Townhall meeting about the implications of ACA/Obamacare Milpitas, October 24, 2013 How the Affordable Care Act Affects You Jessica Oney, Certified Educator, Covered California Jessica Olney currently works as a Covered California Certified Educator. She has been working in the field of health outreach for the past four years with organizations such as Planned Parenthood, West County Health Centers, AmeriCorps, and the Center for Prevention and Outreach. Her work with these organizations has shaped her interest and research in health care reform and she especially enjoys being speaking one-on-one with individuals in the community about their questions and concerns about Covered California.

1. Covered California
Planned Parenthood Mar Monte

2. VISION
Improve the Health of All Californians
Access Affordable Care
Provide High Quality Care
MISSION
Increase Insured Californians
Improve Healthcare Quality
Lower Costs
Reduce Health Disparities
Choice & Value

3. Affordable Care Act Improvements
• Guaranteed coverage
• Standardized benefits
• No annual limits, no denial for pre-existing
conditions
• Rates are not based on your health status

4. Penalties
• Under the ACA, if you don’t have health
insurance by March 2014:
– You will be assessed a tax penalty
– 2014: 1% of family income or $95 per
adult, $47.50 per child
– 2015: 2% of family income or $325 per
adult, $162.50 per child
– 2016 +: 2.5% of family income or $695 per
adult, $347.50 per child.

5. Plans Available Through Covered
California
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4 Plans Available: Bronze, Silver, Gold, Platinum
Catastrophic Plan Available to Few Participants
Enhanced Silver Plan for those Eligible for “Cost Sharing”
Premium Assistance Available Up to 400% of the Poverty
Line

6. Plan Benefits

7. Enhanced Silver Benefits

8. Essential Health Benefits
1. Ambulatory patient
services
2. Emergency Services
3. Hospitalization
4. Maternity and newborn
care
5. Mental health and
substance use disorder
services, including
behavioral health
treatment
6. Prescription drugs
7. Rehabilitative services
and devices
8. Laboratory services
9. Preventative and
wellness services and
chronic disease
management
10. Pediatric services

9. Health Insurance That’s Affordable
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Assistance based on income
More affordable co-pay options
Zero deductible for many plans
Free preventive care
Lower out-of-pocket maximums

10. June Health
Insurance
Plans
Announced
March 31st
Open
Enrollment
Ends
October
First Open
Enrollment
2014
2013
July Public
Education
Campaign
Launched
January
Coverage
Begins
2015+

11. Health Insurance Companies
• Alameda Alliance
for Health
• Anthem Blue Cross
of California
• Blue Shield of California
• Chinese Community
Health Plan
• Contra Costa Health Plan
• Health Net
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•
•
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Kaiser Permanente
L.A. Care Health Plan
Molina Healthcare
Sharp Health Plan
Valley Health Plan
Ventura County Health
Care Plan
• Western Health
Advantage

12. Health Coverage for Small Businesses
• Small Businesses Health Options Program
(SHOP)
• Less than 50 employees
• Tax Credits
• Plan choice

13. THANK YOU
For more information you can:
• Submit an Enrollment Referral Form
with a Certified Educator
• Visit www.CoveredCA.com
• Call 1-888-975-1142