe ngumqashi. Abantu bangabhalisela ukuthengwa emakethe ngayinye ekwindla (November 1 kuya kuDisemba 15 yisikhathi esizolandelwa kusukela ekupheleni kuka-2017 nokuqhubeka phambili), ukuze kutholakale ukutholakala okuphumelelayo ngoJanuwari olandelayo. Noma bangabhalisa nganoma yisiphi isikhathi phakathi nonyaka uma behlangabezana nesenzakalo esifanelekayo esibangela isikhathi sokubhalisa esikhethekile .
Ukulahlekelwa kohlelo oluxhaswe ngumqashi kubhekwa njengomcimbi ofanelekayo, noma ngabe uthola ukufinyelela ku-COBRA. Unganciphisa i-COBRA futhi ubhalise ohlelweni lomakethe ngamunye (noma ukushintshaniswa, kepha ukhumbula ukuthi ukuxhaswa ukuze kukwazi ukukwazi ukukhokhela kuyatholakala kuphela ngokushintshaniswa), kodwa kufanele wenze njalo kungakapheli izinsuku ezingu-60 ngokulahlekelwa ngumqashi wakho oxhasiwe plan. Uma ulinde isikhathi eside kunalokho, isikhathi sakho sokubhalisa esikhethekile sizophela, futhi kuzomele ulinde kuze kube yisikhathi sokubhalisa okulandelayo.
Ukuvikeleka Kwempilo Yesikhathi Esifishane Yesikhashana: Ukulinganiselwa ku-3 Izinyanga
Izinqubomgomo zomshuwalense wesikhathi esifushane, owaziwa nangokuthi umshuwalense we-gap noma umshuwalense wesikhashana, zenzelwe ukunikeza ezinye zezinga lokuhlinzeka ngezempilo isikhathi esilinganiselwe. Kusukela ngo-Ephreli 2017, izinhlelo zesikhathi esifushane azikwazi ukuhlala isikhathi esingaphezu kwezinsuku ezingu-90. Eziningi zalezi zinhlelo zihlanganisa izimo eziphuthumayo eziphathelene nempilo, kuhlanganise nokuhlala esibhedlela, kanye nemithi yokwelashwa okunamandla.
Nakuba lezi zinhlelo zingabizi kakhulu kune-inshuwalense yempilo ejwayelekile, zinokulinganiselwa okubalulekile, okungahlanganisi ukuhlinzekwa kwezimo ezikhona ngaphambili nokunakekelwa kwezempilo njalo, kanye nezindleko ezidonswayo eziphezulu kanye nezindleko zangaphandle. Asikho futhi isiqinisekiso sokuthi ungavuselela lolu hlelo emva kwesikhathi sakho sokuqala sokuqala.
Inqubomgomo yomshuwalense wezempilo yesikhashana ingase ikufanele uma unendlela yokuphila enempilo, ungenayo izimo zezokwelapha ezikhona, futhi ulindele ukuthi uphinde usebenze noma ukwazi ukuthenga umshuwalense wezempilo ovamile ngaphambi kokuphela kwesikhathi sokubanjwa kwesikhashana.
Qaphela ukuthi uhlelo oluthile lwesikhashana alubhekwa njengokubambisana okubalulekile ngaphansi kwe-ACA. Lokhu kusho ukuthi uma uthembele ohlelweni lesikhathi esifushane izinyanga ezingaphezu kwezinyanga ezimbili, uzobe uhambisana nesigwebo somuntu ngamunye we-ACA , ngaphandle uma uvumelekile ukukhululwa ehlathini.
Izindleko eziphansi noma izinketho zamahhala: Ukwandiswa Kwama-Medicaid kwenza Ukwenza Okufinyeleleke Kakhulu Kufinyeleleke
Uma imali yakho engenayo ilahlekile kakhulu futhi awukwazi ukuthenga umshuwalense wezempilo, ungase ufanelekele uhlelo lwendawo, lombuso noma lwesifundazwe.
Ngaphansi kwe-ACA, amazwe angakwazi ukwandisa ukufaneleka kweMedicaid kuze kufike kumaphesenti ayisishiyagalombili wezinga lobuphofu (cishe amaRandi angu-28 000 emndenini wabathathu ngo-2017). Uma imali yakho engenayo iphansi ngaphansi kwalesi sizinga ngenxa yokulahlekelwa umsebenzi, ungase ufanelekele i-Medicaid, kuye ngokuthi uhlalaphi. Kunezi-19 ezithi azizange zandise i-Medicaid, futhi ku-18 kulawo mazwe, kukhona "igebe lokuhlanganisa" labantu abanenzuzo engaphansi kwezinga lobuphofu.
Uma ungeke ukwazi ukuthola iMedicaid futhi ungakwazi ukukhokhela ukukhokhelwa ekushintsheni ngisho nezinsizakalo ezitholakalayo, indawo enhle okuzoqala ukufuna ulwazi yiwebhusayithi yeSiseko seMfundo YezeMpilo. Le nhlangano engeyona inzuzo inikeza amathuluzi okusebenzisana ukukusiza ukuthi uthole umshuwalense wezempilo ongabizi noma okunye okukhethwa kukho kuhulumeni wakho. Isayithi linikeza nokufinyelela ku-Line Uninsured Hot Line (800-234-1317) evumela ukuthi ukhulume ku-opharetha ophilayo noma nini-amahora angu-24 ngosuku, izinsuku ezingu-7 ngesonto.
Uma ungenayo izinketho zomshuwalense wezempilo, kunezindawo ongahamba ngazo zokubheka izindleko eziphansi noma ukunakekelwa kwamahhala. Lezi zindlela zihlanganisa:
- Umshuwalense Wezingane: Uma imali yakho yomndeni ingaphansi kwezinga elithile, izingane zakho (ezingaphansi kweminyaka engu-19) zingase zifanelekele inqubomgomo yomshuwalense wezempilo ekhokhelwayo noma ephansi. Lezi zinqubomgomo, ezinikezwe uhulumeni wesifundazwe nombuso wakho, zihlanganisa zonke izinsizakalo zezempilo ezisemqoka kubandakanya ukunakekelwa kwamazinyo nokubona . Ukuhlinzekwa kwezingane kuyatholakala ngisho nasezikhulwini ezingu-18 lapho kune-igebe lokubhekwa kwe-Medicaid kubantu abadala. Ukuze uthole ulwazi, xhumana noMnyango wezeMpilo kahulumeni noma uMnyango Wezingane Nezinsizakalo Zomndeni. Ungafunda kabanzi ngalolu hlobo lomshuwalense wezempilo futhi ufinyelele ohlelweni lwakho lombuso ngamunye ku-InsureKidsNow!
- Izikhungo Zempilo Yomphakathi: Elawulwa uhulumeni wesifundazwe, izikhungo zezempilo zomphakathi zingatholakala ezingxenyeni eziningi zezwe. Le mitholampilo ihlinzeka ukunakekelwa kubantu abangenawo umshuwalense wezempilo futhi babe nesilinganiso sokukhokha esekelwe engenayo. Eziningi zalezi mitholampilo zinezinsizakalo zokweluleka ukusiza abantu bathole umshuwalense wezempilo noma ukunakekelwa kwezindleko eziphansi. Thola isikhungo sempilo emphakathini wakho.
- Imitholampilo yamahhala : Le miitholampilo, etholakala emiphakathini eminingi, inikeza ukunakekelwa kwempilo mahhala noma izindleko ezincane kubantu abangaqinisekisiwe. Bavame ukusebenza ngabahlengikazi nabahlengikazi futhi bathembele ngeminikelo evela emphakathini wendawo. Thola umtholampilo wamahhala emphakathini wakho.
- Izinzuzo ze-Veterans: UMnyango wezokuPhathwa kweVeterans (VA) unikeza ukunakekelwa kwezempilo mahhala noma okungabizi kahle kanye nokwebiwa kwezidakamizwa ezidakamizwa kuma-veteran afanelekile ngokusebenzisa izikhungo zezokwelapha ze-VA. Iwebhusayithi ye-VA inolwazi mayelana nokufaneleka kanye nendawo yamahhovisi e-VA.
Zinakekele
Ukulahlekelwa umsebenzi wakho, inzuzo yakho, nezinzuzo zakho zezempilo kungabangela ukukhathazeka kakhulu futhi, kubantu abaningi, bahlukunyezwa. Enye yezinto ezibaluleke kakhulu okufanele ukwenze ukuzinakekela wena!
Kunezinyathelo ongazithatha ukukusiza ngalesi sikhathi:
- Yiba nomthelela ekutholeni ukutholakala komshuwalense wezempilo kanye nokufuna umsebenzi omusha
- Hlala uxhumene nomndeni nabangani
- Thola iqembu lokusekela lendawo labanye abaye baqedwa
- Khuluma nodokotela wakho mayelana nokuqedwa kwakho nesimo somshuwalense wezempilo. Angakwazi ukuphakamisa izinyathelo zokulondoloza izindleko ezifana nokushintsha imithi yakho yegama lomkhiqizo kuma-generic versions noma ukwenza uhlelo lokukhokha lwezinkokhelo zakho zezokwelapha.
Futhi, okubaluleke nakakhulu, gcina indlela yokuphila enempilo ngokuzivocavoca njalo kanye nemikhuba emihle yokudla! Uzozizwa ungcono futhi awuncane amathuba okudinga amasevisi wezempilo!
> Imithombo:
> UMnyango Wezezimali; Umnyango Wezabasebenzi; UMnyango wezeMpilo kanye nezinsizakalo zabasebenzi. Izinzuzo ezingeziwe; Imingcele yokuphila kanye nonyaka; kanye Nomshuwalense Wesikhathi Esifishane Nesikhathi Esincane . 2016
> Kaiser Family Foundation. Ukuguqulwa Kwemakethe Yempilo Yomshwalense Wezempilo: I-Issue Eqinisekisiwe. Juni 2012.
> Kaiser Family Foundation. I-Gap Yezokuphepha: Abantu Abahluphekayo Abangenayo Insizakalo Emasimini Angenwebise Ukuxilongwa Kwemithi. Ngo-Okthoba 19, 2016.