Health Care Reform

The Affordable Care Act (ACA) of 2010 put in place comprehensive health insurance reforms, including expansion of coverage, reforms to the health care industry, and expansion of the availability of coverage in the Marketplace. As of 2014 individuals are required to have health care coverage or pay a penalty.

Important News: FORM 1095 - New Form You Will Need to File Your 2015 Taxes

How Does the Affordable Care Act Affect Me at Washington State University?

With coverage being available under the Affordable Care Act (ACA) most individuals are required to have health insurance coverage.

Benefits offered to benefit-eligible Washington State University (WSU) Faculty, Staff, non-student hourly employees, and eligible Graduate Student Assistants, have been determined to meet and/or exceed the standard identified by the ACA including premium affordability and acceptable health coverage levels of coverage. If you are offered coverage by WSU you will not be eligible to receive tax credits through the Marketplace. Additionally, under the ACA, WSU is required to offer Full Time Employees employer sponsored health coverage or pay a penalty. This provision is referred to as the Employer Shared Responsibility.

However, employees and students currently not eligible for or covered by benefits through WSU may need/want to review the coverage options available through the Marketplace, a way to buy health insurance under the ACA. The Marketplace offers "one-stop shopping" to find and compare private health insurance options. Some people may be eligible for a kind of tax credit that lowers their monthly premiums and gives cost-sharing reductions.

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Employer Notification (including Employer Plan Information documents)

This notice specifically addresses the requirements of the ACA Employer Notification, but will also provide links to additional information individuals and their families may find helpful. This notice serves as a household employer notification and our employees should provide it to their household members as well.

This notice was provided to all existing employees as of September, 2013 and will be provided to all future employees starting October 1, 2013.

Employer Notification - Faculty, Staff, Graduate Student Assistants, non-student and student hourly employees

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Affordable Care Act Basics

Key Provisions of the Health Care Law

Creates the Health Insurance Marketplace, a new way for individuals and families to get health coverage
Requires insurance companies to cover people with pre-existing health conditions
Helps individuals understand the coverage they're getting
Holds insurance companies accountable for rate increases
Makes it illegal for health insurance companies to arbitrarily cancel health insurance just because someone gets sick
Protects individuals choice of doctors within their provider network
Allows parents to covers young adults under 26
Provides free preventive care
Ends lifetime and yearly dollar limits on coverage of essential health benefits
Guarantees your right to appeal

The Requirement to Buy Health Insurance under the ACA

Along with changes to the health insurance system, the Affordable Care Act includes a requirement that many people be insured or pay a penalty. This is sometimes known as the "individual mandate". The flowchart below illustrates how this requirement works.

Kaiser Family Foundation Individual Mandate Flowchart

The Health Insurance Marketplace

Under the ACA, every state must have a health insurance Marketplace or use the Federal Marketplace to help individuals and families purchase health insurance. The Marketplace offers one-stop shopping and assistance in helping find and compare medical health insurance options offered by private companies. The Marketplace also assist individuals and families in determining if they qualify for premium tax credits or other financial assistance, thus giving them the confidence to choose the plan that best fits their needs and budget. Individuals who are not eligible for coverage through their employer will benefit the most from this program and its services.

Each Marketplace will offer:

Apples-to-apples comparisons of health insurance plans
Financial help to pay for copays and premiums
Expert customer support online, by phone, or in-person through a local organization, insurance broker or agent

You will utilize the above referenced "Plan Information" document for assistance in applying for coverage in the marketplace.