Affordable Care Act FAQs
What is the Affordable Care Act?
Also known as healthcare reform, the Affordable Care Act (ACA) has brought many changes to healthcare coverage in the U.S., providing benefits like free preventive care and coverage for adult children up to age 26.
How does healthcare reform impact me?
Everyone is required to have qualified health insurance coverage. If you don’t have coverage, you may have to pay a penalty on your federal tax return.
How do I get government subsidies to help pay for my insurance? What about spouses or dependents?
In general, if you're eligible for HISD benefits, it's likely you won't be eligible for subsidies to purchase insurance in the Marketplace. This applies to your qualified dependents too. Since each family situation is unique, healthcare.gov offers a number of resources that provide more detailed information. You can also call 800-318-2596 or visit localhelp.healthcare.gov for more information.
What do I need to do to avoid paying a penalty on my taxes?
As long as you’re enrolled in an HISD health plan, you’re not subject to the federal penalty on your income tax return. For tax purposes, the IRS now requires you to verify and report your medical plan eligibility, coverage selection and covered dependents’ tax ID numbers. You should receive 2017 form 1095-C with this information in early 2018. To avoid penalties, you must include your dependents' tax ID numbers, also called social security numbers, when you enroll them for coverage. And please verify the tax ID numbers for each of your dependents already enrolled in the medical plan.
I work more than 30 hours per week, but HISD doesn’t offer me benefits. What should I do?
If you believe your eligibility status is incorrect, contact HISD Employee Services at 713-556-7400 to verify.
I want to buy a health plan in the Marketplace. When can I drop my HISD plan?
You can make changes to your HISD plan, including dropping coverage completely, during Annual Enrollment. which is usually during November. If you decide to drop HISD health coverage, you won’t have the opportunity to regain HISD coverage until the next Annual Enrollment unless you have a qualified life event (such as getting married or giving birth). Losing or dropping coverage from a plan purchased in the Marketplace is not considered a qualified life event.
If I choose to purchase a plan in the Marketplace, who fills out and submits my application?
The application process is your responsibility. There are questions regarding your current job and income that you have to answer, but nothing is required of your current employer. If you have questions about the Marketplace, including filling out an application, call 800-318-2596, 24 hours a day, 7 days a week.
TTY users can call 855-889-4325. Online chat is also available 24/7 at healthcare.gov/contact-us.
How much will I pay for medical coverage if I get it through the Marketplace?
You will pay the full plan cost if you buy coverage through the Marketplace. The cost will depend on a number of factors, including your family size, your age(s), your household income and the plan benefits you select.
I’ve never had coverage through HISD. How do I sign up?
HISD holds Annual Enrollment for benefits each November, providing enrollment communications online and holding benefits meetings to help you sign up. If you’re eligible, you can simply enroll online. Log onto myHISD and click the Benefits heart icon, which takes you to the HISD Benefits website. Click on Enrollment and follow the prompts. If you need help, call the HISD Service Center at 877-780-HISD (4473).
What will happen if I don’t have medical coverage in 2018?
You will likely have to pay a penalty on your federal tax return if you don’t have medical coverage in 2018. The penalty increases each year.
Uninsured individual pays the greater of:
Year Fixed amount % of HH income
2107 and beyond Based on cost-of-living inflation 2.5%
Do I have to buy coverage through HISD to avoid a penalty on my tax return if I’m covered under my s
No. As long as your coverage meets ACA requirements, all that’s required is that you have medical coverage. It does not have to be through HISD.
What if I don’t want to enroll in HISD coverage?
If you buy coverage on your own and not through HISD, keep in mind there is no HISD contribution to your monthly premiums. This means you may have to pay the full cost of coverage if you buy it elsewhere. Depending on your situation, you may be able to obtain coverage through a government program such as Medicaid or CHIP (for your children). Check eligibility requirements with the Texas Health and Human Services Commission at hhs.state.tx.us or by calling 2-1-1 or 877-541-7905.
If I’m covered under Medicaid or Medicare, do I have to switch to a different plan beginning January
No. If you’re covered by Medicaid or Medicare, you don’t need other insurance.
What happens to my HISD health coverage if I lose or leave my job at HISD?
You can continue your health insurance coverage through COBRA, or you can buy a plan in the Marketplace. If your spouse is eligible for coverage through his/her employer, you may also be eligible to enroll under his/her employer's plan.