New Health Insurance Requirements take effect on January 1, 2014
On January 1, 2014, the “individual shared responsibility” provision of the federal Affordable Care Act kicks in. Most individuals must: 1) have minimum essential health coverage (known as minimum essential coverage) for each month, 2) qualify for an exemption, or 3) pay a penalty when filing his or her federal income tax return.
Minimum Essential Health Coverage
On October 1, 2013, the federal government will begin launching new Health Insurance Marketplace (also known as a Health Care Exchanges) to help individuals find health care coverage that qualifies as minimum essential coverage under the Affordable Care Act. Students have unique options other than health care exchanges for coverage, although a student may wish to consider a health care exchange for coverage or for comparison of coverage.
Health Care Exchanges
In many states, the state will be establishing health care exchanges for their residents. In Texas, the federal government will be operating the exchange. Texas residents will use a website “HealthCare.gov”, to apply for coverage, compare plans, and enroll. Specific plans and prices will be available on October 1, 2013, when Marketplace open enrollment begins. Coverage can start as soon as January 1, 2014. You can find more information about Health Care Exchanges at https://www.healthcare.gov/what-is-the-health-insurance-marketplace/.
Student Options Under the Affordable Care Act.
· Insurance offered through the UT System-sponsored Student Health Insurance Plan, by Academic Health Plans/BlueCross BlueShield (AHP/BCBS) satisfies the required minimum essential health coverage.
The UT System Student Health Insurance Plan, which was selected by UT System to be affordable and provide the essential care required by the Affordable Care Act, is available to all students enrolled at a UT System institution and the eligible dependents of students who are enrolled in the plan. You can learn more about the plan at: https://www.academichealthplans.com/utpa/2013-2014/
· If you are under 26 years of age and you have a parent who has health insurance that provides coverage for dependents, you may be eligible to enroll in that plan. If so, you are eligible to stay on that plan until you reach age 26. Talk to your parents about whether they have health insurance that you may be eligible to enroll in.
· Students can also enroll in health care coverage through the Health Care Exchanges described above.
· If you're a full-time student and you're not working, or if you're working part-time, you may not earn enough to trigger the requirement to have health insurance. The penalty for not having health insurance applies only to people who earn enough to be required to file a tax return; that's just under $10,000 this year for a single person under age 65.
· There may be other exceptions that apply to you. For more information, you may want to start with the websites provided in this fact sheet.
Penalties for failing to meet the new requirements
· During 2014, the penalty will be $95 or 1 percent of your taxable income will be fined. In later years, though, the penalty will eventually increase to a maximum of 2.5 percent of taxable income.
If you owe a penalty, it will be assessed beginning with your 2014 income tax form that's due April 15, 2015. You can't go to jail for not paying the penalty; the government can't garnish your wages. The IRS can withhold your tax refund. For more information from the IRS on the Shared Responsibility Provisions of the ACA and the penalties for non-compliance, you can go to: http://www.irs.gov/uac/Questions-and-Answers-on-the-Individual-Shared-Responsibility-Provision
Q: What company provides SHI for the System’s students and eligible dependents?
A: Academic Health Plans, Inc. – https://www.academichealthplans.com/utpa/2013-2014/
Q: As a student, am I required to have SHI?
A: The Board of Regents of The University of Texas System requires all international students holding non-migrant visas and living in the United States to maintain approved health insurance while enrolled at component institutions of the University of Texas.
Q: Do I have to enroll in the UT System sponsored SHI plan?
A: No, students who are required to be enrolled in an insurance plan (see above) do not have to enroll in the Academic Health Plan program as long as proof of comparable coverage can be provided.
Q: As a qualified student enrolled at a System institution, am I guaranteed coverage under the UT SHI plan?
A: Yes, students meeting the eligibility requirements are guaranteed to be accepted for coverage into the System SHI plan.
CONTACT AND ENROLLMENT
Q: Who can I Contact to request additional information regarding the Academic Health Plan, Inc., policy?
A: Information is available through Academic Health Plan's website at https://www.academichealthplans.com/utpa/2013-2014/ .
Q: How do I enroll in the System SHI plan?
A: Enrollment is processed online through Academic Health Plan's website at https://www.academichealthplans.com/utpa/2013-2014/
Q: Where is the student health center on my campus?
A:The UTPA Student Health Center is located on campus at 613 North Suger Rd, Edinburg, TX
Q: If I do not seek care from the Student Health Center at my institution, how do I find a provider (doctors, hospitals, etc) in my area who accepts the SHI plan?
A: After creating an online account on Academic Health Plan's website https://www.academichealthplans.com/utpa/2013-2014/ , you will have access to their network provider locator.
Q: How do I obtain my insurance ID card?
A: After creating an online account, ID cards can be printed from Academic Health Plan's website at https://www.academichealthplans.com/utpa/2013-2014/
Q: If my ID card is lost, how do I get a replacement ID card?
A: Replacement ID cards can be printed from Academic Health Plan's website at https://www.academichealthplans.com/utpa/2013-2014/
MEDICAL INSURANCE 101
Q: What is a deductible?
A: The portion of your health care that you pay before insurance starts covering it.
Q: What is a copayment?
A: A fixed dollar amount you pay at the time services are rendered. Typical copays are for office visits, prescriptions, or hospitalizations.
Q: What is co-insurance?
A: A specified percentage of the cost of treatment the insured is required to pay for all covered medical expenses remaining after the deductible has been met.
Q: How is the UT System (System) sponsored Student Health Insurance (SHI) vendor chosen?
A: The System drafts a request for proposal (RFP) to invite insurance companies to submit competitive bids to provide SHI to students and eligible dependents attending System institutions. System staff meets with the Student Advisory Council to discuss coverage and benefits to be offered under the plan. The various RFP’s are systematically reviewed and a vendor is selected based upon specific criteria and the vendor’s ability to provide comprehensive care at an affordable cost.