FAQ, question blackboard


We know you have questions, especially questions related to Health Care Reform, the Affordable Care Act and the new Healthcare Marketplace. For the best answers to those questions, we believe it’s best to refer you to HealthCare.gov. Their site has the most up-to-date answers on the most frequently asked questions (and some you may not have even considered)!


At HealthCare.gov you’ll find questions like:

What if I have a pre-existing health condition? 

Answer: Starting in 2014, Health insurance plans can’t refuse to cover you or charge you more just because you have a pre-existing health condition. 

Visit https://www.healthcare.gov. 

If you have questions regarding the PEO industry and what services a PEO can provide your company, we recommend the National Association of Professional Employer Organizations (NAPEO) site. 

At Napeo.org you’ll find questions like:

What is the difference between PEOs and Employee Leasing? 

Answer: PEOs do not supply labor to worksites. PEOs supply services and benefits to a small business client and its existing workforce. 

Visit NAPEO’s FAQ page at http://www.napeo.org/peoindustry/faq.cfm.

Other common questions we get: 

Q: What is the penalty if I do not get insurance in 2014?

A: If you do not have health insurance starting in 2014, you will have to pay a fine. Starting in 2014, the fine for not having insurance will be either $95 or 1 percent of a person’s income- whichever is greater.

In 2015, the fine will be either $325 or 2 percent of income.  In 2016, the fine will be $695 or 2.5 percent of income. After 2016, the fine will be based on the cost-of-living adjustment every year.

There are exceptions to this rule. Americans do not have to purchase coverage if their income is below the Federal Poverty Line and Health insurance premiums would cost more than 8 percent of their monthly income. In this case, most would be eligible for Medicaid or Federal subsidies to help pay for health insurance. People who are opposed to the individual mandate for religious reasons also do not have to purchase health insurance.



Most importantly, if you have questions about how the team at Blackwell Benefits Solutions can assist you with acquiring coverage for yourself, your family and/or your employees, let’s talk! Please feel free to contact us at 865.240.4855 or email us! We look forward to working with you!


Q: What is a Drug formulary?

A: A list of drugs your insurance plan covers. A formulary may include how much you pay for each drug. (if the plan uses “tiers”, the formulary may list which drugs are in which tiers). Formularies may include both generic and brand-name drugs. 

Q: What is a subsidy?

A:  Also referred to as Advance Premium Tax credit (APTC). The ACA includes provisions to lower premiums and for certain consumers with low and modest incomes. Subsidies would be provided in the form of advance payments of the premium tax credit. There is a sliding scale of subsidy levels available to Americans in 2014 with annual incomes between 100 and 400 percent of the Federal Poverty Level (FPL).


Income Level:          Premium as a Percent of income:


Up to 133% FPL             2% of income

133 -150% FPL               3-4% of income

150-200% FPL                4-6.3% of income

200-250% FPL                6.3-8.05% of income

250-300% FPL                8.05-9.5% of income

300-400% FPL                9.5% of income 

Q: What is the Federal Poverty Level (FPL)?

A: A measure of income level issued annually by the Department of Health and Human Services. Federal poverty levels are used to determine your eligibility for certain programs and benefits. 

Q: What is the Affordable Care Act (ACA)

A: The comprehensive health care reform law enacted in March 2010. The law was enacted in two parts: The Patient Protection and Affordable Care Act was signed into law on March 23, 2010 and was amended by the Health Care and Education Reconciliation Act on March 30, 2010. The name “Affordable Care Act” is used to refer to the final, amended version of the law.