Also known as health care reform, the Affordable Care Act (ACA) has brought many changes to health care coverage in the U.S., providing benefits like free preventive care and coverage for adult children to age 26.
Everyone is required to have qualified health insurance coverage. If you don’t have coverage, you may have to pay a fee on your federal tax return.
In general, if you're eligible for HISD benefits, it's likely you won't be eligible for subsidies to purchase insurance in the Marketplace. This applies to your qualified dependents, too. Since each family situation is unique, healthcare.gov offers a number of resources that provide more detailed information. You can also call 800-318-2596 or visit localhelp.healthcare.gov for more information.
As long as you’re enrolled in an HISD health plan, you’re not subject to the federal fee on your income tax return. For tax purposes, the IRS now requires you to verify and report your medical plan eligibility, coverage selection and covered dependents’ tax ID numbers. You should receive 2016 form 1095-C with this information in early 2017. Please include your dependents’ tax ID numbers when you enroll them for coverage.
If you believe your eligibility status is incorrect, contact HISD Employee Services at 713-556-7383 to verify.
You can make changes to your HISD plan, including dropping coverage completely, during annual enrollment. Annual enrollment for the 2017 plan year is November 3–17, 2016. If you decide to drop HISD health coverage for 2017, you won’t have the opportunity to regain HISD coverage until annual enrollment for 2018 unless you have a qualified life event (such as getting married or giving birth). Losing or dropping coverage from a plan purchased in the Marketplace is not considered a qualified life event.
The application process is your responsibility. There are questions regarding your current job and income that you have to answer, but nothing is required of your current employer. If you have questions about the Marketplace, including filling out an application, call 800-318-2596, 24 hours a day, 7 days a week. TTY users can call 855-889-4325. Online chat is also available 24/7 at healthcare.gov/contact-us.
You will pay the full plan cost if you buy coverage through the Marketplace. The cost will depend on a number of factors, including your family size, your age(s), your household income and the plan benefits you select.
HISD holds annual enrollment for benefits each November, providing enrollment communications online and holding benefits meetings to help you sign up. Enrollment for 2017 coverage is November 3 –17, 2016. If you’re eligible, you can simply enroll online. Log on to myHISD and click the Benefits heart icon. This takes you to hisdbenefits.org. From there, click Enroll in benefits and follow the prompts. If you need help, call the HISD Benefits Service Center at 877-780-HISD (4473).
You will likely have to pay a fee on your federal tax return if you don’t have medical coverage in 2017. The fee increases each year. See the chart below for more information.
Uninsured individual pays the greater of:
Year Fixed amount % of HH income
2016 $695 for an adult 2.5%
$162.50 for a child under 18
No more than $2,085 per family
2107 and beyond Based on cost-of-living inflation 2.5%
No. As long as your coverage meets ACA requirements, all that’s required is that you have medical coverage. It does not have to be through HISD.
If you buy coverage on your own and not through HISD, keep in mind there is no HISD contribution to your monthly premiums. This means you may have to pay the full cost of coverage if you buy it elsewhere. Depending on your situation, you may be able to obtain coverage through a government program such as Medicaid or CHIP (for your children). Check eligibility requirements with the Texas Health and Human Services Commission at hhs.state.tx.us or by calling 2-1-1 or 877-541-7905.
No. If you’re covered by Medicaid or Medicare, you don’t need other insurance.
You can continue your health insurance coverage through COBRA, or you can buy a plan in the Marketplace. If your spouse is eligible for coverage through his/her employer, you may also be eligible to enroll under his/her employer's plan.