Affordable Care Act

  • ATTN:  RETIREES
     
    Pinellas County Schools understands that for many retirees under the age of 65, the cost of the PCS health insurance plan is very expensive and can take a large portion of your monthly retirement check.   Therefore, PCS would like to offer you the opportunity to explore and compare more affordable health plans through the Health Care Marketplace and to determine if you may be eligible for health insurance subsidies.
     
     
    As a result of the Affordable Care Act, a "Marketplace" has been created.  It offers "one-stop shopping" to find and compare private health insurance options.  You could be eligible for a tax credit that lowers your monthly premiums and cost sharing reductions.   You will want to compare the network of providers and drug formularies to those of your current health plan.
     
     
    Enrollment:  To find out more about the Marketplace, you may visit www.healthcare.gov or call (727)464-8411 to schedule an appointment with a Healthcare Navigator in Pinellas County.   If you are a new retiree, you may have 31 days from your retirement date to explore this option.  
     
    Reinstatement of PCS Group Health Plan
    Many retirees may have considered purchasing a plan through the Marketplace, but are concerned that if they are not satisfied under the new plan, they cannot reenroll in the PCS group health retiree plan.  However, PCS wants to allow you the opportunity to explore this option and reenroll at the same level of health coverage if you are not happy with your decision.   This option is available for the first 12 months of coverage only.  If you wish to reenroll, please contact us at 588-6214 during our next annual enrollment (normally in October) so that we may have your health coverage reinstated in the equivalent plan and at the appropriate new rates.
      

    Summary of Patient Protection & Affordable Care Act

    The goal of the Patient Protection and Affordable Care Act (PPACA) also referred to as the Affordable Care Act (ACA) is to increase access to health care for all Americans.  It includes provisions for health plans, employers and individuals.  Our current Aetna health plan meets or exceeds the provisions of the Affordable Care Act, including limiting the maximum out of pocket expense an individual or family may incur in a plan year.

    Key changes already in effect that you should know about:

    • You can now get preventive services like vaccinations and certain screening through your health plan without a copay or coinsurance when you use an in-network provider.
    • Young adults are now able to stay on your health plan until they turn 26 years old.
    • Dependents younger than 19 years of age with pre-existing health conditions can't be denied healthcare coverage.
    • There is no longer a limit on a health plan's lifetime essential health benefits.



    Changes for PCS Retirees

    • The Individual Mandate: With a few exceptions, U.S. citizens will be required to have coverage or pay a penalty. 
    •  If you receive qualified coverage through your employer or have an individual plan, including Medicare, you will not have to pay this penalty.
    • People will not have to worry that they'll be denied healthcare coverage even if they have pre-existing conditions, like chronic illnesses.  Insurance carriers will sell and renew plans to individuals regardless of a person's health and rates won't be affected by health status or gender.
    • Waiting periods before an employer-sponsored health plan takes effect are limited to 90 days.
    • There's now no annual limit on what your plan pays for your essential benefits, although daily and frequency limits may still apply.
    • If you are enrolled in a PCS-sponsored medical plan, you will not pay a penalty.
    • Depending upon your income, you may be eligible for a premium subsidy through the federal Marketplace
    • Your spouse and your children must also have health insurance coverage.  If you cannot afford to enroll your spouse and/or child (ren) in a PCS medical plan, there may be cost-effective options through the federal Marketplace and/or Florida KidCare.  See your Annual Enrollment material for more information.

    Below you will find the required notice and useful information about the Affordable Care Act.

    Notices: 

    Exchange Notice Information 

    PCS Exchange Notice

     

    Addl. Helpful Links 
     
    Kaiser Family Foundation-http://kff.org/health-reform/
    US Department of Health & Humana Services-http://www.hhs.gov/healthcare/rights/index.html
    US Department of Labor-http://www.dol.gov/ebsa/healthreform/