Employers (11)

Under the Affordable Care Act, do all businesses need to cover their employees?

Businesses with fewer than 50 full-time equivalent employees (FTEs) are exempt from the requirements to offer coverage, and there are no penalties for those businesses if they don’t offer coverage. But businesses with 50 or more FTEs may have to pay a penalty if they do not offer affordable minimum essential coverage (MEC) to their full-time employees.

How do small businesses use Nevada Health Link to purchase coverage for their employers?

Employers with 2-50 full time employees will be able to use the HealthCare.gov SHOP to select which plans their employees can enroll in. Employees will log on and choose the plan they would like from the plans the employer selected. Employers will receive one easy-to-read bill for all of their employees. Learn more about how the SHOP works here.

Can my employees choose any plan offered by Nevada Health Link?

No, as an employer you’ll choose the level of coverage you want to contribute and which QHP your employees can choose. You decide which plan you want to offer and how much you want to contribute to the plan first, then your employees log on and sign up for the plan you selected.

What if my employees want their families covered?

All of the plans offered through Nevada Health link can insure employees’ dependents. As an employer, you will decide if you want to offer spousal and dependent coverage or let your employees decide if they want to purchase coverage for their families through Nevada Health Link’s individual marketplace.

How does an employer qualify and apply for tax credits if they provide health insurance coverage for their employees?

To qualify for tax credits an employer must:

  • have 25 employees or fewer
  • have average firm wages of $50,000/year or less
  • provide health insurance coverage for employees (the employer must contribute a minimum of 50% of the cost of their employees’ coverage)
  • file the appropriate tax returns (Form 8941; Line 44f of Form 990-T for exempt organizations) with their tax preparer

Tax credits are available now. Businesses may apply for the previous years’ credits for which they qualify.

Does a small business need to have a Section 125 plan to participate in Nevada Health Link’s SHOP?

No, a business does not need to have an established Section 125 plan to participate in our SHOP. Here are the eligibility requirements for SHOP participation:

  • 50 or fewer full-time employees in 2014
  • SHOP will be opened up to employers with 100 or fewer full-time employees in 2016
  • Tax credits will be available in 2014 and 2015 for employers with 25 or fewer employees and average company wages less than $50,000/year (excluding the owner(s) and owner(s)’ families).

Only employers with more than 50 Full Time Equivalent employees will be subject to penalties. These employers must offer a health insurance package that meets the Federal Essential Health Benefits (EHBs) and does not cost their employees (not including dependents) more than 9.5% of their household’s annual salary.

The penalty for employers with more than 50 FTEs who do not offer the coverage as outlined above will be $2,000 x (FTEs-30). For example, if an employer had 51 full time employees and did not offer coverage that meets the requirements, the employer would have to pay a penalty of $42,000 ($2,000 x 21 = $42,000).

If I have more than 50 employees and have a plan that meets the EHBs and does not cost employees more than 9.5% of their salary, what happens if they don’t elect the plan and come to Nevada Health Link?

If an employer provides affordable minimum essential coverage (MEC) for their employees, the employees are not eligible for Advanced Premium Tax Credit (APTC) on the HealthCare.gov individual online marketplace. During the enrollment process, the employee will have to:

  • attest that they do not have access to affordable MEC; and
  • list their employer, employer’s address and employer’s telephone number

The employer will not be penalized for an employee who does not elect to participate in an employer-sponsored health insurance plan that is affordable and meets MEC.

What are the options for my family if my employer offers me coverage?

When the affordability regulations for employer-sponsored insurance coverage were passed, they did not take the cost of dependent coverage into account. If your spouse’s employer offers him/her minimum essential health insurance coverage that costs less than 9.5% of your annual household income, then the coverage is deemed affordable. If the employer also offers spousal coverage, then you would be ineligible for Advanced Premium Tax Credit (APTC) or a subsidy on Nevada Health Link.

If your spouse’s employer does not offer spouse coverage then you could come to Nevada Health Link and apply for a subsidy. All large group plans are required to offer dependent coverage, so your children would be ineligible for Advanced Premium Tax Credit through Nevada Health Link. There may be cheaper plans available than the employer-provided dependent coverage, but the children will not qualify for a subsidy. If the employer’s plan did not offer dependent care then the children could get subsidized coverage through Nevada Health Link.

If I decide to cover my employees, how does Nevada Health Link help me?

In 2015, Nevada Health Link will be powered by HealthCare.gov. HealthCare.gov provides small businesses with a SHOP (Small Business Health Options Program) that will let you easily compare many Qualified Health Plans (QHPs) offered by private insurance companies. Everything you need to choose the plans that are right for your business and employees will be available, and you can continue to work with your broker or agent to enroll in plans if you wish. HealthCare.gov offers the same plans you’re used to, but with more choice and more advantages, including better coverage and lower-cost deductibles and premiums.

How is Nevada Health Link new and different?

Nevada Health Link is now powered by HealthCare.gov. All of the plans offered are still certified by Nevada Health Link, but enrollment will now take place through HealthCare.gov. Nevada Health Link is still the only health insurance resource that can provide individuals federal tax credits and subsidies to help cover the cost of insurance. Plus, Nevada still provides its citizens with many ways to obtain in-person assistance throughout the State.

Is Nevada Health Link HealthCare.gov?

Nevada Health Link is still its own website, by Nevadans, for Nevadans, but it is now powered by HealthCare.gov. This means that eligibility and enrollment will take place through HealthCare.gov. All of the plans are still State-certified, and NevadaHealthLink.com still houses a lot of information and resources specific to Nevadans. Plus, Nevada still provides its citizens with many ways to obtain in-person assistance throughout the State.

Individuals (19)

What is insurance?

Insurance is legal entitlement to payment or reimbursement for your health care costs, generally under a contract with a health insurance company, a group health plan offered in connection with employment, or a government program like Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP).

Why do I need insurance?

Health insurance helps you get the care you need, when you need it. Insurance will help keep you and your family healthy. If you have insurance, you’ll be able to get preventive care (such as regular check-ups, screenings and immunizations) so you and your family will be sick less often. Health insurance also protects you financially; you won’t have to worry about high medical bills you can’t pay.

Additionally, the Affordable Care Act (ACA), a U.S. law, says everyone must have health insurance. If someone doesn’t have health insurance, he or she will incur a penalty (a fine) on his or her income taxes. Nevada Health Link is here to protect Nevadans from the tax penalty by helping them find insurance based on their budget.

What exactly is Nevada Health Link?

Nevada Health Link is the State of Nevada’s online marketplace for consumers and small businesses. In November 2014, this website will become the online marketplace, where you can shop for, compare and enroll in health insurance plans. Nevada Health Link provides new ways to get insurance for people who, until now, had not been able to because of cost or other obstacles, such as pre-existing conditions. Learn more about how it works here.

How do I enroll?

During open enrollment (November 15, 2014 to February 15, 2015) you will be able to enroll by:

Learn more about the process here.

What if I need help or can’t enroll online on my own?

If a person doesn’t have Internet access and/or would like some help shopping for and enrolling in a health insurance plan, the Nevada Health Link team will be here to help. You can find a person who can help you by using our in-person assistant search tool, visiting one of our enrollment stores in your area, or by visiting one of our Navigator organizations.

Learn more about how to find help here.

What if I qualify for a public health insurance program like Medicaid?

If you or someone in your family appears to qualify for government health coverage programs such as Medicaid or Nevada Check Up (CHIP), through our pre-screener tool, Nevada Health Link will alert you during the screening process and direct you to the right place to enroll in those programs if you wish. Additionally, if you are found eligible for Medicaid or Nevada Checkup through the application process on HealthCare.gov, your information will be sent to those programs to finalize enrollment.

Help with Insurance Terms

For help with any words and terms, click here to see our glossary.

 

Why should I buy insurance through NevadaHealthLink.com?

Buying insurance through Nevada Health Link guarantees that you are enrolled in a Qualified Health Plan (QHP) with Essential Health Benefits.

All information about the plans offered through Nevada Health Link will be presented in clear language, so there’s no guesswork about what’s covered or what it costs. Because Nevada Health Link offers a variety of plans from different private insurance companies, we don’t have any connection with one insurance carrier. This means that all of the information about the plans is presented objectively, so you can pick the plan that’s right for you.

Nevada Health Link is the only place that you can receive cost assistance in the form of an Advanced Premium Tax credit (APTC) or Cost Sharing Reductions (CSRs).

Can I buy a Qualified Health Plan (QHP) outside of Nevada Health Link?

Yes, insurance carriers that offer Qualified Health Plans (QHPs) on NevadaHealthLink.com may offer the exact same (or similar) product outside of Nevada Health Link. But, you must enroll through Nevada Health Link if you want to receive help with your premium in the form of an Advanced Premium Tax credit (APTC).

I am currently uninsured by choice. I prefer alternative and holistic medicine. I do not take any prescription medication or vaccines. I am in very good health and very concerned about this new healthcare law. I feel I will be forced into paying for something I will never use and if I don’t, then I will be penalized. What, if any, options are there for people like me?

The Supreme Court ruling issued in June of 2012 stated that the federal government could impose a tax on individuals who do not purchase health insurance. Nevada Health Link has been put in place to help Nevadans comply with the new law. There are exemptions from the individual mandate for certain religious groups, Native Americans and for people who face a financial hardship that precludes them from purchasing health insurance. If you are a member of one of the groups spelled out in the ACA, you are exempt from the individual mandate to purchase health insurance. If you don’t fall into one of the exempt classifications, the IRS will enforce a tax penalty of $95 or 1% of your income (whichever is greater) in calendar year 2014. In 2015, the penalty increases to $325 or 2% of your income (whichever is greater). The penalty will increase to $695 or 2.5% of your income (whichever is greater) in calendar year 2016.

What are the Special Provisions for Native Americans?

  • Native Americans who are members of a federally recognized tribe are exempt from the individual mandate.
  • Native Americans who earn less than 300% of the Federal Poverty Level (FPL) are exempt from cost sharing; for example, they will not have to pay copayments or deductibles when they use medical services.
  • There are special provisions for the calculation of Modified Adjusted Gross Income for Native Americans, meaning that some revenue earned on reservations and from Federal Trust payments are exempt.
  • Native Americans can change Qualified Health Plans (QHPs) once per month, and they are not bound to the open enrollment dates.

How do I calculate my income?

Calculating Modified Adjusted Gross Income (MAGI):

Modified Adjusted Gross Income (MAGI) is calculated by adding back certain items to your Adjusted Gross Income. Your Adjusted Gross Income (AGI) can be found on line 38 of your Form 1040; line 22 of your Form 1040A; or line 36 of your Form 1040NR.

The following items must be added to your Adjusted Gross Income (AGI) to calculate your Modified Adjusted Gross Income (MAGI):

  • Traditional IRA contributions that were deducted.
  • Student loan interest amounts deducted.
  • Tuition and fees deducted.
  • Domestic production activities deducted.
  • Foreign income or housing costs excluded on Form 2555.
  • Foreign housing deduction taken on Form 2555.
  • Savings bond interest excluded on Form 8815.
  • Adoption benefits from an employer excluded on Form 8839.

Worksheet 1-1, found on page 17 of IRS Publication 590, provides information for a step-by-step calculation of Modified Adjusted Gross Income (MAGI).

What are the options for my family if my employer offers me coverage?

When the affordability regulations for employer-sponsored insurance coverage were passed, they did not take the cost of dependent coverage into account. If your spouse’s employer offers him/her minimum essential health insurance coverage that costs less than 9.5% of your annual household income, then the coverage is deemed affordable. If the employer also offers spousal coverage, then you would be ineligible for Advanced Premium Tax Credit (APTC) or a subsidy on Nevada Health Link.

If your spouse’s employer does not offer spouse coverage then you could come to Nevada Health Link and apply for a subsidy. All large group plans are required to offer dependent coverage, so your children would be ineligible for Advanced Premium Tax Credit through Nevada Health Link. There may be cheaper plans available than the employer-provided dependent coverage, but the children will not qualify for a subsidy. If the employer’s plan did not offer dependent care then the children could get subsidized coverage through Nevada Health Link.

Who can use Nevada Health Link?

Nevada Health Link is here to help any Nevadan looking for health insurance, whether you already have insurance or not. If you already have health insurance, through your employer for example, you aren’t required to enroll through Nevada Health Link but are welcome to explore new plans through the online marketplace if you like.

The only requirement to apply for and purchase insurance on NevadaHealthLink.com is that you are lawfully present in the U.S. and living in the State of Nevada. Filling out an application will not trigger an immigration/ INS investigation. This program’s goal is simply to reduce the cost of health insurance and insure more Americans.

What do military veterans need to know?

There are many important considerations for military veterans. For more information, please click the following link:

Considerations for Military Veterans

How is Nevada Health Link new and different?

Nevada Health Link is now powered by HealthCare.gov. All of the plans offered are still certified by Nevada Health Link, but enrollment will now take place through HealthCare.gov. Nevada Health Link is still the only health insurance resource that can provide individuals federal tax credits and subsidies to help cover the cost of insurance. Plus, Nevada still provides its citizens with many ways to obtain in-person assistance throughout the State.

Is Nevada Health Link HealthCare.gov?

Nevada Health Link is still its own website, by Nevadans, for Nevadans, but it is now powered by HealthCare.gov. This means that eligibility and enrollment will take place through HealthCare.gov. All of the plans are still State-certified, and NevadaHealthLink.com still houses a lot of information and resources specific to Nevadans. Plus, Nevada still provides its citizens with many ways to obtain in-person assistance throughout the State.

If an individual enrolled in health insurance through Nevada Health Link during the last open-enrollment period, will they need to enroll again?

Yes. Nevada Health Link is improving the way it enrolls individuals, and enrollment will now take place using HealthCare.gov’s tools. Because of this change, all individuals who enrolled during the 2013 open-enrollment period (October 2013-March 2014) through Nevada Health Link will need to re-enroll starting November 15, 2014 in order to keep their income-based health insurance plan through Nevada Health Link. To ensure your financial assistance continues starting January 1, 2015, you must re-enroll by December 15, 2014. Additionally, if you do NOT take action, you will be auto-renewed into a health insurance plan that is not eligible for financial assistance. Also, keep in mind that new carriers and plans will be available for the 2015 plan year. This allows you to review your options as you re-enroll.

Find out more about the re-enrollment process here.

You can start the re-enrollment process here.

 

How has Nevada Health Link changed?

Nevada Health Link is now a supported state-based exchange. This means that NevadaHealthLink.com uses HealthCare.gov’s system to enroll Nevadans, but plans are still certified through Nevada Health Link. Plus, Nevada still provides its citizens with many ways to obtain in-person assistance throughout the State.

Partners (10)

Will people be able to enroll in government insurance programs through Nevada Health Link?

After a person has filled out application pre-screener on NevadaHealthLink.com, we will be able to determine if that individual or a family member appears to be eligible for a government program, such as Nevada Check Up (CHIP) or Medicaid. If one person in the family qualifies for Medicaid, that person can be enrolled in Medicaid and the rest of the family will be able to enroll in a health insurance plan or plans through HealthCare.gov.

Will people be able to enroll in non-insurance government programs through Nevada Health Link?

No, Nevada Health link will not be able to pre-populate applications for non-insurance government programs such as SNAP or TANF; however, by applying through Access Nevada for Medicaid or Nevada Checkup, that system will also determine eligibility for SNAP and TANF.

How do I calculate my income?

Calculating Modified Adjusted Gross Income (MAGI):

Modified Adjusted Gross Income (MAGI) is calculated by adding back certain items to your Adjusted Gross Income. Your Adjusted Gross Income (AGI) can be found on line 38 of your Form 1040; line 22 of your Form 1040A; or line 36 of your Form 1040NR.

The following items must be added to your Adjusted Gross Income (AGI) to calculate your Modified Adjusted Gross Income (MAGI):

  • Traditional IRA contributions that were deducted.
  • Student loan interest amounts deducted.
  • Tuition and fees deducted.
  • Domestic production activities deducted.
  • Foreign income or housing costs excluded on Form 2555.
  • Foreign housing deduction taken on Form 2555.
  • Savings bond interest excluded on Form 8815.
  • Adoption benefits from an employer excluded on Form 8839.

Worksheet 1-1, found on page 17 of IRS Publication 590, provides information for a step-by-step calculation of Modified Adjusted Gross Income (MAGI).

What are the options for my family if my employer offers me coverage?

When the affordability regulations for employer-sponsored insurance coverage were passed, they did not take the cost of dependent coverage into account. If your spouse’s employer offers him/her minimum essential health insurance coverage that costs less than 9.5% of your annual household income, then the coverage is deemed affordable. If the employer also offers spousal coverage, then you would be ineligible for Advanced Premium Tax Credit (APTC) or a subsidy on Nevada Health Link.

If your spouse’s employer does not offer spouse coverage then you could come to Nevada Health Link and apply for a subsidy. All large group plans are required to offer dependent coverage, so your children would be ineligible for Advanced Premium Tax Credit through Nevada Health Link. There may be cheaper plans available than the employer-provided dependent coverage, but the children will not qualify for a subsidy. If the employer’s plan did not offer dependent care then the children could get subsidized coverage through Nevada Health Link.

How do I become a Navigator, Enrollment Facilitator, or CAC?

Exchange Enrollment Facilitators (EEFs) will facilitate enrollment in qualified health plans offered by the Exchange. They consist of Navigator organizations, certified enrollment assisters, and Certified Application Counselors (CACs). Enrollment assisters are hired by entities that have been awarded grants by the Exchange.

The Exchange utilized an application for grants for Navigator organizations and enrollment assisters for the first open enrollment period (October 1, 2013 thru March 31, 2014). Grants were renewed for the three entities listed below through February 15, 2015. The Exchange is not hiring individuals to serve in any EEF positions. If you have interest in serving as a CAC, you will need to be certified by the Nevada Division of Insurance prior to becoming appointed with the Exchange. If you have interest in serving as an enrollment assister, please contact one of the entities listed below.

NAVIGATOR/ENROLLMENT ASSISTER GRANTS AWARDED TO:

Ramirez Group

531 7th Street, Las Vegas, Nevada 89101

702-530-5249

Nevada Primary Care Association

755 N. Roop, Suite 211, Carson City, Nevada 89701

775-887-0417

Consumer Assistance and Resource Enterprise (CARE)

1785 East Sahara Avenue, Suite 360, Las Vegas, NV 89104

702-836-9033

 

Some questions you might hear

Click here to see some FAQs you might get from your clients.

How is Nevada Health Link new and different?

Nevada Health Link is now powered by HealthCare.gov. All of the plans offered are still certified by Nevada Health Link, but enrollment will now take place through HealthCare.gov. Nevada Health Link is still the only health insurance resource that can provide individuals federal tax credits and subsidies to help cover the cost of insurance. Plus, Nevada still provides its citizens with many ways to obtain in-person assistance throughout the State.

Is Nevada Health Link HealthCare.gov?

Nevada Health Link is still its own website, by Nevadans, for Nevadans, but it is now powered by HealthCare.gov. This means that eligibility and enrollment will take place through HealthCare.gov. All of the plans are still State-certified, and NevadaHealthLink.com still houses a lot of information and resources specific to Nevadans. Plus, Nevada still provides its citizens with many ways to obtain in-person assistance throughout the State.

If an individual enrolled in health insurance through Nevada Health Link during the last open-enrollment period, will they need to enroll again?

Yes. Nevada Health Link is improving the way it enrolls individuals, and enrollment will now take place using HealthCare.gov’s tools. Because of this change, all individuals who enrolled during the 2013 open-enrollment period (October 2013-March 2014) through Nevada Health Link will need to re-enroll starting November 15, 2014 in order to keep their income-based health insurance plan through Nevada Health Link. To ensure your financial assistance continues starting January 1, 2015, you must re-enroll by December 15, 2014. Additionally, if you do NOT take action, you will be auto-renewed into a health insurance plan that is not eligible for financial assistance. Also, keep in mind that new carriers and plans will be available for the 2015 plan year. This allows you to review your options as you re-enroll.

Find out more about the re-enrollment process here.

You can start the re-enrollment process here.

 

How has Nevada Health Link changed?

Nevada Health Link is now a supported state-based exchange. This means that NevadaHealthLink.com uses HealthCare.gov’s system to enroll Nevadans, but plans are still certified through Nevada Health Link. Plus, Nevada still provides its citizens with many ways to obtain in-person assistance throughout the State.