The following information is an overview and for your benefit only.  For a more detailed study of the ACA please visit the web sites listed below.

What is important about insurance requirements under the Affordable Care Act (ACA) - also known as Health Care Reform?

  • A provision of the Affordable Care Act requires that all persons have insurance or pay a penalty (called the “individual mandate”).
  • The Affordable Care Act (ACA) provides for the operation of insurance exchanges which started in 2014. Exchanges are national, state-operated, or a combination. Exchanges were established to provide access to health care coverage for all persons.
  • Children can now stay on their parent’s health insurance plan until the age of 26, regardless of the child’s marital status, financial dependency, enrollment in school, or place of residence.
  • In-network and participating providers must cover preventive services.
  • You are not able to purchase health insurance outside of open enrollment unless you qualify with a “triggering event”. Some examples of a triggering event is loss of minimum essential coverage for an individual or their dependent, gaining or becoming a dependent, or newly gaining citizenship, etc.

What is the Health Insurance Marketplace?

The State of Iowa has chosen to establish a State Insurance Exchange. Eligible individuals may purchase health coverage through the exchange without regard to health status. If you are not a resident of the state of Iowa, you should reference information for your state of residence.  Please be aware that some state plans will not meet Waldorf’s adequate coverage policy as they are HMOs or State Aid type of coverage.

Where can I get more information on the health insurance exchanges?