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FAQs

Employers (9)

Under the Affordable Care Act, do all businesses need to cover their employees?

Businesses with fewer than 50 full-time equivalent employees (FTEs) are exempt from the requirements to offer coverage, and there are no penalties for those businesses if they don’t offer coverage. But, starting in 2014, businesses with 50 or more FTEs may have to pay a penalty if they do not offer affordable minimum essential coverage (MEC) to their full-time employees.

If I decide to cover my employees, how does Nevada Health Link help me?

Nevada Health Link’s SHOP will let you easily compare many Qualified Health Plans (QHPs) offered by private insurance companies. Everything you need to choose the plans that are right for your business and employees will be available on NevadaHealthLink.com, and you can continue to work with your broker to enroll in plans if you wish. Nevada Health Link offers the same plans you’re used to, but with more choice and more advantages, including better coverage and lower cost, deductibles and premiums.

How do small businesses use Nevada Health Link to purchase coverage for their employers?

Starting in 2014, employers with 2-50 full time employees will be able to use Nevada Health Link’s SHOP to select which plans their employees can enroll in. Employees will log on and choose the plan they would like from the plans the employer selected. Employers will receive one easy-to-read bill from Nevada Health Link for all of their employees, regardless of how many different plans were chosen. Learn more about how SHOP will work here.

Can my employees choose any plan offered by Nevada Health Link?

No, as an employer you’ll choose the level of coverage you want to contribute and which QHPs offered by Nevada Health Link your employees can choose from. You decided which plans you want to offer and how much you want to contribute to those plans first, then your employees log on and choose from the plan options you selected.

What if my employees want their families covered?

All of the plans offered through Nevada Health link can insure employees’ dependents. As an employer, you will decide if you want to offer spousal and dependent coverage or let your employees decide if they want to purchase coverage for their families through Nevada Health Link’s individual marketplace.

How does an employer qualify and apply for tax credits if they provide health insurance coverage for their employees?

To qualify for tax credits an employer must:

  • have 25 employees or fewer
  • have average firm wages of $50,000/year or less
  • provide health insurance coverage for employees (the employer must contribute a minimum of 50% of the cost of their employees’ coverage)
  • file the appropriate tax returns (Form 8941; Line 44f of Form 990-T for exempt organizations) with their tax preparer 

Tax credits are available now and increase in 2014. Businesses may apply for the previous years’ credits for which they qualify.

Does a small business need to have a Section 125 plan to participate in Nevada Health Link’s SHOP?

No, a business does not need to have an established Section 125 plan to participate in our SHOP. Here are the eligibility requirements for SHOP participation:

  • 50 or fewer full-time employees in 2014
  • SHOP will be opened up to employers with 100 or fewer Full time employees in 2016
  • Tax credits will be available in 2014 and 2015 for employers with 25 or fewer employees and average company wages less than $50,000/year (excluding the owner(s) and owner(s)’ families).

Only employers with more than 50 Full Time Equivalent employees will be subject to penalties. These employers must offer a health insurance package that meets the Federal Essential Health Benefits (EHBs) and does not cost their employees more than 9.5% of their household’s annual salary.

The penalty for employers with more than 50 FTEs who do not offer the coverage as outlined above will be $2,000 x (FTEs-30). For example, if an employer had 51 employees and did not offer coverage that meets the requirements, the employer would have to pay a penalty of $42,000 ($2,000 x 21 = $42,000).

If I have more than 50 employees and have a plan that meets the EHBs and does not cost employees more than 9.5% of their salary, what happens if they don’t elect the plan and come to Nevada Health Link?

If an employer provides affordable minimum essential coverage (MEC) for their employees, the employees are not eligible for Advance Premium Tax Credit (APTC) on Nevada Health Link’s individual online marketplace. During the enrollment process, the employee will have to:

  • attest that they do not have access to affordable MEC; and
  • list their employer, employer’s address and employer’s telephone number

Nevada Health Link will contact the employer to verify that the employee does not have access to affordable MEC. If the employer provides affordable MEC, the employee is not eligible to purchase subsidized coverage through Nevada Health Link; however, they may still enroll in a plan through Nevada Health Link if they wish.

The employer will not be penalized for an employee who does not elect to participate in an employer-sponsored health insurance plan that is affordable and meets MEC.

What are the options for my family if my employer offers me coverage?

When the affordability regulations for employer sponsored insurance coverage were passed, they did not take the cost of dependent coverage into account. If your spouse’s employer offers him/her minimum essential health insurance coverage that costs less than 9.5% of your annual household income, then the coverage is deemed affordable. If the employer also offers spouse coverage, then you would be ineligible for Advance Premium Tax Credit or a subsidy on Nevada Health Link. If your spouse’s employer does not offer spouse coverage then you could come to Nevada Health Link and apply for a subsidy. In 2014 all large group plans are required to offer dependent coverage, so your children would be ineligible for Advance Premium Tax Credit through Nevada Health Link. There may be cheaper plans available than the employer provided dependent coverage, but the children will not qualify for a subsidy. If the employer’s plan did not offer dependent care then the children could get subsidized coverage through Nevada Health Link.

Individuals (15)

How do I calculate my income?

Calculating Modified Adjusted Gross Income (MAGI):

Modified Adjusted Gross Income (MAGI) is calculated by adding back certain items to your Adjusted Gross Income. Your Adjusted Gross Income (AGI) can be found on line 38 of your Form 1040; line 22 of your Form 1040A; or line 36 of your Form 1040NR.

The following items must be added to your Adjusted Gross Income (AGI) to calculate your Modified Adjusted Gross Income (MAGI):

  • Traditional IRA contributions that were deducted.
  • Student loan interest amounts deducted.
  • Tuition and fees deducted.
  • Domestic production activities deducted.
  • Foreign income or housing costs excluded on Form 2555.
  • Foreign housing deduction taken on Form 2555.
  • Savings bond interest excluded on Form 8815.
  • Adoption benefits from an employer excluded on Form 8839.

Worksheet 1-1, found on page 17 of IRS Publication 590, provides information for a step-by-step calculation of Modified Adjusted Gross Income (MAGI).

What is insurance?

Insurance is like a pot that you put money into every month in case you need to use it later on to cover big expenses. This monthly payment is called a premium. You may not need the pot of money every month, but it’s there for you when you do need it. If you get sick or hurt, you can use the pot of money to pay for doctor’s visits, medical bills and prescriptions.

Why do I need insurance?

Health insurance helps you get the care you need, when you need it. Insurance will help keep you and your family healthy. If you have insurance, you’ll be able to get preventive care (such as regular check-ups, screenings and immunizations) so you and your family will be sick less often. Health insurance also protects you financially; you won’t have to worry about high medical bills you can’t pay.

Additionally, the Affordable Care Act (ACA), a U.S. law, says everyone must have health insurance by 2014. If someone doesn’t have health insurance, he or she will incur a penalty (a fine) on his or her income taxes. Nevada Health Link is here to protect Nevadans from the tax penalty by helping them find insurance based on their budget.

What exactly is Nevada Health Link?

Nevada Health Link is the State of Nevada’s online marketplace for consumers and small businesses. In October 2013, this website will become the online marketplace, where you can shop for, compare and enroll in health insurance plans. Nevada Health Link provides new ways to get insurance for people who, until now, had not been able to because of cost or other obstacles, such as pre-existing conditions. Learn more about how it works here.

Who can use Nevada Health Link?

Nevada Health Link is here to help anyone looking for health insurance, whether you already have insurance or not. If you already have health insurance, through your employer for example, you aren’t required to enroll through Nevada Health Link but are welcome to explore new plans through the online marketplace if you like.

The only requirement to apply for and purchase insurance on NevadaHealthLink.com is that you are lawfully present in the U.S. and living in the State of Nevada. Filling out an application will not trigger an immigration/ INS investigation. This program’s goal is simply to reduce the cost of health insurance and insure more Americans.

How do I enroll?

During open enrollment (October 2013 to March 31, 2014) you will be able to enroll by:

  • Visiting this website (NevadaHealthLink.com)
  • Calling Nevada Health Link’s Toll-Free Call Center
  • Getting help from your health insurance agent or broker
  • Meeting with a licensed Navigator. A list of licensed and certified Navigators will be posted on this website as soon as it is available.
  • Visiting with a licensed Enrollment Assister at a community location near you. A list of Enrollment Assisters and locations will be posted on this website as soon as it is available.

Learn more about the process here.

What if I need help or can’t enroll online on my own?

If you don't have Internet access or would like some help shopping for and enrolling in a health insurance plan, the Nevada Health Link team will be here to help. You will be able to call a toll-free number to get a person who can help you or search the website for a list of in-person assistants in your area. These assistants will be at a variety of community locations across Nevada and will be able to sit down with you and help you through the entire application and enrollment process.

What if I qualify for a public health insurance program like Medicaid?

If you or someone in your family qualifies for government health coverage programs such as Medicaid or Nevada Check Up (CHIP), Nevada Health Link will alert you during the application process and help enroll you in those programs if you wish. You will not need to fill out another application.

Help with Insurance Terms

For help with any words and terms, click here to see our glossary.

 

Why should I buy insurance on NevadaHealthLink.com?

Buying insurance through Nevada Health Link guarantees that you are enrolled in a Qualified Health Plan with Essential Health Benefits.

All information about the plans offered through Nevada Health Link will be presented in clear language, so there’s no guesswork about what’s covered or what it costs. Because Nevada Health Link offers a variety of plans from different private insurance companies, we don’t have any connection with one insurance carrier. This means that all of the information about the plans is presented objectively, so you can pick the plan that’s right for you.

While using Nevada Health Link, you’ll be able to sort and narrow down your options by a variety of categories – including monthly costs, insurance carrier and provider network – based on what’s most important to you.

You’ll also be able to choose your top plan options and compare them based on the details that are most important to you. For example, you could choose four different plan options, and compare them by deductible, monthly premium and doctor's visit copayment to decide which plan is right for you.

Nevada Health Link is the only place that you can receive cost assistance in the form of an Advance Premium Tax Credit (APTC) or Cost Sharing Reductions (CSRs).

Can I buy a Qualified Health Plan (QHP) outside of Nevada Health Link?

Yes, insurance carriers that offer QHPs on NevadaHealthLink.com will offer the exact same product outside of Nevada Health Link. But, you must enroll through NevadaHealthLink.com if you want to receive help with your premium in the form of an Advance Premium Tax Credit (APTC).

I am currently uninsured by choice. I prefer alternative and holistic medicine. I do not take any prescription medication or vaccines. I am in very good health and very concerned about this new healthcare law. I feel I will be forced into paying for something I will never use and if I don’t, then I will be penalized. What, if any, options are there for people like me?

The Supreme Court ruling issued in June of 2012 stated that the federal government could impose a tax on individuals who do not purchase health insurance. Nevada Health Link has been put in place in Nevada to help Nevadans comply with the new law. There are exemptions from the individual mandate for certain religious groups, Native Americans and for people who face a financial hardship that precludes them from purchasing health insurance. If you are a member of one of the groups spelled out in the ACA, you are exempt from the individual mandate to purchase health insurance. If you don’t fall into one of the exempt classifications, the IRS will enforce a tax penalty of $95 or 1% of your income (whichever is greater) in calendar year 2014. The penalty will increase to $695 or 2.5% of your income (whichever is greater) in calendar year 2016.

What are the Special Provisions for Native Americans?

  • Native Americans who are members of a federally recognized tribe are exempt from the individual mandate.
  • Native Americans who earn less than 300% of the Federal Poverty Level (FPL) are exempt from cost sharing; for example, they will not have to pay copayments or deductibles when they use medical services. 
  • There are special provisions for the calculation of Modified Adjusted Gross Income for Native Americans, meaning that some revenue earned on reservations and from Federal Trust payments are exempt.
  • Native Americans can change Qualified Health Plans (QHPs) once per month, and they are not bound to the open enrollment dates.

What are the options for my family if my employer offers me coverage?

When the affordability regulations for employer sponsored insurance coverage were passed, they did not take the cost of dependent coverage into account. If your spouse’s employer offers him/her minimum essential health insurance coverage that costs less than 9.5% of your annual household income, then the coverage is deemed affordable. If the employer also offers spouse coverage, then you would be ineligible for Advance Premium Tax Credit or a subsidy on Nevada Health Link. If your spouse’s employer does not offer spouse coverage then you could come to Nevada Health Link and apply for a subsidy. In 2014 all large group plans are required to offer dependent coverage, so your children would be ineligible for Advance Premium Tax Credit through Nevada Health Link. There may be cheaper plans available than the employer provided dependent coverage, but the children will not qualify for a subsidy. If the employer’s plan did not offer dependent care then the children could get subsidized coverage through Nevada Health Link.

What do military veterans need to know?

There are many important considerations for military veterans. For more information, please click the following link:

Considerations for Military Veterans

Partners (6)

How do I calculate my income?

Calculating Modified Adjusted Gross Income (MAGI):

Modified Adjusted Gross Income (MAGI) is calculated by adding back certain items to your Adjusted Gross Income. Your Adjusted Gross Income (AGI) can be found on line 38 of your Form 1040; line 22 of your Form 1040A; or line 36 of your Form 1040NR.

The following items must be added to your Adjusted Gross Income (AGI) to calculate your Modified Adjusted Gross Income (MAGI):

  • Traditional IRA contributions that were deducted.
  • Student loan interest amounts deducted.
  • Tuition and fees deducted.
  • Domestic production activities deducted.
  • Foreign income or housing costs excluded on Form 2555.
  • Foreign housing deduction taken on Form 2555.
  • Savings bond interest excluded on Form 8815.
  • Adoption benefits from an employer excluded on Form 8839.

Worksheet 1-1, found on page 17 of IRS Publication 590, provides information for a step-by-step calculation of Modified Adjusted Gross Income (MAGI).

Will people be able to enroll in government insurance programs through Nevada Health Link?

After a person has filled out their application on NevadaHealthLink.com, we will be able to determine if that individual or a family member is eligible for a government program, such as the Nevada Check Up (CHIP) or Medicaid. If one person in the family qualifies for Medicaid, that person can be enrolled in Medicaid and the rest of the family will be able to enroll in a health insurance plan or plans through Nevada Health Link. They will be able to do this using only one application, and will not need to fill out a separate one to enroll in the government insurance program. The family will still only pay one bill for all of its plans.

Will people be able to enroll in non-insurance government programs through Nevada Health Link?

No, Nevada Health link will not be able to pre-populate applications for non-insurance government programs such as SNAP or TANF. However, all enrollees will be offered the option to apply for government insurance programs – such as Medicaid or Nevada Check Up – whether they initially appear to qualify or not.

Some questions you might hear

Click here to see some FAQs you might get from your clients.

What are the options for my family if my employer offers me coverage?

When the affordability regulations for employer sponsored insurance coverage were passed, they did not take the cost of dependent coverage into account. If your spouse’s employer offers him/her minimum essential health insurance coverage that costs less than 9.5% of your annual household income, then the coverage is deemed affordable. If the employer also offers spouse coverage, then you would be ineligible for Advance Premium Tax Credit or a subsidy on Nevada Health Link. If your spouse’s employer does not offer spouse coverage then you could come to Nevada Health Link and apply for a subsidy. In 2014 all large group plans are required to offer dependent coverage, so your children would be ineligible for Advance Premium Tax Credit through Nevada Health Link. There may be cheaper plans available than the employer provided dependent coverage, but the children will not qualify for a subsidy. If the employer’s plan did not offer dependent care then the children could get subsidized coverage through Nevada Health Link.

How do I become a Navigator, Enrollment Facilitator, or CAC?

The Navigator and Enrollment Assister entities were announced at our June 12, 2013 Board Meeting. Please refer to the below link for more information:

http://exchange.nv.gov/Resources/Navigators,_Enrollment_Assisters_and_CACs/