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The Affordable Care Act and International Students/Scholars
Who We Are Susan-Ellis Dougherty
Director International Student/Scholar ServicesUniversity of Maryland
Karen Kline, RHIAManager, Student Health InsurancePennsylvania State University
Jennifer FrankelMarketing DirectorInternational Student Insurance
Who Are You?
Identify your state: Delaware, DC, Maryland, Pennsylvania, Virginia, West Virginia, Other
Identify your international population: F-1/J-1 students & scholars; F-1/J-1 students; F-1 students only; J-1 students only; J-1 scholars onlyIdentify your policy requirements: Mandatory for all students at institution; mandatory for all students at undergraduate level; mandatory for all international students; mandatory for all international undergraduates; mandatory but not enforced; no policy; currently being discussed
Whose insurance policy is ACA compliant? Yes; No; Don’t Know
Has your insurance policy changed since ACA implementation? Yes; No; Don’t Know
ACA Roadmap
What is the ACA? ACA and your international students
& scholars Student Coverage Options, Post –
ACA State Healthcare Exchange On Campus Implementation of the
ACA Panel Discussion
What Is It?
ACA, PPACA, Obamacare, Healthcare Reform
=
Patient Protection and Affordable Care Act
Uncertainty about International Students & Scholars
International students not high on the agenda
Primary concern with Americans in the US
50 million uninsured
End Result – certainty on the big questions
International Students Exempt from ACA
International students on F, M, Q and J visas are exempt as non-resident aliens for their first 5 calendar years in the US
IRS analysis based on resident vs. non-resident alien status
Once you become a resident alien, you must have ACA coverage or pay the penalty
J visa holders in non-student categories get a 2 year exemption
What are the legal obligations? Legal requirements to maintain
health insurance: J students still subject to State
Department requirements F students must maintain coverage as
required by their school
Student Coverage Options Student Group Plan – ACA Compliant Student Group Plan – ACA Exempt Individual Student Plans
Student Group Plans – ACA Compliant
Pros: Comprehensive coverage, can combine with domestic students, don’t have to worry about tax status
Cons: Out-of-pocket can be higher, not tailored to international needs, pre-ex covered from day one, expensive
Specific coverage requirements:• No annual or lifetime limits• Preventative care: no cost sharing• No pre-existing condition limitations
Student Group Plans – ACA Exempt
Pros: Tailored coverage to international student and scholars needs, less out of pocket, more affordable
Cons: Coverage isn’t as comprehensive, pre-existing conditions subject to waiting period, doesn’t cover wellness
Group plan exempt under the Short Term Limited Duration, 364 days or less with the option to renew
Individual Student Plans
Pros: Ease of administration, students like options, custom-crafted for international students, reasonably priced, low out-of-pocket expenses
Cons: Need to have control for sub-par plans (benefit concerns), administration and monitoring coverage, no point-person to contact
Most are not ACA compliant, and work for students who need an individual plan:
Schools with no group plans or waiver option
OPT, scholars, dependents, ESL, short-term programs
State Healthcare Exchanges
To what extend will international students be eligible for coverage? Students on valid visas are “lawfully present” Must be a “resident” of the state, inconsistent
with student visa Other requirements?
Will international students be eligible for subsidies? Some say no, some say perhaps Same residency issue
StaState Health Insurance Marketplace Decisions, 2014tpSource: Kaiser Family Foundationlace Decisions, 2014
Partnership Marketplace (7 states)State-based Marketplace (16 states and DC)
Federally-facilitated Marketplace (27 states)
WA
OR
WY
UT*
TX
SD
OK
ND
NM
NV NE
MT
LA
KS
ID
HI
CO CA
ARAZ
AK
WI
WV VA
TN SC
OH
NCMO
MS
MN
MI
KY
IA IN IL
GA
FL
AL
VT
PA
NY
NJ
NHMA
ME
CT
DE
RI
MD DC
* In Utah, the federal government will run the marketplace for individuals while the state will run the small business, or SHOP, marketplace.SOURCE: State Decisions For Creating Health Insurance Marketplaces, 2014, KFF State Health Facts: http://kff.org/health-reform/state-indicator/health-insurance-exchanges/.
The Pennsylvania State University Mandatory insurance requirement for all J1
and F1 visa holders and their dependents Graduate Assistants and Graduate Fellows
Offered medical, dental and vision benefits Subsidized by Penn State
Undergraduate and Graduate Students Offered medical benefits No subsidy
The Pennsylvania State University Waiver standards are based upon J1
visa requirements and ACA Original understanding per insurance
carrier was that if in US for more than 90 days had to have health insurance and meet the mandate
Allow J1 visa holders to meet visa mandates for insurance only if in US for 90 days or less
The Pennsylvania State University Reasons for Penn State’s waiver
requirements: Town and Gown Issue No Insurance or Underinsured J1 Visa Regulations ACA Regulations
University of Maryland College Park
ACA compliant plans offered by UMCP
Student health insurance Employee benefits plan as long as
the employee selects the prescription plan
University of Maryland College Park Who is insured?
All undergraduate students are covered by the University’s health policy
All students with assistantship Some scholars are covered by
employee benefits plans; all scholars are eligible to enroll in the student health plan
All faculty are offered the employee benefits
University of Maryland College Park What part of the community is
required to find their own policy?
Graduate students without assistantship
J-1 scholars that are self-funded
University of Maryland College Park What are we doing on campus?
UM educates the employees and the scholars on ACA requirements. HR is the primary communicator to employees. ISSS is the primary communicator to self-support J-1 scholars.
The individual mandate in the ACA is not applied to international students and scholars until they become RA for tax purposes.
Questions? Susan-Ellis Dougherty
University of Maryland [email protected]
Karen KlinePennsylvania State [email protected]
Jennifer FrankelInternational Student [email protected]
