Uma usulahlekelwe umshuwalense wakho wezempilo futhi ufuna isuquko sezempilo, ungase usabe ukhathazekile uma ufunda ukuthi ukushintshaniswa komshuwalense wezempilo wombuso wakho (kanye nemakethe yokushintshaniswa kwezomnotho kuwo wonke amazwe ngaphandle kwe-Nevada) ikuvumela ukuba ubhalisele uhlelo lwezempilo ngesikhathi sokubhalisa ngonyaka ovulekile . Kodwa kwenzekani uma ulahlekelwa yomshuwalense wakho wezempilo futhi unayo izinyanga ngaphambi kokuhamba kwesikhathi esivulekile sokubhalisa?
Uthola kanjani umshuwalense wezempilo futhi ugweme ukungaqinisekisiwe?
Isikhathi Esibalulekile Sokubhalisa
Kuye ngokuthi nini futhi kungani ulahlekelwa umshuwalense wakho wezempilo, ungase uvumeleke isikhathi sokubhalisa esikhethekile ku-Career Affordable Care Act (exchange rates) (iningi lezikhathi, isikhathi sokubhalisa esikhethekile sisebenza ngaphandle kwe-exchange). Isikhathi sokubhalisa esikhethekile sikuvumela ukuba ubhalisele umshuwalense wezempilo noma ngabe akuyona ukubhaliswa okuvulekile.
Izikhathi zokubhalisa ezikhethekile zilinganiselwe isikhathi, ngokuvamile izinsuku ezingu-60, futhi zibangelwa izinhlobo ezithile zemicimbi. Uma u-dawdle futhi ungabhalisi ohlelweni olusha ngaphambi kokuphela kwesikhathi sakho sokubhalisa esikhethekile, kuzomele ulinde kuze kube yisikhathi sokubhalisa esilandelayo sokubhalisa. Phakathi naleso sikhathi, ungase uzithole ungaqinisekisi nje kuphela kodwa ungaphansi kwesigwebo se - ACA sokungabi nomshuwalense wezempilo .
Ingabe Uyakufanelekela UkuBhaliswa Okukhethekile?
Izenzakalo ezithile ezifanelekayo ziqala isikhathi sokubhalisa esikhethekile (SEP) esizokuvumela ukuthi ubhalisele uhlelo lokushintshaniswa komshuwalense wezempilo, noma ngokuqondile nomthengisi wempilo yomshwalense emakethe yokushintshanisa.
Lezi zivame izinto ezifana nokulahlekelwa komunye umshuwalense wezempilo kanye noshintsho usayizi lomndeni. Nazi ezinye izibonelo eziqondile zokubangela izenzakalo ezenza uvumeleke isikhathi sokubhalisa esikhethekile:
- Utholiwe bese ulahlekelwa umshwalense wakho wempilo esekelwe emsebenzini.
- Uhlukanisa futhi ulahlekelwa ngumshuwalense wezempilo umsebenzi wakho wangaphambili womngane womshado onikeziwe.
- Uphendulela ama-26 futhi awufanelekile ukuhlinzeka ngaphansi kohlelo lwezempilo lomzali wakho.
- Oshade naye uyafa ekulahlekeleni umshuwalense wezempilo awunikezile.
- Uphuma endaweni yakho yesevisi yezempilo manje futhi angeke ikumboze ekhelini lakho elisha (inothi eliya endaweni entsha kuphela umcimbi ofanelekayo uma usuvele uhlanganiswe nomshuwalense endaweni yakho yangaphambili).
- Umqashi wakho uhlehlisa emuva emsebenzini wakho okwenza ungabi nemvume yomshwalense wempilo esekelwe emisebenzini.
- Unomntwana noma ushade.
Ezimweni ezimbili, izikhathi zokubhalisa ezikhethekile azisebenzi ngaphandle kwezingxoxo. Ngamanye amazwi, ungathola ukukhokhelwa ekushintsheni ngalezi zikhathi ezikhethekile zokubhalisa, kodwa uma uya ngqo kumphathi womshuwalense wezempilo, akudingeki ukuba wamukele ukubhaliswa kwakho:
- Ukuba ngumuntu waseMelika waseMelika (izikhathi zokubhalisa ezikhethekile ziqhubeka unyaka wonke)
- Ukuthola isakhamuzi sase-US noma ukubeka ngokomthetho isimo sokuhlala e-US
Into eyodwa engavame ukuqala isikhathi sokubhalisa esikhethekile ilahlekelwa yomshuwalense wakho wezempilo ngoba awuzange ukhokhe amaprimiyamu wenyanga noma ngenxa yokuthi ngokuzithandela ukhansele ukufakwa. Lokhu akufakiwe njengesenzakalo esenza kube lula ngoba kuzovumela abantu ukuba bathuthukise uhlelo futhi bashintshe kuhlelo olusha lwezempilo noma ngabe befuna.
Isibonelo, ungathenga uhlelo lwezempilo nge-cover lousy ngokungabizi kahle bese ushintshela ohlelweni nge-coverage kangcono uma ugula. Lokhu kunganqoba inhloso yokubhalisa okuvulekile.
Ukulahlekelwa umsebenzi kanye / noma ukwehla kwemali engenayo nakho akuyona into efanelekayo ngaphandle kokuba usuvele ubhalisile ohlelweni ngokusebenzisa ukushintshaniswa, lapho kungenzeka ukuthi ube nethuba lokushintshela ohlelweni oluhlukile. Kodwa uma ubhalisile ohlelweni ngaphandle kwe-exchange - ngoba awufanelekile ukuthola usizo ngenkathi ubhalisile, isibonelo - futhi ulahlekelwa umsebenzi wakho phakathi nonyaka, awungeke ube nethuba lokushintshela kuhlelo ukushintshaniswa ngaleso sikhathi.
Indlela Ukubhalisa Okubalulekile Kusebenza
Nasi isibonelo.
Unomshwalense wezempilo ngomsebenzi wakho, kodwa inkampani yakho ayikwenzi kahle ngokwezezimali. Ezinyangeni ezimbalwa emva kokuthi i-Obamacare ivule isikhathi sokubhalisa, uthola phansi futhi ulahlekelwe umshwalense wakho wempilo esekelwe emsebenzini.
Ungase uvumelekile ukuqhubeka nesimiso sakho samanje sezempilo usebenzisa ukufakwa kwe- COBRA , kodwa kunalokho, unquma ukuthi ungathanda ukuthola uhlelo olusha lwezempilo empilweni yomshwalense wakho wezempilo. Ufanelekile isikhathi sokubhalisa esikhethekile ngoba usanda kulahlekelwa umshuwalense wezempilo esekelwe emsebenzini ngenxa yokuthi ususiwe (inothi ukuthi uyakufanelekela ukuthola uhlelo kumakethe ngamunye noma ukushintshaniswa-ngisho noma nawe unenketho yokuqhubeka nomshuwalense wakho wemisebenzi nge-COBRA.Unezinsuku ezingu-60 ezikhethiwe zokukhethwa ukukhetha i-COBRA noma uhlelo lomakethe ngalunye, futhi uvumelekile ukuguqula ingqondo yakho ngaphakathi kwewindi lezinsuku ezingu-60 futhi, okwakungekho 'icala ngaphambi kuka 2017).
Uya kuwebhusayithi yakho yokushintshanisa umshuwalense wezempilo noma ushayele ukushintshanisa kwakho ngemva kwamasonto ambalwa bese ubhalisa ohlelweni lwezempilo olusha. Uma uhlelo lomqashi wakho lumboza oshade naye nabantwana, bafanelekile isikhathi sokubhalisa esikhethekile, futhi. Ungabhalisela ngamunye umshuwalense wezempilo ngamunye noma ungathola uhlelo lomndeni ekushintsheni.
Njengoba imali yakho engenayo ithathwe ngokuqedwa, ungase ufanelekele ukuthola usizo lokukhokhela izinkokhelo zomshuwalense wezinyanga zenyanga. Ukufaneleka kwezibonelelo kuncike kwimali yakho engenayo futhi kungakhokhwa ngqo kwinkampani yakho yomshuwalense entsha ukunciphisa inani okufanele ukhokhe ngenyanga ngayinye ukuze uthole ukukhokhelwa. Kukhona futhi izinsizakalo zokusiza ukwehlisa izibopho zakho zokwabelana ngezindleko ezifana nokudonswa kwemali, ukukhokhelwa kwama-copayments, nokuqinisekiswa kwezimali. Futhi, kunesibonelelo sokunciphisa ukuphuma kwakho kwepokhethi .
Insizakalo eyanciphisa ukwabelana kwakho kwezindleko nokuphuma kwepokhethi esiphezulu ibizwa ngokuthi ukuncishiswa kokubiza izindleko, noma i-CSR, futhi itholakale kuphela uma unayo imali efanelekile futhi ukhetha uhlelo lwesiliva . Insizakalo yokunciphisa amaphrimiyamu akho angasetshenziswa nanoma yiziphi izinhlelo zezinsimbi zensimbi (ithusi, isiliva, igolide, noma i-platinum).
Ufaka isicelo salezi zinsizakalo ngokusebenzisa ukushintshwa komshuwalense wezempilo njengoba uqhubeka nenqubo yokubhaliswa yomshuwalense wezempilo. Ukuxhaswa kungasetshenziswa kuphela ngomshwalense wezempilo owathengiwe ku-Care Affordable Care Act. Ngakho-ke nakuba isikhathi sakho sokubhalisa esikhethekile sizokunika ithuba lokubhalisa ngaphandle kokushintshaniswa uma ukhetha, awukwazi ukuthola usizo lokukhokhela umshuwalense wezempilo ongathengi nge-exchange yakho (efaka i-COBRA; uma ukhetha ukugcina ukufakwa kwakho nge-COBRA, kuzodingeka ukhokhe i-premium egcwele ngokwakho).
Ayikho i-SEP Uma Ulahlekelwa Ukukhiqiza Okungekho Okuncane Okubalulekile Okubalulekile
Ukulahlekelwa okungahleliwe kokuqashwa kuyisenzakalo esifanelekayo esibangela isikhathi sokubhalisa esikhethekile, kodwa kuphela uma ukushicilelwa okulahlekelwayo kubhekwa njengokubambisana okubalulekile. Uma unemibiko engabhekwa njengento encane yokubambisana okudingekayo (uhlelo olude lwesikhashana , ngokwesibonelo, noma inqubomgomo engaguqukiyo), ukulahlekelwa kwalolu hlelo ngeke kubangele isikhathi sokubhalisa esikhethekile.
Lokhu kubaluleke kakhulu ukuqonda uma unesivumelwano ngaphansi kwepulani lesikhashana, njengoba lezo zinqubomgomo zinezinsuku zokuqedwa ezinqunyiwe ngaphambili, futhi ngo-2017, azikwazi ukuba ngaphezu kwezinsuku ezingu-90 esikhathini ( okungenzeka ukuthi zishintshe noMongameli I-Trump sika-Okthoba 2017 yokuhleleka ). Uma uhlelo lwe-short-term luphela, awunelungelo lokubhalisela uhlelo lwe-ACA-oluhambisanayo uma lungaphandle kokubhalisa okuvulekile.
> Imithombo:
I-Cornell Univerity Law School, i-Legal Information Institute, i-45-CFR-155.420, Izikhathi Ezibalulekile Zokubhalisa.
UMnyango WezeMpilo kanye Nezinsizakalo Zabantu, PPACA; Ukuchitshiyelwa kwezikhathi ezikhethekile zokubhalisa kanye nohlelo lwabathengi olusetshenzisiwe futhi oluhlelekile .