September 11, 2013

You are receiving this email based on your employment by the University of Illinois within the last six months and the fact that you are not participating in a health insurance plan offered through the State of Illinois Department of Central Management Services (“CMS”) based on your employment with the University. If you and your family members do not maintain health insurance coverage, please read this email carefully to determine whether you may need to take action in the near future.

INDIVIDUAL RESPONSIBILITY TO OBTAIN HEALTH CARE COVERAGE:

The federal Patient Protection and Affordable Care Act (“PPACA”) requires that nearly all individuals with income above the tax-filing threshold secure health insurance coverage by January 1, 2014, for themselves and their family members or pay a penalty when filing their income tax return. (See the links in the Resources section below for more information on the threshold, exemptions, and penalties.) Certain University employees are not currently eligible for coverage through CMS under the requirements set forth in the State of Illinois Group Insurance Act. If you do not already have health insurance coverage through a spouse or other family member, you must obtain coverage by the January 1, 2014 deadline or be subject to the penalty.

HEALTH INSURANCE MARKETPLACE NOTICE:

This month, the University will mail a mandated notice (“Insurance Marketplace Notice”) to each employee at the home mailing address that is on file with the University. The notice explains the option to purchase health insurance through the Health Insurance Marketplace (formerly known as the “Exchange”). The notice will also be available online in NESSIE. Please note that the Insurance Marketplace Notice refers to the health plans provided through CMS as the “State Employees’ Group Insurance Program” or “SEGIP.”

WHAT IF I ALREADY HAVE HEALTH INSURANCE COVERAGE?

If you already have health insurance coverage through a spouse or other family member, then the Insurance Marketplace Notice will be for informational purposes because you will already satisfy your responsibility to maintain health insurance coverage. You do not need to purchase insurance through the Marketplace as long as you and your dependent family members maintain insurance coverage.

WHAT IF I DO NOT HAVE HEALTH INSURANCE COVERAGE?

If you are not eligible for health insurance coverage through CMS based on your University employment and do not otherwise have health insurance coverage through a spouse or other family member, then you should carefully review the Insurance Marketplace Notice and understand your option to purchase health insurance through the Marketplace.

If you were eligible for health insurance coverage through CMS but declined or opted-out of that coverage and do not have any other health coverage through a spouse or family member, then you can elect coverage through CMS during the May 2014 Benefit Choice Period for coverage effective July 1, 2014, or earlier if you experience a qualifying event, to satisfy your individual responsibility under PPACA. In that case, you would not be liable for the penalty for the period from January 1, 2014 through June 30, 2014. For example, if you are a part-time employee (working 50 to 99% of a normal work period) who declined health insurance through CMS previously, you can elect coverage through CMS at the applicable time to fulfill your obligation under PPACA.

RESOURCES:

We hope that this email has been useful in informing you about the upcoming requirements of PPACA. If you have additional questions regarding these issues, please consult the resources listed below.

PPACA Overview
https://www.healthcare.gov/blog/2014-in-214-words/

PPACA Penalties, Minimum Coverage, and Exemptions
https://www.healthcare.gov/what-if-someone-doesnt-have-health-coverage-in-2014/

Tax-Filing Thresholds for Most Taxpayers
Please consult with your tax advisor regarding your tax-filing status.
http://www.irs.gov/publications/p501/ar02.html#en_US_2012_publink1000270109

Insurance Marketplace Notice
View a copy of the notice at https://nessie.uihr.uillinois.edu/pdf/benefits/InsMarketplaceNotice.pdf

Health Insurance Marketplace
https://www.healthcare.gov/

Eligibility criteria for coverage through CMS
See the State of Illinois Employees Benefits Handbook at http://www2.illinois.gov/cms/Employees/benefits/StateEmployee/Documents/2011_State_Employee_Benefits_Handbook.pdf

QUESTIONS?

If you are unsure whether you are eligible for health insurance coverage based on your University employment, please contact your supervisor or your unit’s hiring manager.

If you have other questions about your employment status, please contact your campus/central HR office:

If you have questions about CMS health insurance coverage, please contact the UPB-Benefits Services office:

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