Obamacare Exemption & Great Healthcare at ½ Price

Health Share plans are not compliant, but they are exempt, so you won’t have to pay the ACA penalty

Health Share Plans are exempt from the tax penalties outlined in the Affordable Care Act. If you are enrolled in one of these plans, you won’t have to pay the Obamacare health insurance penalty. Also, you can get quality PPO health care at around half the price.

What Is the ACA Penalty?

Under the original provisions of the Affordable Care Act, uninsured individuals were required to pay a penalty for not having “minimum essential coverage,” which is a plan that meets a minimum set of qualifications. For 2017 and 2018, the amount of the penalty is the greater of $695 per adult and $347.50 per child plus Cost of Living Adjustment (COLA) — or 2.5 percent of your taxable household income minus the federal tax-filing threshold.

The 2018 tax reform bill has eliminated the penalty starting in 2019. However, you must still pay the penalty for the 2018 tax year (and previous years) if you did not have minimum essential coverage. The only way to avoid the penalty is to have coverage under a qualified health plan or to have a valid exemption.

List of Top 6 Health Sharing Organizations

Better Business Bureau Rating

Aliera Healthcare A+ Rating
Altrua HealthShare B- Rating
Christian Healthcare Ministries Meets Standard
Liberty HealthShare Not Rated
MediShare A Rating
Samaritan Ministries Meets Standard

Health Share Plans Are Recognized by the Affordable Care Act

There are six Health Share (HCSMs) that are recognized by the ACA, which we’ve listed above. These six meet all the criteria above and offer penalty exemptions for their enrolled members. Health Share Plans are 501(c)(3) nonprofit organizations that share the cost of health care, which typically results in much lower rates than those found in the “traditional” marketplace. Plans can provide basic or comprehensive coverage or a combination of the two. Temporary Health Share Plans are also available for individuals who are waiting for coverage to begin under an employer-sponsored plan.

While the criteria for membership in a Health Share Plan will vary, they’re typically faith-based organizations where members share common religious, moral or ethical beliefs. Prospective enrollees must be free of any pre-existing medical conditions and agree to adhere to a commitment to maintaining good health. As you can see on the chart above, the Better Business Bureau ratings for these organizations range from A+ to standard.

Exempt vs. Compliant

The status as a 501(c)(3) organization ensures a number of benefits related to health insurance that are not available to for-profit entities with 50 or more full-time employees. For example, businesses that don’t offer “affordable” healthcare coverage to their workers may incur significant financial penalties. Health Share Plans are different — these plans are exempt, meaning that they do not have to meet the requirements of the Affordable Care Act. And, those enrolled on these plans do not have to pay the penalty.

However, these plans are not compliant. Compliant plans must be traditional health insurance plans and must meet all the benefit requirements of Obamacare. Compliant plans must include free preventive care and all the minimum essential benefits as outlined in the ACA. Specifically, ACA-compliant group policies must provide coverage for the following 10 “essential” health benefits with no annual or lifetime coverage maximums:

  • Hospital stays
  • Visits to healthcare providers and outpatient medical treatment
  • Care provided in the emergency room or an urgent care facility
  • Maternity and newborn baby care
  • Treatment for substance abuse and mental health disorders (depression, anxiety, bipolar disorder, etc.)
  • Cost of prescription medications
  • Laboratory/diagnostic tests
  • Preventive services for chronic disease management such as high blood pressure, breast cancer, prostate cancer, colorectal cancer and obesity
  • Pediatric services for children such as dental and vision care
  • Rehabilitative services such to help an individual improve the functions required for daily living such as speech or occupational therapy

Requirements to Be Exempt

Health Care Sharing Plans must meet all the following criteria in order to be exempt:

  • Must be a 501(c)(3) organization
  • Members must share common ethical or religious beliefs*
  • Members cannot lose membership due to the development of a medical condition
  • Must have existed and been in practice continually since December 31, 1999 (grandfather clause)
  • Must be subject to an annual audit by an independent CPA

Contact Health for California to Learn More About the Obamacare Exemption

Health for California can connect you with high-quality, affordable coverage from Aliera Health Care, a leading provider of Health Share Plans featuring a stellar A+ rating from the Better Business Bureau. Contact Aliera for a no-obligation quote today. You can also reach out to us directly if you have questions or need additional information regarding the Obamacare exemption.

*Note: Aliera Health Care offers coverage for individuals of all different faiths.

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