Affordable Care Act (ACA)
The following is an overview regarding how a part-time Town of Mansfield employee may become eligible under the Affordable Care Act (ACA) regulations. To be eligible for a healthcare plan under ACA, you must have an average of 30 hours of service per week.
Newly hired part-time employees must be regularly scheduled to work 20 or more hours (30 under the ACA) to be eligible for healthcare insurance coverage.
If you are a variable hour, part-time employee and feel you meet the qualifications for health care coverage under the Affordable Care Act but have not received an offer of coverage, please contact the Human Resources Department at 508-261-7480.
Healthcare Coverage Availability
An important note regarding your healthcare plan coverage availability:
The Town of Mansfield wants to make sure that employees are well-informed about the change in options that are now available to them. It is possible that you may qualify for a lower rate, which could be even greater when coupled with a tax subsidy, through the state and federally-operated Marketplace.
Beginning October 1, 2013, the federal government opened the Public Health Insurance Marketplace with more than 6 million people having enrolled in Marketplace coverage.
Public Health Insurance Marketplace
Based on the available Marketplace healthcare plans, and potential tax subsidies for which you may qualify, you could pay less for similar health insurance coverage through the Marketplace than you pay for your medical plan through the Town of Mansfield. We encourage all of our part-time, benefit-eligible and/or ACA eligible employees to visit HealthCare.gov website to learn more information about, or enroll in, the Public Health Insurance Marketplace.
Sample Health Insurance Plans
You can find sample health insurance plans and rates from the Marketplace. Visit HealthCare.gov website to review information through a simple, interactive questionnaire by click on the link for “Find plans and sample prices.” After answering a few of the questions regarding the type of plans you are looking for, the tool will provide the most applicable plans for your situation, along with sample prices. These sample prices do not reflect any tax subsidy that you may be eligible for through the Marketplace.
Based on your family income, you may qualify for a federal tax subsidy to help pay for the cost of your health insurance coverage through the Marketplace. You can find additional information regarding these tax subsidies and use a calculator to estimate a potential tax subsidy that you could qualify for at the following sites:
- HealthCare.gov - Income Levels and Savings
- Henry J Kaiser Family Foundation - Health Insurance Marketplace Calculator
Medicaid / Children's Health Insurance Program
The Marketplace can help individuals navigate the Medicaid program and/or Children’s Health Insurance Program (CHIP). For families with limited income, the Marketplace will review the information and share it with the appropriate state agencies if it looks like you qualify. Based on the state agency review, you would be contacted regarding eligibility for the Medicaid and/or CHIP programs.
For more details regarding ACA, visit the United States Department of Labor Consumer Information on the Affordable Care Act website.
Apply to the Health Insurance Marketplace
You will need to do the following to apply for the Health Insurance Marketplace:
- Fill out an application and see all the health plans available in your area
- Learn if you qualify for lower out-of-pocket costs
- Provide some information about your household size and income to find out if you can get lower costs on your monthly premiums for private insurance plans
The Health Insurance Marketplace is sometimes known as the health insurance “exchange.” The Marketplace will tell you if you qualify for free or low-cost coverage available through Medicaid or the Children’s Health Insurance Program (CHIP). Most Americans will be eligible to use the Marketplace. Learn more about Marketplace eligibility.
Insurance plans in the Marketplace are offered by private companies. They cover the same core set of benefits called essential health benefits. No plan can turn you away or charge you more because you have an illness or medical condition. They must cover treatments for these conditions. Plans can’t charge women more than men for the same plan. Many preventive services are covered at no cost to you.
Marketplace Presents Plan Information
The Marketplace simplifies your search for health coverage by gathering the options available in your area in one place. You can compare plans based on price, benefits, and other features important to you before you make a choice. Plans will be presented in four categories - bronze, silver, gold, and platinum - to make comparing them easier.
Prices & Benefits
In the Marketplace, information about prices and benefits will be written in simple language. You get a clear picture of what premiums you’d pay and what benefits and protections you’d get before you enroll. Compare plans based on what’s important to you, and choose the combination of price and coverage that fits your needs and budget.
Health Insurance Marketplace in Massachusetts
If you live in Massachusetts, you’ll use the HealthCare.gov website to apply for coverage, compare plans, and enroll. When enrolling in Marketplace coverage, it can begin as soon as January 1, 2017. Open enrollment starts November 1, 2016, and ends January 31, 2017.
Apply for Coverage
You can apply for Marketplace coverage three ways: online using the website above, by mail, or in-person with the help of a Navigator or other qualified helper. Telephone help and online chat are available 24/7 by calling 800-318-2596 to help you complete your application. Downloadable and paper applications will be available October 1.
Through the HealthCare.gov website, you can also learn about your options if you need coverage that begins before January 1, 2016.
Visit HealthCare.gov website or call 800-318-2596, 24 hours a day, 7 days a week.
Documents & Forms
View the New Health Insurance Marketplace Coverage Options (PDF) to learn more about Marketplace Insurance.