Health Care Reform

The District is in compliance with the Health Care Reform Affordable Care Act (HCR/ACA) and continues to provide you with affordable and comprehensive coverage to meet your health care needs.

(As a retiree, you do not need to do anything relating to HCR/ACA, and you are not responsible for purchasing additional coverage through Covered California, the state’s insurance exchange).

The Health Care Reform Affordable Care Act (HCR/ACA) was signed into law by President Obama on March 23, 2010. The law requires several new provisions to be implemented January 1, 2014. These provisions, some of which the District has already implemented, include:

  • Essential health benefits, such as preventive care and immunizations
  • No annual limits on essential health benefits
  • Dependent children may be covered for health, vision and dental benefits to age 26
  • Individual mandates that require most Americans to have health insurance or pay a penalty
  • New Health Insurance Marketplace (Covered California)

NOTE: Covered California does not apply to Medicare-eligible retirees.

About the Individual Mandate

Active Employees:

Effective January 1, 2014, the individual mandate requires legal U.S. residents to buy a minimum level of health insurance coverage or pay a penalty for each month of non-compliance. The penalty equals the greater of $95 per adult and $47.50 per child (up to $285 per family), or 1% of your family income. The penalty will increase significantly in 2015 and 2016. Some people will be exempt from the mandate and penalty due to religious, financial or other reasons, while others may be given financial assistance to help pay the cost of their coverage.

In 2014, you will have to submit a form with your federal income tax return proving that you have insurance. If you are covered by a District medical plan, you will receive a certificate from your medical plan that indicates you have the minimum coverage.

For Active Employees: No Need to Purchase Health Insurance

As an active employee, you do not need to do anything relating to HCR/ACA and you are not responsible for purchasing additional coverage through Covered California.

Before October 1, 2013, you will receive a “Notice of Health Insurance Options” informing you that you have the option to purchase health insurance through the Health Insurance Marketplace, “Covered California.” It’s important to note that if you purchase coverage through Covered California, instead of accepting the health coverage offered by the District, or by your spouse/domestic partner’s employer, then:

  • You will lose the employer contribution the District pays toward your coverage;
  • You would not likely be eligible for any tax credit or subsidy, since the District’s medical plans meet or exceed minimum ACA standards for coverage and affordability; and
  • You may pay higher taxes, since payments for coverage through the Marketplace are made on an after-tax basis.

To learn more about Covered California visit http://www.coveredca.com

Please email any questions you have to the Human Resources Department at BenefitQuestions@sbccd.cc.ca.us