The Affordable Care Act and the Health Insurance Marketplace: Questions and Answers
The Patient Protection and Affordable Care Act (PPACA), commonly called The Affordable Care Act (ACA), or Healthcare Reform, provides for a national Health Insurance Marketplace. The Marketplace serves as a new way to enable individuals who do not have insurance to find and buy health care coverage. The university is required by law to inform employees about the Marketplace, and all employees recently received a notice that explains the Marketplace, entitled “New Health Insurance Marketplace Coverage Options and Your Health Coverage.” All employees, even those who aren’t eligible for the State and School Employees’ Plan, are required to receive the Marketplace notice form.
State and School Employees’ Health Plan Eligibility
If you are an active full-time faculty or staff member employed in a position that is 50% time (half time) or more, and your position is expected to last more than 4 ½ months, then you as well as your spouse and dependents are eligible for the Mississippi State and School Employees’ Health Plan, which means health insurance coverage is available to you and has been offered. The plan defines eligibility as a full-time employee who receives compensation directly from an institution of higher learning. An employee making contributions to a retirement plan approved by the Mississippi Public Employees’ Retirement System (PERS or ORP) is considered a full-time employee.
No action is required of you if you already have health insurance through the State and School Employees’ Health Plan.
The university will continue to provide regular contributions toward your plan premiums just as it has in the past, and you are not required to enroll in a plan through the Marketplace. You will not be impacted by the implementation of the Marketplace.
A summary plan description, premiums, and full descriptions of eligibility criteria may be found online using the “Publications” link on the following Web site: https://www.dfa.ms.gov/insurance
Who May Participate in the Marketplace?
The Health Insurance Marketplace is open to everyone. If you are eligible for the Mississippi State and School Employees’ Health Plan, you may still evaluate options using the Marketplace; however, the Marketplace notice clearly states “if you purchase a health plan through the Marketplace instead of accepting health coverage offered by your employer, then you may lose the employer contribution to the employer-offered coverage. Also this employer contribution – as well as your employee contribution to employer-offered coverage – is often excluded from income for Federal and State income tax purposes. Your payments for coverage through the Marketplace are made on an after-tax basis.” More information about the Marketplace may be found by visiting HealthCare.gov.
Information about the Marketplace
If you intend to explore coverage through the Marketplace, the following Notice entitled “New Health Insurance Marketplace Coverage Options and Your Health Coverage” will provide information for you: Marketplace Notice Form Information. The university will not engage in advising employees about plans available through the Marketplace.