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Posts from the ‘Navigating the Affordable Care Act’ Category

2
Jan

Navigating the Affordable Care Act – Why “Young Invincibles” Need It

Navigating th Affordable Care Act
Learn how the Affordable Care Act will affect you and your practice in this ongoing series from LOMAP.

Navigating th Affordable Care Act

In preparing to write this “Young People’s ACA” post, I called a young attorney in hopes that she would clue me in to what a younger-than-me solo or small firm attorney would be thinking. She reminded me that the younger-than-me set feels invincible. “Really?” I wanted to ask. “Is that still true?” It is — and it always will be, according to my youthful cohort, for many in the younger set. (I refuse to use the “Gen-X/Gen-Y/Millennial” terms. It’s like categorizing people by their astrological signs to me.) This view made me feel more than ever like the harbinger of doom. I started looking up accidents and youth in our region. That turned dismal abominably quickly.

Is there any other way for me, a slightly older lawyer (though very youthful-older), to write this article? Carol M. Ostrom of the Seattle Times angled in with the mother position (see no. 7). But she was literally speaking to your mothers, not you. Besides, I think you already know that bad stuff can happen to young people. The 18-to-34 age bracket is one of the heaviest users of emergency rooms. Things happen and we need health insurance, more when we are older, but sometimes when we are younger, too. Read more »

12
Dec

Navigating the Affordable Care Act – What’s In a Health Insurance Plan?

Navigating th Affordable Care Act
Learn how the Affordable Care Act will affect you and your practice in this ongoing series from LOMAP.

Navigating th Affordable Care ActRead other posts from our Navigating the Affordable Care Act series.

What made up an insurance plan before the Affordable Care Act varied widely, or was hard to ferret out with no comparison tool available. The Marketplace changes that by giving baseline requirements and putting all plans in one location, allowing for side by side comparison. Some of those old plans will still exist, because they will be grandfathered, but none of the plans found in the Marketplace have grandfathered components. If you get it at the Marketplace, you get a guarantee that a uniform set of essential health benefits will be in every plan.

Essential Health Benefits

The essential health benefits are:

  1. Ambulatory patient services (outpatient care you get without being admitted to a hospital)
  2. Emergency services
  3. Hospitalization (such as surgery)
  4. Maternity and newborn care (care pre- and post- birth)
  5. Mental health and substance use disorder services, including behavioral health treatment (including counseling and psychotherapy) Read more »
5
Dec

Navigating the Affordable Care Act — How the ACA affects solo attorneys

Navigating th Affordable Care Act
Learn how the Affordable Care Act will affect you and your practice in this ongoing series from LOMAP.

Navigating th Affordable Care Act

Read other posts from our Navigating the Affordable Care Act series.

Last week we determined that most solo and small firms are probably small employers. This week we speak to the solo attorney.

How does the ACA affect you when you are the only employee of your firm?

If you are a true solo, meaning you do not have any employees except you in the firm, then you are not considered an employer and you can get health insurance through the Washington Marketplace (or a state or federal Marketplace for your location, if you are not in Washington).

The ACA uses the common law definition of employee. Generally, if you can control what that person does for you, she is considered your employee. This broad definition may very plausibly bump even a contract attorney or a contract bookkeeper into the employee category for purposes of the ACA, making you an employer with certain notice and reporting requirements. Even if you don’t think you are, do the analysis to determine if you are an employer.

I’m a true solo attorney. How do I use the Marketplace? Read more »

20
Nov

Navigating the Affordable Care Act — What Small-Business Owners Need to Know

Navigating th Affordable Care Act
Small business owners, are you ready for the changes brought on by the ACA?

Navigating th Affordable Care Act

Read other posts from our Navigating the Affordable Care Act series.

Small business owners, are you ready for the changes brought on by the Affordable Care Act (ACA)?

If you are, well done! If not, do not despair. The WSBA’s Law Office Management Assistance Program is rolling out short articles that break out key points of the law for you in bite-size pieces. Look for a related article in an upcoming issue of NWLawyer and a webinar in early 2014.

How to determine if you are a small or large employer

Large employers have 50 or more full-time employees or the equivalent (e.g., 25 full-time employees and 50 at 50% part-time). Use the reported number of employees for the last calendar year, or for a new business, as the projected number you will report next year.

Small employers generally have fewer than 50 full-time employees or the equivalent. As a small firm or solo owner, you are probably not a large employer. This is good news! Large employers have more reporting obligations and healthcare offering obligations to coordinate. Read more »

13
Nov

Navigating the Affordable Care Act — 10 Ways Women Win

Navigating th Affordable Care Act
Learn how about the ACA’s strides in women’s healthcare in this ongoing series from LOMAP.

Navigating th Affordable Care Act

Read other posts from our Navigating the Affordable Care Act series. 

Women made great strides in equal treatment under the Affordable Care Act (ACA), though it seems this is one of the best-kept secrets about the health care law. A recent report showed 40% of women today are a household’s primary income earner, but they are more likely to not be insured through their own employer than men, and 20% of women between 18 and 64 go uninsured. That is 1 in 5 women who could benefit from the Marketplace’s health insurance plans.

The ACA changes have a direct impact on women’s healthcare in 10 significant ways:

1. Gender-rating is no longer permitted.

Before the ACA, women paid more for health insurance premiums than men of the same age. Not anymore.

2. Pre-existing conditions have changed.

Even a past pregnancy could have been considered a pre-existing condition before the ACA. Since pre-existing conditions are no longer a way to deny coverage, women can get insurance more readily. Diabetic women, cancer survivors, and domestic abuse victims (all things previously taken into account in denying or charging more to women) will also benefit from this change. Read more »

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