As we all know, the world of healthcare can be confusing to navigate. But don’t worry, we’ve got you covered.

Check out our glossary of Affordable Care Act terms. It will help you understand the lingo surrounding the ACA so you can make informed decisions.

Accountable Care Organizations

The network of doctors, physicians, and hospitals that fall under the ACA. These organizations strive to live out the mission of the ACA: “to provide affordable, quality health care for all Americans and reduce the growth in health care spending.”

Bundled Payment

A part of Medicare and Medicaid that serves as payment for doctors to treat various ailments and illnesses.

Cadillac Tax

A tax that will take effect in 2020. This tax is mainly for employers – it allocates a 40% tax on any healthcare coverage that extends above $10,200 for individuals and $27,500 for families. Although you’ve got a few years, you may want to make a Post-It note for this one.

Community Rating

Have existing medical conditions or health problems? Don’t worry about those premiums. You can’t be charged additional premiums because of it thanks to the ACA. This term ensures that the price of coverage can only be changed based on how many people you cover (e.g. if you have dependents), if you use tobacco, and your age.

Defined Contribution Health Plans

These types of healthcare plans allow you as an employer to contribute a certain amount of money towards your employees’ healthcare. These contributions can be used to offset premiums.

Employer Mandate

This stipulates that employers must offer health coverage to their employees. For businesses that have 50 or more full-time workers, you must pay at least $2,160 for healthcare for every employee after 30 (e.g. the 31^st hired employee, then the 32^nd, etc.). For the healthcare provided, employers must pass the ACA’s affordability test – essentially that an employee should not have to pay over 9.5% of their income for their insurance.

Forms 1094 and 1095

These forms require insurers (e.g. employers) to provide the information of their health coverage to those that are covered (e.g. employees).

Full-Time Employee

Any employee that works 30 hours or more each week.

Individual Membership Associations

These associations allow civic groups to receive group coverage. Civic groups include church groups, Toastmasters, etc. In general, civic groups are groups that come together through volunteer work to improve the surrounding communities.

Preventive Services

Essentially, being proactive when it comes to your healthcare. The usual: going to get screenings and vaccinations, getting your blood pressure checked, etc. You know, all the things you need to do to be ready for the zombie apocalypse. 😉

Waiting Period

The time that someone must wait for their healthcare coverage to go into effect after gaining employment or submitting a health insurance application. 

Variable Hour Employee

Similar to how it sounds, it is an employee that works an unset amount of hours per week – sometimes it can be under 30 hours, and sometimes it can be over 30 hours.