OFF MARKETPLACE

www.thehealthinsurancebarn.com

ON MARKETPLACE

www.healthcare.com

MARKETPLACE

TAX CREDIT

C.H.I.P.

S.B.C.

PPACA

QUALIFIED HEALTH PLAN

CO-PAY

ACTUARIAL VALUE

EMPLOYER MANDATE

INDIVIDUAL MANDATE

MEDICAID

Medicaid Eligibility

NON-FINANCIAL

PREGNANT WOMEN PARENT/GURADIAN < 18 DISABLED > 65 U.S. CITIZEN or LAWFUL

ALIEN

FINANCIAL

PREGNANT WOMEN & NEWBORN 185% of FPL

CHILDREN AGE 1-5 133% of FPL CHILDREN AGE 6-18 100% of FPL

MEDICAID ALSO PAYS

THE LARGEST

PERCENT OF LONG TERM CARE BILLS

FOR THE ELDERLY

MEDICAID EXPANSION

GOLD PLAN

SILVER PLAN

BRONZE PLAN

PLATINUM PLAN

COPPER PLAN

CATASTROPHIC PLAN

SPLIT INSURANCE

OUT OF POCKET MAXIMUM

OUT OF POCKET MAXIMUM

$6350 for individuals / $12,700 for families

Only when a network provider is used.

CMS

AFFORDABLE

SHARED RESPONSIBILITY PAYMENT

SHARED RESPONSIBILITY PAYMENT

2015 PENALTY

2% of household income above tax filing threshold

Or$325/adult & $162.50/child

whichever is greater

SMALL BUSINESS HEALTH INSURANCE TAX CREDIT

CO-INSURANCE

SUBSIDY

SUBSIDY

QUALIFICATION LEVELS FOR SUBSIDIES CHANGE EACH YEAR. THESE ARE WHAT WERE USED FOR 2014.

SUBSIDIES CAN EITHER BE TAKEN AS AN ADVANCED

TAX-CREDIT OR APPLIED ON A PERSON’S 1040 WHEN THEY KNOW WHAT THEIR INCOME ACTUALLY WAS.

ANYTHING THAT THE IRS ADVANCES THAT A PERSON DOES NOT QUALIFY FOR WILL HAVE TO BE REPAID.

SUBSIDY

NON-QUALIFIED POLICY

MEDICAL LOSS RATIO

S.H.O.P.

ESSENTIAL HEALTH PLAN

ESSENTIAL HEALTH BENEFITS

AMBULATORY CARE EMERGENCY CARE HOSPITAL CARE MATERNITY/NEWBORN

CARE MENTAL HEALTH AND

SUBSTANCE ABUSE

PRESCRIPTION REHAB PREVENTIVE LABORATORY PEDIATRIC DENTAL

ADULT DENTAL INSURANCE IS OPTIONAL

METAL PLANS

SUPPLEMENT

SUPPLEMENTAL INSURANCE PLANS Accidental Injury

Scheduled benefit Rider

Hospital Indemnity Per day in the hospital Lump sum per hospitalization

Critical Illness Cancer Heart attack Stoke Misc.

Disability Income Accident only Short Term Long Term

Long Term Care Traditional Hybrid

Life

MEDICARE

FEDERAL POVERTY LEVEL

QUALIFIED DENTAL PLAN

DEDUCTIBLE

COST SHARING

FULL TIME EQUIVALENT

EXEMPTION

STATUTORY EXEMPTIONS

Religious Conscience Indian Tribe Not Required To File

1040 Short Coverage Gap

Health Care Sharing Ministry

Affordable Plan Incarceration Not Lawfully Present

HARDSHIP EXEMPTIONS

Homeless Evicted/Foreclosed Utilities Shut Off Domestic Violence Family Death Fire/Flood/Significant

Property Damage Bankruptcy

LTC Expenses Child Custody Court

Order Marketplace Error State Did Not Expand

Medicaid And You Would Have Qualified

Your QHP Was Canceled By Your Insurance Company

You Experienced Another Hardship

HIX