Affordable Care Act (ACA) | Wellmark
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Signed into law on March 23, 2010, the ACA made health insurance available to all Americans. Here's what you need to know: 

  • Individual Mandate: All Americans must have health insurance or pay a tax penalty.
  • Guaranteed Issue: No one can deny you coverage based on your health status. 
  • Essential Health Benefits: A set of 10 health care service categories that health plans must cover.
  • Open Enrollment Period: A specific time of year you can purchase health insurance for the upcoming year. You can enroll outside that window if you experience a Special Enrollment Event, like marriage or birth.
  • Tax penalties: If you don’t buy insurance, you’ll pay either a flat dollar amount or 2.5 percent of your income, whichever is greater.
  • Summary of Benefits and Coverage: This important document gives an overview of your plan and coverage options.

About your rights

All Americans must have health insurance (called Minimum Essential Coverage) or pay a tax penalty.

The ACA includes a number of important benefits and protections. For example, dependents can now be covered on family plans up to age 26, and no one can deny you coverage based on pre-existing conditions. All new Wellmark plans meet or exceed these requirements.

The tax penalties are significant

Penalties are in place to encourage everyone — even the young and healthy — to get insured.

If you're not insured, you must specify on your annual tax return, and your penalty may cost hundreds of dollars or 2.5 percent of your yearly household income, whichever is higher. Fines for families with children can cost thousands. 

If you want to avoid penalties but feel like you may not be able to afford health insurance, you may qualify for federal subsidies. Eligibility is based on your household income and insurance plan. Learn more about tax penalties at External Site.


Visit our Uniform Glossary of Benefits

Most people don’t use words like "coinsurance" and "in-network" in their day-to-day life, so that's why a Uniform Glossary of Benefits is also available. With simple and concise definitions, the glossary makes it easier to understand some of the common terms used in health insurance.