Frequently asked questions about the Health Care Law

If you have any additional questions, please contact our enrollment office.

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Am I required to have health coverage?

Under the new Health Care Law, everyone is required to have health coverage.

What if I am afraid I will not be able to afford health coverage?

The Health Care Law has provisions that help make health coverage affordable for all individuals. Some examples include the expansion of Medicaid to include all individuals between the ages of 19-65 with an income of less than 138% Federal Poverty Level. Other examples include premium tax credits and cost-sharing reductions.

Income Eligibility Charts

What if I have health coverage through my employer?

If your employer offers health coverage that is satisfactory, you will not need any additional coverage. However, you will still be able to buy coverage from the Exchange if your employer’s health coverage is considered unaffordable. Coverage is considered unaffordable if an individual’s contribution is more than 9.5% of the annual income.

What if I have a pre-existing condition?

Under the new Health Care Law, individuals will not be denied health coverage or charged more for current or past health issues.

Is anyone exempt from having to enroll in health coverage?

The following individuals and/or circumstances will prevent people from having to enroll in health coverage and be subjected to a fine:

• A member of a federally recognized American Indian tribe;
• Someone in jail or prison;
• An undocumented immigrant;
• A member of a federally recognized religion that prevents you from accepting health benefits;
• A member of a recognized health care sharing ministry; and
• If your income is below the federal tax filing threshold.

What is the Illinois Health Exchange?

The Illinois Health Exchange is an insurance marketplace where one can find quality health coverage. Filling out an application will allow you to see all health plan options available in your area.The Exchange can also determine if you qualify for lower out-of-pocket costs, Medicaid, or AllKids by providing household size and income.

What are the health benefits with the plans in the Illinois Health Exchange?

The health benefits include the following:

• Hospitalization
• Emergency services
• Ambulatory services
• Prescription drugs
• Maternity and newborn care
• Medical equipment and supplies
• Mental health and substance abuse treatment
• Physician services
• Rehabilitative services
• Laboratory services
• Pediatric medical, dental, and vision care

Who are the providers in Illinois Health Exchange?

There are five major providers in the Illinois Health Exchange:

• Health Alliance Medical Plans
• Blue Cross Blue Shield of Illinois
• Humana Health Plan, Inc.
• Land of Lincoln Mutual Health Insurance Co.
• Coventry Health Care

What is the Open Enrollment Period?

The Open Enrollment Period is the time frame individuals and families are eligible to enroll in health coverage through the Exchange. For 2015, the Open Enrollment Period is November 15, 2014 through February 15, 2015.

When will health coverage begin?

Individuals who sign up and pay their premium between November 15, 2014 through December 15, 2014 will have health coverage by January 1, 2015. For individuals who sign up and pay their premium between December 15, 2014 through February 15, 2015, coverage will begin as follows:

• 1st through the 15th of the month, coverage will begin the 1st of the following month(Example: Apply for coverage and pay premium on January 3rd, coverage will begin February 1st.)

• 16th through the end of the month, coverage will begin the 1st of the second following month.(Example: Apply for coverage and pay premium on January 21st, coverage will begin March 1st.)

What if I miss the Open Enrollment Period?

After the Open Enrollment Period ends March 31, 2014, individuals will not be able to sign up for health coverage through the Exchange until November 15, 2014 and may be subjected to a penalty when filing the 2014 income taxes. Individuals may only obtain health coverage outside of the enrollment period if a special event occurs, e.g. death, pregnancy, divorce, marriage.

What is the penalty for not getting coverage?

Failure to comply with the rules set forth by the Health Care Law will result in a fee when filing the 2014 income taxes. For 2014, the penalty will be either $95 or 1% of total income, whichever is higher. For 2015, the penalty will be either $325 or 2% of total income, whichever is higher.

How will Central Counties Health Centers (CCHC) assist me?

Certified Application Counselors (CACs) at CCHC will NOT direct people towards a specific health coverage option or provider, as well as make any decision for an individual’s health coverage. Instead, CACs will assist individuals by providing education and information about the different health coverage options available so individuals can make an informed, sound decision based on their health care needs.

What do I need when applying?

The information you will need when applying through the Illinois Health Exchange is:

• Full names and birth dates for each family member applying
• Employer/income information (W2s, paystubs, etc.)
• Social security card (or legal documentation numbers) for each family member applying
• Current policy numbers from your insurance provider