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ACA INSURANCE EXCHANGES

How Healthcare Reform Will Affect Your LACERA-administered Health Plan

The healthcare reform law, officially called the Patient Protection and Affordable Care Act of 2010 (ACA for short), is here to stay. Several of its key provisions, including the requirement for most Americans to have health insurance, take effect January 1, 2014.

As we get closer to 2014, you will hear more and more about healthcare reform, particularly about state and federal insurance exchanges. Beginning October 1st, Americans will be able to use exchanges, which are online marketplaces, to buy health insurance. Buyers will be able to choose from an assortment of plan types and carriers. It’s likely you’ll see extensive media coverage regarding the exchanges, as well as ads for various exchanges on television, online, and in your mailbox. The ads (mostly from health insurance companies) will focus on encouraging you to elect healthcare coverage through an exchange.

Important Things to Know

As coverage of insurance exchanges and ACA intensifies, here are a few tips to help you process the topics:

  • Healthcare reform was intended for people who do not have health insurance. As long as you’re enrolled in a LACERA-administered medical plan (or other plan providing similar coverage), you meet the requirement to have health insurance.
  • Healthcare reform was also intended for people who are not eligible for Medicare. If you are over age 65 or Medicare-eligible due to disability, you have access to coverage through LACERA-administered group Medicare Advantage Prescription Drug Plans, such as Kaiser Senior Advantage, SCAN Health Plan, United Healthcare Medicare Advantage, Cigna-HealthSpring Preferred with Rx (available in Maricopa County and Apache Junction, Pinal County, AZ) and Medicare Supplement Plan, Anthem Blue Cross Plan III. If you’re enrolled in any of these plans, you’re not eligible to enroll through a public exchange.
  • If you’re enrolled in an LACERA-administered medical plan (or another similar plan), no action is required on your part. ACA will not affect your LACERA-administered healthcare benefits.

If You Don’t Have Healthcare Coverage

You can enroll for coverage through LACERA or through a state or federal exchange. If you were eligible for LACERA coverage when you retired but declined to enroll, or were previously covered by a LACERA plan and dropped your coverage, you will be eligible for LACERA-administered coverage six months after LACERA receives your enrollment form.

If you are under age 65, you will be able to enroll for medical coverage through a state or federal exchange (not all states will offer an exchange). California has announced it will offer a health benefit exchange, called Covered California. For more information, visit CoveredCA.com or call 888-975-1142.

To find out if your state is establishing a healthcare marketplace, or if the federal healthcare marketplace will be offered instead, visit kff.org/state-health-exchange-profiles/.

Will I Receive Financial Help If I Enroll through An Exchange?

In many cases, the current LACERA-administered Retiree Healthcare Benefits Program will provide retirees more comprehensive and lower-cost coverage than an exchange. As such, it will make sense to remain enrolled in the LACERA plan. However, some LACERA retirees who are not eligible for Medicare will qualify for financial help (subsidy) from the government to pay for coverage purchased from a state or federal exchange, depending upon their income. Those retirees may find it more financially advantageous to enroll in the state or federal exchange.

To determine the best option for you and your family, investigate state and federal exchange opportunities carefully.

Additional Information

To find out more about LACERA-administered medical coverage, call 800-786-6464 (press 1) to speak with a LACERA Retiree Healthcare Benefits Specialist. Specialists are available weekdays from 7:00 a.m. to 5:30 p.m. You mail also email us at healthcare@lacera.com.

We will continue to keep you informed with the latest information on ACA and how it may affect you.

9/14/15