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Human Resources Department

New Health Care Legislation
Frequently Asked Questions...

Q.  What is this new health care legislation? 

A.  In March 2010, the U.S. Congress passed the Patient Protection and Affordable Care Act. This legislation is aimed at expanding access to affordable health insurance, particularly the 32 million uninsured – approximately one tenth of the nation's population. Hamilton County employees have the option of participating in a group insurance plan through their employer. 

Q.  How is healthcare reform being funded? Will my insurance premiums go up?  

A.  Much of it will be paid for by changes in  Medicare and Medicaid spending, imposing fees on health care insurers, drug companies and medical device companies, and increasing Medicare taxes on those earning more than $200,000 a year. 

As for premium increases, that will be determined in negotiations between the county and insurers. It is possible that insurers will ask for increases as a result of the changes, but Hamilton County won’t know whether increases will come until a new agreement is negotiated. 

Q.  When do the changes in this new law take effect? 

A.  For Hamilton County employees, some changes will begin Jan. 1, 2011, and others will be phased in through coming years until 2018. 

Q.  How will this new law affect Hamilton County? 

A.  Hamilton County will comply with the law’s provisions, but much is unknown until various federal agencies issue specific compliance regulations. Many do not take effect for two to four years, and things could change. County leaders will follow the legislative and rules process closely. 

Q.  How will this new law affect me? 

A.  It will affect employees in different ways, depending on their individual situation. Details on specific changes are below. Hamilton County’s Human Resources Department will communicate key changes as they become known.  

Q.  Must I carry insurance?  

A.  By 2014, citizens must carry health insurance or pay a fine. The penalty would start at $95 for an individual or $285 for a family, up to 1 percent of income, whichever is greater. By 2016, that would rise to $695 for an individual, $2,085 for a family, or up to 2.5 percent of income. 

Q.  Must my employer offer me insurance? 

A.  No, but your employer is subject to a financial penalty if insurance is not offered. The law does require larger employers to automatically enroll employees in their insurance program unless the employee opts out.  

Q.  How will the government know if I have insurance? 

A.  Beginning in 2011, Hamilton County is required to report the value of an employee's health care to the government on employees' W-2 tax forms.  

Q.  Can I add my adult children to my health insurance? 

A.  There is a provision in the new law that allows parents to cover their children up to age 26, provided that the child does not have an offer of insurance from his or her employer. This will take effect January 1, 2011. Hamilton County employees can add their adult children during Open Enrollment this fall. Human Resources will provide information about dependent eligibility and the process to enroll them. Beginning in 2014, adult children can join their parent’s insurance plan up to age 26 even if they have an offer of insurance from their employer.  

Q.  Can I obtain coverage if I have a pre-existing condition? 

A.  Under the new law, insurance companies cannot exclude people with pre-existing conditions (beginning with children in 2011 and adults in 2014). Hamilton County’s current insurance plans do not exclude anyone with a pre-existing condition.

Q.  What if I get ill with a serious disease? Can I be dropped? Are there lifetime or annual limits to my coverage? 

A.  No. The law calls for a ban on lifetime dollar limits and allows only restricted annual dollar limits until 2014, when they, too, will be banned. Hamilton County does not have dollar limits on its current insurance plans. 

Q.  I’m a part-time employee. Will I get coverage? 

A.  Under the law, by 2014 employers with insurance plans are required to offer insurance to employees who work at least 30 hours per week or face financial penalty. Employers do not have to offer coverage to employees working less than 30 hours a week.  Hamilton County offers coverage to employees regularly scheduled at least 30 hours a week. 

Q.  Can I keep the same doctor? 

A.  The law does not impose any changes on who can be your healthcare provider.   

Q.  Will there be changes in my health care coverage? 

A.  Not this year, however, changes for future plan years have yet to be determined.  The law does require some plans  to provide certain preventive services, such as wellness checks, with little or no cost to the patient.  Hamilton County needs to determine if this provision will have an impact on future health care plans. 

Q.  How will this impact my Flexible Spending Account? 

A.  There are a few key changes to such accounts in the new law. Beginning next January, you will not be eligible to receive reimbursement for over-the-counter medications. In 2013, participants will be limited to a maximum annual contribution of $2,500.

Q.  How will this impact my taxes? 

A.  Hamilton County will begin reporting the value of health benefits on employees' W-2 tax forms in 2011. This value is for reporting purposes only and is not included as part of your taxable income. Also, in 2013, the threshold for claiming medical expenses on itemized tax returns is raised to 10% from 7.5% of income. The threshold remains at 7.5% for the elderly through 2016.