Tsanangudzo mbiri dzakasiyana dzeBenchmark Plan
Mumakore kubvira pa Affordable Care Act (ACA) yakagadziridzwa, izwi rokuti "chirongwa chekuenzanisa" rakashandiswa zvikuru. Asi inoshandiswa kurondedzera zvinhu zviviri zvakasiyana zvakasiyana nemitemo yemitemo, iyo inogona kuvhiringidza vatengi. Kazhinji, mamiriro ezvinhu achakutendera kuti uone kuti tsanangudzo ipi inotaridzwa, chero bedzi iwe unonzwisisa mhando dzose dzezvirongwa zvekuenzanisa.
Purogiramu yeBenmark inoreva:
- Yechipiri-yakaderera-inodhura chirongwa chesirivha mukutsinhanisa munzvimbo imwe neimwe, mumushuwarisi yemusika, OR
- Chirongwa icho nyika imwe neimwe inoshandisa kurondedzera zvidikanwi zvehutano zvakakosha mukati memamiriro ezvinhu ega uye mapoka maduku maduku.
Aya ndiwo mazano maviri akasiyana, asi iwo maviri ane zita rimwe chete, iro rinogona kutungamirira kunyangadza. Ngatitarisei kuti rudzi rumwe rwerongwa hwekufananidzira runoshanda sei.
Yechipiri-Yakaderera-Inosvika Sirivha Yechipo muKushandura
Kune vanhu vanofanirwa kubhadhara mari yeAACA (premium tax credits) , mari yekubhadhara inobva pakuchengetedza purogiramu inotevera-rubatsiro rwechipiri-yakaderera-purogiramu yegoridhe pane imwe yezvakatemerwa muzana wemari yavanowana . Chirongwa chechipiri-chakanyanya kudhura chinonzi chirongwa chekufananidzira.
Chirongwa chekufananidzira chinoparadzaniswa kubva kune imwe nzvimbo kuenda kune imwe, uye kubva kune rimwe gore kusvika kune imwe kubva pakurarama kwaro sechiratidzo chinotsanangurwa zvachose nemutengo wayo maererano nezvimwe zvirongwa zvesirivha zviripo munzvimbo iyoyo.
Saka mukati mehurumende, pane zvingave zvakasiyana-siyana zvirongwa zvekuenzanisa kana hurumende ine yakasimba yemusika yemusika unoshanduka kubva kune imwe nzvimbo kuenda kune imwe, kana pangave neurongwa humwe hunobata nzvimbo yekufananidzira munzvimbo yose, kana nyika ine imwe chete inshuwarisi kana vazhinji vevaiti vebhadhari vane mutengo wakazara munyika yose.
Panguva yekunyorwa kwekutsvaga kwekutengeswa kwemusika mumwechete (November 1 kusvika kuDecember 15), vatengi vanogona kuona kuti mari yepurogiramu yekuenzanisa ichave yei gore rinouya. Vachaonawo chiyero-kana chiripo-anonyora achapiwa muhomwe yekubatsira, zvichienderana nehuwandu hwerongwa hwekufananidzira huchabhadhara kune avo vanobhadhara, mari yerongwa chaihwo ravanoda kutenga, nemari yavo (uye inowanikwa muzana yemari yavanowana kuti vangatarisirwa kubhadhara chirongwa chekufananidzira; mathemoni ayo anotsanangurwa pano).
Chirongwa chekufananidzira chinogona kugoverwa nekambani yeinishuwarenzi yakasiyana kubva kune rimwe gore kuenda kune inotevera, sezvo bhizimisi vanochinja matengo avo gore negore. Mitengo yacho inogadzirirwa gore, saka chirongwa chekufananidzira mune imwe nzvimbo inenge isingazoshanduki kusvikira gore rakatevera kunze kwekuti mubhadhari anobva mumusika mukati megore (izvi hazvisi nyore, asi zvakaitika - zvimwe zveAACA CO-OPs vakamanikidzwa kupfigira pakati pemakore muna 2015 uye muna 2016). Asi kune gore rakatevera, vatsigiri vema-inshuwarisi pamwero wekutengesa vanogona kuvhara-svetuka, sezvakangoita vamwe vatsigiri vehurumende vanosimudza mararamiro avo kupfuura vamwe, uye vamwe vanoderedza mitero yavo kubva kune rimwe gore kuenda kune rinotevera.
Asi iyo inotora pfungwa inonzwisisika ndeyokuti yako yekubhadhara mari yepamusoro inobva pane mari yaizokutenga kuti utenge chirongwa chekufananidzira.
Iwe unogona kushandisa rubatsiro irworwo kuti utenge chero hurongwa hwehuni-yehuni muhutano. Iwe haufaniri kutenga chirongwa chekufananidzira, asi mari yako yekubhadhara ichave yakafanana, pasinei nokuti urongwa hupi huri kusarudza (yako inotevera-kubhadhara premium yemari ichasiyana zvikuru, zvichienderana nesarudzo ipi yaunosarudza).
Hurongwa hweHurumende-Hwakagadzirirwa hunokosha hutano huripo
Chimwe chirongwa chekufananidzira chirongwa chinoronga zvirongwa munharaunda imwe neimwe yekugadzirisa zvipi zvinowanikwa nezvirongwa zveboka neboka duku muhurumende. Zvose zvitsva zvevanhu uye zvishomanana zvirongwa zvinofanira kuvhara maAAA gumi ekubatsira kwehutano hunokosha (kune imwe nzira yekubatsira vana mazino / maonero ekuona, asi mamwe mapfumbamwe anobatsira mararamiro anofanira kubatanidzwa mune zvose zvirongwa zveAACA-zvinoenderana nemapoka emapoka maduku).
Uye kunyange zvazvo zvirongwa zveboka guru zvisingafaniri kuvhara zvakakosha zvoutano, hazvigoni kupa mutemo wegore negore kana kuti hupenyu hunobatsira maximums pane chero hupi hunokosha hwehutano hwavanowana.
Saka zvakakosha kusimbisa izvo zvinokosha sechikonzero chinokosha chehutano. IAACA inovatsanangurira nekurova nemaune, kuchengetedza rondedzero yegumi zvakakosha yehutano kune zvikwata zvinotarisana nehafu ye peji. Murairo zvakare wakataura kuti Dhipatimendi reZvipatano neHuman Services (HHS) yaizopiwa basa rekuita kuti kuchengetwa kuve "kwakaenzana nehuwandu hwezvipo zvakapiwa pasi peurongwa hwekushandira.
Kubvira ipapo, hurumende yehurumende yakasiya iyo kusvika kuHHS kuti ibudise mashoko acho. HHS, zvakare, yakagadza hurumende imwe neimwe nekuronga hurongwa hwekufananidzira hunogona kushandiswa sehuwandu hwerondedzero yevanhu vatsva uye mapoka maduku mashoma muhurumende iyoyo. Muna 2012, HHS yakabudisa rondedzero ye FAQs pamusoro pezvirongwa zvekufananidzira , kubatsira nyika inoteerera nzira, uye humwe hutungamiri hwakabudiswa muna 2015 . Nyika dzakabvumirwa kusarudza chirongwa chavo chekucherechedza kubva pane chimwe chezvinhu zvina zvinotevera ("guru" rinotsanangurwa zvichienderana nekunyora):
- Chimwe chezvikamu zvitatu zvakakura zvikuru zvedunhu muhurumende
- Chimwe chezvinhu zvitatu zvakakura muhurumende mushandi wezvirongwa zvehutano hwehutano (chinyorwa chinopiwa kuvashandi vehurumende)
- Imwe yevatatu vakuru vehurumende vashandi vezvirongwa zvehutano hwehutano (FEHBP sarudzo dzakapiwa kuvashandi vehurumende)
- Chimwe chikuru chisiri cheMedicaid HMO chirongwa chinopiwa mumakambani ekutengeserana enyika.
Pfungwa iyi ndeyekuti chimwe chezvinhu izvi zvaizoita kuti zvive zvakasimba, kupararira kwakasimba, uye zvingave zvisingaiti kupa "mabhupa asina kubvumira" kubva pakupiwa kwavashandi vehurumende kana kuti vakanga vasarudzwa nenhamba zhinji yebhizimisi kuti vatsigire vashandi vavo.
Kwegore ra2014 kusvika muna 2016, chirongwa chekufananidzira chaive chirongwa chakapiwa muna 2012 (kubva panguva iyoyo apo nyika dzaiva kugadzirisa zvirongwa zvavo zvekufananidzira). Vamwe vavo vaifanira kubhadharwa kuitira kuti vave nechokwadi chekuti vakafukidza maEHB ose, sezvo zvirongwa zvakanga zvisati zvichitarisirwa kuva ACA-zvinopindira muna 2012. Kubva muna 2017 uye mberi, chirongwa chekufananidzira chirongwa chakapiwa muna 2014. Inenge dzose dzehurumende dzakasarudza zvirongwa zveduzhinji sechiratidzo chavo. Tsanangudzo yepurogiramu yakajeka yekusarudzwa kwepurogiramu yehurumende yega yega inowanikwa apa.
Mumwe mutengesi nemapoka maduku maduku anopiwa muhurumende anofanira kusanganisira kugoverwa "kwakakosha zvakaenzana" kune zvipo zvinopiwa nehurongwa hwekuenzanisa huri hutungamiri hwehurumende. Ikoko kune kuenderera kubva kune imwe nyika kuenda kune imwe, sezvo ACA inotsanangura maitiro ose eEHBs. Asi kuchinja kwehurongwa hwehutano hwehurumende ndechikonzero nei uchatarisa mamwe mabasa-kufanana nekushaya rubatsiro-akawanikwa zvakasiyana kubva kuhurumende kuenda kuhurumende, zvichibva pane dzimwe mvumo dzinoshandiswa muhurumende, kana kuti kusiyana kwechimwe chirongwa chekuenzanisa kwehurumende kune imwe.
Muna Gumiguru 2017, HHS yakabudisa zvikwereti zvinobatsira uye zvipo zvekubhadhara zvegore ra2019, izvo zvaisanganisira dzimwe shanduko dzakagadziriswa dzine chokuita nemaitiro ekuenzanisa EHB. Kana kugadziriswa sezvakataurwa, nyika inenge iine zvimwe zvigadziriswe kubva muna 2019, kusanganisira sarudzo yekutora chirongwa cheimwe chimiro chehurumende seyoyo, kana kuisa zvikamu zvakasiyana zvezvikamu zvakasiyana-siyana zvehurumende zvirongwa zvekugadzira purogiramu yavo yehuwandu hwekuenzanisa. Mukuwedzera, nyika inogona kukwanisa kusarudza kana kuronga hurongwa hutsva hwekuenzanisa gore negore, panzvimbo yekufanira kuramba uchishandisa hurongwa hwekuenzanisa hwakagadzirirwa muna 2017.
Shoko Rinobva
Paunonzwa mumwe munhu achitaura nezverongwa hwekufananidzira maererano neAACA, mamiriro acho ezvinhu achakutendera kuti uone kuti chirongwa chekuenzanisa chinokurukurwa.
Vari kutaura pamusoro pechipiri-pasi-inodhura mari yesarudzo inowanikwa mumusika mumwe nomumwe pamusoro pekutsinhanisa, kana nezverongwa urongwa hwakapiwa huchashanda sehutano huripo hunodiwa iyo ACA-yakakwana yeboka rimwe nerimwe neboka duku rinoronga mu nyika yakabva? Kana uchinge wakaziva izvozvo, zvinyorwa zviri pamusoro apa zvichakubatsira kuti uve nechinangwa chekukurukurirana.
> Sources:
> Centers for Medicare neMedicaid Services. Nzvimbo yeVatengi Ruzivo uye Inishuwarenzi Kutarisa. Inokosha Health Health Benefits Standards: Kuvimbisa Quality, Zvisingakwanisi Kubatsira.
> Centers for Medicare neMedicaid Services. Nzvimbo yeVatengi Ruzivo uye Inishuwarenzi Kutarisa. Mashoko pamusoro peEight Health Health Benefits (EHB) Benchmark Plans.
> Centers for Medicare neMedicaid Services. Inokosha Health Health Benefits: Rwendo rweMakuru Matatu Mashoma Mashizha neHurumende . April 8, 2015.
> House.gov. Nhamba yeMurwere Kuchengetedzwa uye Kutengeswa Kwezvakagadzirwa Mutemo .
> Internal Revenue Service. Revenue Procedure 2017-36 .
> Kaiser Family Foundation. Inokosha Health Health Benefit (EHB) Benchmark Plans, 2017.