Search
Search

Insurance

Health Hippo: Insurance

Health Hippo: Insurance

US CODE || CFR || CASES || REPORTS || CONGRESSIONAL RECORD || BILLS || FEDERAL REGISTER


Wherever the art of medicine is loved, there is also a love of humanity.

The Health Insurance Marketplace helps uninsured people find health coverage. By filling out a Marketplace application you’ll find out if you qualify for private health insurance, lower costs based on your household size and income, Medicaid and the Children’s Health Insurance Program (CHIP). If you don’t have coverage, you’ll pay a fee of either 1% of your income, or $95 per adult ($47.50 per child), whichever is higher, on your 2015 income taxes. Some people may qualify for an exemption to the fee, based on income or other factors.

You’re considered covered if you have Medicare, Medicaid, CHIP, any job-based plan, any plan you bought yourself, COBRA, retiree coverage, TRICARE, VA health coverage, or some other kinds of health coverage. You can also buy a plan outside the Marketplace and still be considered covered. If you buy outside the Marketplace, you won’t be eligible for premium tax credits or lower out-of-pocket costs based on your income. If you’re eligible for job-based insurance, you can consider switching to a Marketplace plan, but you won’t qualify for lower costs based on your income unless the job-based insurance isn’t considered affordable or doesn’t meet minimum requirements.

Marketplace Open Enrollment ends on March 31, but you can still buy a Marketplace health plan if you qualify for a special enrollment period. Open Enrollment coverage starts again on November 15. You can apply for Medicaid and CHIP any time.


U.S. Code

  • Affordable Care Act: Insurance Provisions
    • Sec. 1001. Amendments to the Public Health Service Act.
      • No Lifetime or Annual Limits
      • Prohibition on Recessions
      • Coverage of Preventative Health Services
      • Extension of Dependant Coverage
      • Uniform Coverage Explanations
      • Prohibition of Discrimination Based on Salary
      • Ensuring Quality Care
      • Bringing Down the Cost of Care
      • Appeals
    • Sec. 1002. Health insurance consumer information.
    • Sec. 1003. Ensuring that consumers get value for their dollars.
    • Sec. 1004. Effective dates.
    • Sec. 1101. Immediate Access To Insurance For Uninsured Individuals With A Preexisting Condition.
    • Sec. 1102. Reinsurance for early retirees.
    • Sec. 1103. Immediate information that allows consumers to identify affordable coverage options.
    • Sec. 1104. Administrative simplification.
    • Sec. 1105. Effective date.
    • Sec. 1201. Amendment to the Public Health Service Act.
      • Prohibition of Preexisting Condition Exclusions
      • Fair Health Insurance Premiums
      • Guaranteed Availability of Coverage
      • Guaranteed Renewability of Coverage
      • Prohibiting Discrimination Based on Health Status
      • Non-Discrimination in Health Care
      • Comprehensive Covereage
      • Prohibition on Excessive Waiting Periods
    • Sec. 1251. Preservation of right to maintain existing coverage.
    • Sec. 1252. Rating reforms must apply uniformly to all health insurance issuers and group health plans.
    • Sec. 1253. Effective dates.
    • Sec. 1301. Qualified health plan defined.
    • Sec. 1302. Essential health benefits requirements
    • Sec. 1303. Special rules.
    • Sec. 1304. Related definitions.
    • Sec. 1311. Affordable choices of health benefit plans.
    • Sec. 1312. Consumer choice.
    • Sec. 1313. Financial integrity.
    • Sec. 1321. State flexibility in operation and enforcement of Exchanges and related requirements.
    • Sec. 1322. Federal program to assist establishment and operation of nonprofit, member-run health insurance issuers.
    • Sec. 1323. Community health insurance option.
    • Sec. 1324. Level playing field.
    • Sec. 1331. State flexibility to establish basic health programs for low-income individuals not eligible for Medicaid.
    • Sec. 1332. Waiver for State innovation.
    • Sec. 1333. Provisions relating to offering of plans in more than one State.
    • Sec. 1341. Transitional reinsurance program for individual and small group markets in each State.
    • Sec. 1342. Establishment of risk corridors for plans in individual and small group markets.
    • Sec. 1343. Risk adjustment.
    • Sec. 1401. Refundable tax credit providing premium assistance for coverage under a qualified health plan.
    • Sec. 1402. Reduced cost-sharing for individuals enrolling in qualified health plans.
    • Sec. 1411. Procedures for determining eligibility for Exchange participation, premium tax credits and reduced cost-sharing, and individual responsibility exemptions.
    • Sec. 1412. Advance determination and payment of premium tax credits and cost-sharing reductions.
    • Sec. 1413. Streamlining of procedures for enrollment through an exchange and State Medicaid, CHIP, and health subsidy programs.
    • Sec. 1414. Disclosures to carry out eligibility requirements for certain programs.
    • Sec. 1415. Premium tax credit and cost-sharing reduction payments disregarded for Federal and Federally-assisted programs.
    • Sec. 1421. Credit for employee health insurance expenses of small businesses.
    • Sec. 1501. Requirement to maintain minimum essential coverage.
    • Sec. 1502. Reporting of health insurance coverage.
    • Sec. 1511. Automatic enrollment for employees of large employers.
    • Sec. 1512. Employer requirement to inform employees of coverage options.
    • Sec. 1513. Shared responsibility for employers.
    • Sec. 1514. Reporting of employer health insurance coverage.
    • Sec. 1515. Offering of Exchange-participating qualified health plans through cafeteria plans.
    • Sec. 1551. Definitions.
    • Sec. 1552. Transparency in government.
    • Sec. 1553. Prohibition against discrimination on assisted suicide.
    • Sec. 1554. Access to therapies.
    • Sec. 1555. Freedom not to participate in Federal health insurance programs.
    • Sec. 1556. Equity for certain eligible survivors.
    • Sec. 1557. Nondiscrimination.
    • Sec. 1558. Protections for employees.
    • Sec. 1559. Oversight.
    • Sec. 1560. Rules of construction.
    • Sec. 1561. Health information technology enrollment standards and protocols.
    • Sec. 1562. Conforming amendments.
    • Sec. 1563. Sense of the Senate promoting fiscal responsibility.
    • Sec. 3502. Establishing community health teams to support the patient-centered medical home.
    • Sec. 3506. Program to facilitate shared decisionmaking.
    • Sec. 3510. Patient navigator program.
    • Sec. 3602. No cuts in guaranteed benefits.
    • Sec. 4001. National Prevention, Health Promotion and Public Health Council.
    • Sec. 4002. Prevention and Public Health Fund.
    • Sec. 4003. Clinical and community preventive services.
    • Sec. 4004. Education and outreach campaign regarding preventive benefits.
    • Sec. 4102. Oral healthcare prevention activities.
    • Sec. 4201. Community transformation grants.
    • Sec. 4202. Healthy aging, living well; evaluation of community-based prevention and wellness programs for Medicare beneficiaries.
    • Sec. 4203. Removing barriers and improving access to wellness for individuals with disabilities.
    • Sec. 4204. Immunizations.
    • Sec. 4205. Nutrition labeling of standard menu items at chain restaurants.
    • Sec. 4206. Demonstration project concerning individualized wellness plan.
    • Sec. 4207. Reasonable break time for nursing mothers.
    • Sec. 4301. Research on optimizing the delivery of public health services.
    • Sec. 4302. Understanding health disparities: data collection and analysis.
    • Sec. 4303. CDC and employer-based wellness programs.
    • Sec. 4304. Epidemiology-Laboratory Capacity Grants.
    • Sec. 4305. Advancing research and treatment for pain care management.
    • Sec. 4306. Funding for Childhood Obesity Demonstration Project.
    • Sec. 4401. Sense of the Senate concerning CBO scoring.
    • Sec. 4402. Effectiveness of Federal health and wellness initiatives.
    • Sec. 10101. Amendments to subtitle A.
      • No Lifetime Or Annual Limits
      • Provision Of Additional Information
      • Prohibition On Discrimination In Favor Of Highly Compensated Individuals
      • Bringing Down The Cost Of Health Care Coverage
      • Appeals Process
      • Patient Protections
    • Sec. 10102. Amendments to subtitle B.
      • Connecting To Affordable Coverage
    • Sec. 10103. Amendments to subtitle C.
      • Coverage For Individuals Participating In Approved Clinical Trials
      • Annual Report On Self-Insured Plans
      • Study Of Large Group Market
    • Sec. 10104. Amendments to subtitle D.
      • State Opt-out of Abortion Coverage
      • Multi-State Plans
    • Sec. 10105. Amendments to subtitle E.
      • Study Of Geographic Variation In Application Of FPL
    • Sec. 10106. Amendments to subtitle F.
      • Effects On The National Economy And Interstate Commerce
      • Tax Penalties
    • Sec. 10107. Amendments to subtitle G.
      • GAO Study Regarding The Rate Of Denial Of Coverage And Enrollment
      • Small Business Procurement
    • Sec. 10108. Free choice vouchers.
    • Sec. 10109. Development of standards for financial and administrative transactions.
    • Sec. 10201. Amendments to the Social Security Act and title II of this Act.
    • Sec. 10329. Developing methodology to assess health plan value.
    • Sec. 10334. Minority health.
    • Sec. 10401. Amendments to subtitle A.
      • Research, health screenings, and initiatives
    • Sec. 10405. Amendments to subtitle E.
      • Striking section 4401
    • Sec. 10406. Amendment relating to waiving coinsurance for preventive services.
    • Sec. 10407. Better diabetes care.
    • Sec. 10408. Grants for small businesses to provide comprehensive workplace wellness programs.
    • Sec. 10411. Programs relating to congenital heart disease.
    • Sec. 10412. Automated Defibrillation in Adam’s Memory Act.


Code of Federal
Regulations

  • 5 CFR PART 890 – FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM (890.101 to 890.1210)
  • 29 CFR CHAPTER XXV – EMPLOYEE BENEFITS SECURITY ADMINISTRATION, DEPARTMENT OF LABOR
    • SUBCHAPTER A GENERAL (Part 2509 INTERPRETIVE BULLETINS RELATING TO ERISA)
      • Sec. 2509.75-2 Interpretive bulletin relating to prohibited transactions.
      • Sec. 2509.75-3 Interpretive bulletin relating to investments by employee benefit plans in securities of registered investment companies.
      • Sec. 2509.75-4 Interpretive bulletin relating to indemnification of fiduciaries.
      • Sec. 2509.75-5 Questions and answers relating to fiduciary responsibility.
      • Sec. 2509.75-6 Interpretive bulletin relating to section 408(c)(2) of the Employee Retirement Income Security Act of 1974.
      • Sec. 2509.75-8 Questions and answers relating to fiduciary responsibility under the Employee Retirement Income Security Act of 1974.
      • Sec. 2509.75-9 Interpretive bulletin relating to guidelines on independence of accountant retained by Employee Benefit Plan.
      • Sec. 2509.75-10 Interpretive bulletin relating to the ERISA Guidelines and the Special Reliance Procedure.
      • Sec. 2509.78-1 Interpretive bulletin relating to payments by certain employee welfare benefit plans.
      • Sec. 2509.94-3 Interpretive bulletin relating to in-kind contributions to employee benefit plans.
      • Sec. 2509.95-1 Interpretive bulletin relating to the fiduciary standards under ERISA when selecting an annuity provider for a defined benefit pension plan.
      • Sec. 2509.99-1 Interpretive Bulletin Relating to Payroll Deduction IRAs.
    • SUBCHAPTER B DEFINITIONS AND COVERAGE UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (Part 2510)
    • SUBCHAPTER C REPORTING AND DISCLOSURE UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (Part 2520)
    • SUBCHAPTER D MINIMUM STANDARDS FOR EMPLOYEE PENSION BENEFIT PLANS UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (Part 2530)
    • SUBCHAPTER E [Reserved]
    • SUBCHAPTER F FIDUCIARY RESPONSIBILITY UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (Part 2550)
    • SUBCHAPTER G ADMINISTRATION AND ENFORCEMENT UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (Parts 2560 to 2578)
    • SUBCHAPTER H [Reserved]
    • SUBCHAPTER I TEMPORARY BONDING RULES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (Part 2580)
    • SUBCHAPTER J FIDUCIARY RESPONSIBILITY UNDER THE FEDERAL EMPLOYEES’ RETIREMENT SYSTEM ACT OF 1986 (Parts 2582 to 2584)
    • SUBCHAPTER K ADMINISTRATION AND ENFORCEMENT UNDER THE FEDERAL EMPLOYEES’ RETIREMENT SYSTEM ACT OF 1986 (Part 2589)
    • SUBCHAPTER L GROUP HEALTH PLANS (Part 2590)


Cases

  • CIGNA Corp. v. Amara (U.S. 2010)(ERISA did not give the district court authority to reform CIGNA’s plan as relief was authorized by section which allowed a participant, beneficiary, or fiduciary “to obtain other appropriate relief” to redress violations of ERISA “or the [plan’s] terms.” Because ERISA authorized “appropriate equitable relief” for violations, the relevant standard of harm would depend on the equitable theory by which the district court provided relief.
  • Curtiss-Wright Corp. v.
    Schoonejongen
    (U.S. 1995) (standard provision in many employer-provided benefit plans
    stating that company reserves the right at any time to amend the plan- sets forth an amendment
    procedure that satisfies ERISA requirements)

  • New York State Conference of Blue
    Cross & Blue Shield Plans v. Travelers Ins. Co.
    (U.S. 1995)
    (surcharges that indirectly impact ERISA plans not preempted)

  • Safeco Life Ins.
    Co. v. Musser
    (7th Cir. 1995) (Wisconsin fees on health insurers to subsidize health
    care for the poor not preempted by ERISA)

  • Varity Corporation v. Howe (U.S. 1996) (Varity and Massey-Ferguson, acting as ERISA fiduciaries, harmed plan beneficiaries
    through deliberate deception violating ERISA’s 404(a)’s fiduciary obligation)


Reports


Talking

Health Hippo ©1996-present
Contact Information