November 2013
October 25, 2013

The Affordable Care Act What SRPs need to know

Author: Leslie Duncan Fottrell
Source: NYSUT United
NYSUT Vice President Kathleen Donahue engages School-Related Professionals on a variety of topics, including health care, during their recent conference.
Caption: NYSUT Vice President Kathleen Donahue engages School-Related Professionals on a variety of topics, including health care, during their recent conference. Photo by Timothy Harrison Raab.

President Obama's Affordable Care Act and its impact is a top concern among School-Related Professionals.

"SRPs are vulnerable because many work on an hourly basis, which may be subject to change. Some already pay a very high monthly premium for insurance through their districts," said NYSUT Vice President Kathleen Donahue, who oversees NYSUT's SRP programs and services.

NYSUT SRP Advisory Committee members received a special briefing on ACA during NYSUT's recent SRP Leadership Conference where leaders said they were concerned about the high costs of health care for both employers and employees.

Annie McClintock, president of the United Teaching Assistants of Harborfields, voiced concern about the future affordability of health care for her members, who make modest salaries. Less than 20 TAs in her unit are eligible to enroll in the district's health insurance plan.

"Contractually, teaching assistants must work 30 hours per week to be eligible for coverage through the district and must pay 50 percent of the premiums," McClintock said. "For family coverage, that costs more than $800 per month."

Gail Reissman is area vice president for paraprofessionals for the BOCES Educators of Eastern Suffolk. "My members are very confused on how the act will affect them," she said. Her members have health insurance, but since many have modest salaries also, they wonder, "will it be better for us to buy it through the marketplace?"

The ACA created health insurance marketplaces, or health exchanges, in each state primarily for those who are uninsured or do not have affordable coverage through their employers.

The marketplace is an online clearinghouse where you can select from among a variety of private health insurance plans.

You should have already been notified by your employer of the availability of the online marketplace. New York state has its own marketplace, the "New York State of Health," available at https://nystateofhealth.ny.gov/.

Here are six things SRPs should know about ACA:

1. If you already have affordable coverage through your employer, you do not need to do anything.The act's definition of affordability is that the premium for individual coverage is less than 9.5 percent of household income. Unfortunately, the cost of family coverage is not taken into account. The good news: Child Health Plus is still available.

2. Collective bargaining agreements generally supersede the act and can provide better benefits than coverage purchased through the marketplace.

3. Open enrollment for the marketplace is Oct. 1 – March 31, 2014.Coverage starts as early as Jan. 1. If you are interested in the marketplace, check with your employer as these dates may vary from your employer's open enrollment period.

4. If you do not have an offer of affordable health insurance through your employer and purchase coverage in the marketplace, you may be eligible to receive a subsidy. The income thresholds are $45,960 for individuals and $94,200 for a family of four.

5. Medicaid eligibility was expanded.

Healthy New York coverage terminates Dec. 31, but participants should be able to enroll in a marketplace product. Family Health Plus is being phased out. Almost everyone needs to be insured by Jan. 1 or pay a $95 annual penalty.

6. Certified navigators help guide you through marketplace choices.

NYSUT members can call NYSUT Social Services at 800-342-9810, ext. 6206, for assistance with locating a navigator. Local presidents can contact their labor relations specialist to discuss the health care component of their local's contracts and discuss how it fits in ACA.

NYSUT Health Benefits Specialist Sue Klug contributed to this story.

AFFORDABLE CARE ACT EXPLAINED

Visit http://kff.org/health-reform/video/youtoons-obamacare-video/ to view “The YouToons Get Ready for Obamacare,” a seven-minute animated video explaining the Affordable Care Act.