Emshuwalense wezempilo, inkinga eqinisekisiwe ibhekisela esimweni lapho inqubomgomo yokunakekelwa kwezempilo inikezwa khona kunoma yikuphi noma bonke abafake isicelo esifanelekayo kungakhathaliseki isimo sezempilo. Inkinga eqinisekisiwe ivumela abantu abanezinkinga zezokwelapha ezisekhona isikhathi eside, bathola umshuwalense wezempilo, njengoba umlando wabo wezokwelapha ungacatshangelwa.
I-Issue Eqinisekisiwe Ngaphansi Komthetho Wokunakekelwa Onganakekelwa (ACA)
Ngaphansi koMthetho Wokunakekelwa Okunakekelwayo , yonke imigomo yomshuwalense wezempilo ngamunye ngezinsuku eziphumelelayo zikaJanuwari 2014 noma kamuva kufanele ithengiswe ngendaba eqinisekisiwe.
Ababambisisi bangasakwazi ukuthola ukufaneleka kokuthola ulwazi emlandweni wezokwelapha, futhi izimo ezandulele azikwazi ukushiywa ngaphandle kwamacebo amasha.
Lokhu kwakungeyona neze icala ngaphambi koMthetho Wokunakekelwa Okunganakwa. Kusukela ngo-2012, kwakunamazwe ayisithupha kuphela lapho ukuthengiswa khona kwamakethe (uhlobo oluthengayo ngokwakho, kunokuba uthole kumqashi) kwakuyikhinga eliqinisekisiwe. Ema-44 asele, ama-insurers abheka amarekhodi wezokwelapha ngabanye abafake izicelo kanye nalabo abanezimo eziphawulekayo noma ngezikhathi ezithile ezingakabi khona ngaphambili bekunqatshelwa ukufakwa.
Ngaphandle kokukhishwa okuqinisekisiwe, ukuthengiswa emakethe yeqembu ngalinye namancane futhi manje kukhishwe ukulinganisa komphakathi okuguquliwe ngenxa ye-ACA. Lokho kusho ukuthi amaprimiyamu awakwazi ukusekelwa emlandweni wezokwelapha; zingashintsha kuphela ngokususelwa eminyakeni yobudala, ukusetshenziswa kogwayi kanye nekhodi ye-zip. Inkinga eqinisekisiwe nokulinganisa komphakathi okuguquliwe ngokuqinisekile kuyindaba ezinhle kulabo abanezimo zezokwelapha ezikhona ngaphambili.
Noma kunjalo, kusabalulekile ukuxoxa ngezimo zakho ezikhona ngaphambili nomthengisi noma obhalisile, noma umuntu ophethe umnyango womsebenzi womqashi wakho, ngaphambi kokuba ukhethe uhlelo. Kungenxa yokuthi amanethiwekhi omhlinzeki kanye namakhemikhali e-odakamizwa asemthethweni ayahluka ngokuphawulekayo kusuka kwelinye icebo kuya kwelinye.
Uma unesimo esandulele, uzofuna ukuqinisekisa ukuthi uma kungenzeka, uhlelo olukhethayo lubandakanya odokotela kwinethiwekhi yakho futhi luhlanganisa imithi oyithathayo.
Issue Eqinisekisiwe Uma Uthenga Umshwalense Wezempilo Kwenkampani Encane
Umthetho wase-Federal udinga ukuthi zonke izinhlelo zokunakekelwa kwezempilo zithengiswe izinkampani ezinabasebenzi aba-2 kuya ku-50 zibe yingqinamba eqinisekisiwe. Lokhu bekulokhu kwenzeka kusukela i-HIPAA yaqala ukusebenza ngo-1997-amashumi amabili eminyaka, abathinteli abakwazi ukuphika ukukhokhelwa kwabaqashi abancane ngokusekelwe esimweni sezempilo sabasebenzi.
Kodwa-ke, i-HIPAA ayizange igweme ama-insurers ekusekeni ama-premium amaqembu amancane emlandweni jikelele wezokwelapha weqembu. Lokhu kusho ukuthi ngaphandle kokuthi izwe lingavunyelwe, abanikezeli besikhwama banganikeza izaphulelo emaqenjini anempilo, futhi bakhokhele amaphrimiyamu aphezulu kumaqembu anabasebenzi abancane abanempilo kanye / noma abaxhomekile. Bangakwazi futhi ukukhokhisa amaphrimiyamu aphezulu kumaqembu anezinto ezinobungozi, naphezu kokuthi abasebenzi abasebenza (ngokuphambene nomshuwalense wezempilo wabasebenzi) bahlanganisa ukulimala emsebenzini.
Kodwa i-ACA iphelile umkhuba wokusekela ama-premium emlandweni wezokwelapha amaqembu amancane noma uhlobo lomkhakha. Ngaphandle kokukhishwa okuqinisekisiwe, ukufakwa kweqembu elincane manje kulandela imithetho efanayo yokulinganisa yomphakathi esetshenziselwa emakethe ngayinye: amaprimiyamu angahluka kuphela ngokususelwa eminyakeni yobudala, ukusetshenziswa kogwayi kanye nekhodi ye-zip.
Issue Guaranteed for Groups Large Employer
Abaqashi abakhulu kudingeka banikele ukunikeza abasebenzi babo ngaphansi kwe-ACA. Ukwenza lokhu kube lula, ababhalisi abasavunyelwe ukuphoqa izimfuneko zokubamba iqhaza okungenani lapho abaqashi abakhulu befuna ukuhlinzekwa kwabasebenzi babo. Iningi elikhulu kakhulu iqembu elizimele, noma kunjalo, okwenza lokhu kube yi-moot point.
Ukufakwa kweqembu elikhulu akudingeki ukuba ulandele imithetho yokulinganisa yomphakathi eguquliwe esebenzayo eqenjini elincane namapulani ngamanye. Lokhu kusho ukuthi amanani amaqembu amakhulu asengase asekelwe ekuhlangeneni nakho konke okukhulunywa ngakho kweqembu, ngezinga lokunciphisa amaqembu anempilo, namanani aphakeme ngamacembu aphansi aphilile.
Ukubhekisela, "iqembu elikhulu" lisho abasebenzi abangaphezu kuka-50, nakuba kunezimbalwa ezimbalwa lapho kusebenza khona kumaqembu anabasebenzi abangaphezu kuka-100 .
I-Issue Eqinisekisiwe Ngaphandle Kwe-United States
Ngenkathi i-Care Affordable Act Act yenza ukuba umshuwalense wezempilo e-United States kube lula kakhulu kubantu abanezimo ezikhona ngaphambili, kunemikhawulo yawo. I-Care Affordable Act kuphela ithinta umshuwalense wezempilo e-United States. Amazwe angaphandle kwe-United States anemithetho ehlukene elawula ukuthengiswa komshuwalense wezempilo.
> Imithombo:
> UMnyango wezeMpilo kanye nezinsizakalo zabasebenzi, iHhovisi loMsizi Wesekela likaHlelo nokuHlola. Umthelela Wokuthola Ukutholakala Kwempilo Yomshwalense Wezimakethe ZezeMpilo, Issue Eqinisekisiwe Nokuvuselelwa. Okthoba 20, 2000.
> I-Employee Benefit Research Institute. Izinhlelo Zempilo Ezizimele Ezizimele: Amathrendi Wakamuva KaFirm Size, 1996-2015 . Julayi 2016; I-Vol 37, No. 7.
> HealthCare.gov. Funda uMthetho Wokunakekelwa Onganakekelwayo.
> Kaiser Family Foundation. Ukuguqulwa Kwemakethe Yempilo Yomshwalense Wezempilo: I-Issue Eqinisekisiwe . Juni 2012.