Kwi-inshorensi yempilo, umbandela oqinisekileyo ubhekisela kwimeko apho umgaqo-nkqubo wokunakekelwa kwempilo unikezelwa kunoma yimuphi na nabo bonke abanokufaka izicelo ezifanelekileyo kungakhathaliseki imeko yezempilo. Umbambano oqinisekisiweyo uvumela abantu abaneemfuno zonyango ezangexesha elide, bafumane inyhuwarensi yezempilo, njengoko imbali yabo yezonyango ingabandakanywa.
Ingxaki eqinisekisiwe phantsi koMthetho wokuNakekelwa ongenakuncedo (ACA)
Ngaphantsi koMthetho woNonophelo ongenakuncedo , yonke imigaqo-nkqubo yomshuwalense yempilo kunye nemisebenzi efanelekileyo yoJanuwari 2014 okanye kamva kufuneka kuthengiswe ngombandela oqinisekileyo.
Abaqinisekisi abanakho ukufumana ilungelo lokufumana inkxaso kwimbali yonyango lomfaki sicelo, kwaye izimo eziye zangaphambili azikwazi ukukhutshwa ngaphandle kwezicwangciso ezintsha.
Ngokuqinisekileyo oku kwakungekho imeko phambi koMthetho woNonophelo ongenakunciphisa. Ukususela ngo-2012, kwakukho kuphela ezintandathu ezithetha apho ukuthengwa komthengi (uhlobo oluzithenga ngalo, kunokuba lufumane umqeshi) lukhutshwe. Kwimizuzu engama-44 asele, i-insurers ibhekisele kwiirekhodi zonyango ngamnye zomfaki sicelo kunye nalabo abaneemeko ezibalulekileyo okanye ngezinye iimeko ezincinci eziye zahlala zikhokelwa.
Ukongeza kwimiba eqinisekisiweyo, ukuhanjiswa kwimakethi yecandelo ngalinye kunye nelincinci ngoku lukhutshwe ngokuchithwa komgangatho woluntu ngenxa ye-ACA. Oko kuthetha ukuba ii-premiums azikwazi ukusekelwe kwimbali yonyango; ziyakwazi ukuhluka kuphela ngokusekelwe kwiminyaka yobudala, ukusetyenziswa kwecuba kunye nekhodi ye-zip. Umba oqinisekileyo kunye nokuhlaziywa kweendawo zoluntu ngokuqinisekileyo ziindaba ezilungileyo kulabo abanezimo zonyango ebezikhona.
Nangona kunjalo, kusabalulekile ukuxoxa ngeemeko zakho zangaphambili ezikhoyo kunye nomthengisi okanye ubhaliso, okanye umntu ophethe isebe lomntu wabasebenzi bakho, phambi kokukhetha isicwangciso. Kungenxa yokuba amanethiwekhi anikezelayo kunye neempompo zonyango zonyango ziyahlukahluka ngokubanzi kwisicwangciso esinye.
Ukuba unemeko esele ikhona ngaphambili, uya kufuna ukuqinisekisa ukuba, xa kunokwenzeka, isicwangciso okhethileyo siquka oogqirha bakho kwinethiwekhi kunye nokufakela amayeza owathathayo.
Ingxaki Eqinisekisiwe Ukuba Uthenga Intshurensi yezeMpilo kwiNkampani encinci
Umthetho we-Federal ufuna ukuba zonke izicwangciso zonyango zithengiswe kwiinkampani ezine-2 ukuya kwabasebenzi abangama-50 zibe ngumbandela oqinisekileyo. Oku kuye kwenzeka ukuba i-HIPAA iphumelele ngo-1997-kangangeminyaka engama-20 ubudala, abaqhankqalazi abazange bakwazi ukukhanyela ukuhanjiswa kwabaqeshi abancinci ngokusekelwe kwiimeko zabo zempilo yabasebenzi.
Nangona kunjalo, i-HIPAA ayizange ithintele abaqhorensi ekusekeni ama-premium kumaqela amancinci kwimbali yonyango jikelele yeqela. Oko kwakuthetha ukuba ngaphandle kokuba i-state ingavunyelwanga, i-inshorensi inokunikela ngezaphulelo kumaqela aphilileyo, kwaye ihlawulwe iiprayimari eziphezulu kumaqela anabasebenzi abangenampilo kunye / okanye abaxhomekeke kuyo. Baye banokuhlawula iiprayimari eziphezulu kumaqela aneemisebenzi enobungozi, nangona kubakho abasebenzi (ngokuchasene ne-inshurensi yempilo yabasebenzi) iquka ukulimala emsebenzini.
Kodwa i-ACA iphelile umkhuba wokusekela iiprayimari kumlando wezonyango ezincinane okanye uhlobo lwezoshishino. Ukongeza kwimiba eqinisekisiweyo, ukukhutshwa kweqela elincinci ngoku kulandelelanisa imigaqo yokulinganiswa kwemimiselo yoluntu esetyenzisiweyo kwimarike nganye: iiprayimenti ziyahlukahluka ngokusekelwe kwiminyaka yobudala, ukusetyenziswa kwecuba kunye nekhodi ye-zip.
I-Issue eqinisekisiwe yeqela eliqeshisayo lamaqela
Abaqeshi abakhulu kufuneka ukuba banikezele ngokubhengezwa kwabasebenzi phantsi kwe-ACA. Ukuququzelela oku, abaqinisekiso-mali abasayi kuvunyelwa ukunyanzelisa iimfuno zokuthatha inxaxheba emncinci xa abaqeshi abaninzi befuna ukunikezelwa kwabasebenzi babo. Ininzi kakhulu iqela elikhulu elizimeleyo, nangona kunjalo, okwenza oku kube ngumbono wendawo.
Ukukhutshwa kweqela elikhulu akumele kulandele imigaqo yokulinganisa yoluntu esetyenziswayo kwiqela elincinci kunye nezicwangciso zomntu ngamnye. Oko kuthetha ukuba amaxabiso ngamaqela amakhulu asenokuba kusekelwe kumava onke amabango eqela, kunye namazinga athatshelwe amaqela aphilileyo, kunye namazinga aphezulu angamaqela aphilileyo angaphantsi.
Ukubhekisela, "iqela elikhulu" lithetha ngokugqithiseleyo abasebenzi abangaphezu kwama-50, nangona kukho iindawo ezimbalwa apho kusebenza khona kumaqela anabasebenzi abangaphezu kwe-100 .
I-Issue Guaranteed ngaphandle kwe-United States
Nangona i-Care Affordable Act yenza ukuba i-inshurensi yempilo e-United States ibe lula kakhulu kubantu abaneemeko esele ikhona ngaphambili, inemida yayo. Umthetho ononophelo loNonophelo ochaphazelekayo kuphela uthintela i-inshorensi yempilo e-United States. Amazwe angaphandle kwe-United States anemithetho eyahlukileyo yokulawula ukuthengiswa kwe-inshorensi yempilo.
> Imithombo:
> Isebe Lempilo Neenkonzo Zoluntu, i-Ofisi yoNcedisi uNobhala weCwangciso noVavanyo. Impembelelo yoMgaqo wokuFikelela kwiMpilo ye-Intshumo yezeMashishini ye-Arhente, iNkcazo eqinisekisiweyo nokuvuselelwa. Oktobha 20, 2000.
> I-Institution Research Benefit Institute. Izicwangciso Zempilo Ezizimeleyo: Iimpawu Zangoku ziFakela ngamandla, 1996-2015 . Julayi 2016; I-Vol 37, uNombolo 7.
> HealthCare.gov. Funda uMthetho woNonophelo ongenakunceda.
> Kaiser Family Foundation. Inguqu yeeNtsholongwane yezeMshuwalense yezeMpilo: Ingxaki eqinisekisiwe . Juni 2012.