(Based on a 1.5 hour training with CTA. I will be getting more training, but here is the ESSENTIAL information right now)
-There is a mathematical definition for what is AFFORDABLE: Employers are only obligated to offer an AFFORDABLE plan for its employees, not for families. Dependents will be able to get affordable coverage through the exchange.
-An Affordable Employer Package is one that costs less than or equal to 9.5% of your wage. Since all VTA members who choose health coverage are covered fully, our district offers affordable care for us.
-This may not be the case for classified. Because classified employees pay 20% of their own health care costs and typically they are lower wage earners, the District may not be offering them “affordable” health care.
-If the District does not offer EVERY employee “affordable” care, then the DISTRICT could incur penalties: $3000 per employee that gets health care through the exchange AND receives a federal subsidy (help with paying their health care costs). If you don’t qualify for a subsidy and decide to get health coverage for yourself under the exchange, the District would not incur a penalty for you.
-To be eligible for a FEDERAL SUBSIDY in the Health Exchange, you must have household income less than 400% of the FEDERAL POVERTY LINE. Most of our members will probably not fit into this category, but some might. If a fairly new teacher with dependents is the only wage earner for his/her household, then his/her family may be eligible for subsidies.
-The Health Exchange should be up and running by October with coverage beginning January 1, 2014.
-Our CalPERS plans (Kaiser and Blue Shield) are really low-copay plans. I went looking on the Kaiser and Blue Shield Websites and couldn’t find copays as low as ours. They also offer plans with deductibles. It is almost like they have set up “mini-exchanges” of plans to get ready for the CA Health Exchange (bronze, silver, gold and platinum choices).
-YOU DON’T HAVE TO WAIT FOR THE EXCHANGE TO DO SOME SHOPPING AROUND! My spouse Ron rarely goes to the doctor and doesn’t have any prescriptions. We are currently shopping Kaiser for a plan with larger copays. This may save us money until we can shop in the Health Exchange this fall.
-I CAN DROP MY SPOUSE FROM MEDICAL COVERAGE and HE WILL STILL BE COVERED UNDER DENTAL AND VISION!!!! This is true for any and all dependents and those who choose in lieu instead of medical coverage. Every member and dependent gets dental and vision covered by the District (all that money comes out of our $4.25 million cap).
-Brenda Hensley
