Kevin Knauss: Health, History, Travel, Insurance
Posts related to calculating the Premium Tax Credit received through Covered California, subsidy, form 8962, MAGI household income.
Anyone who did not have health insurance for a period of more than three months during 2014 will have to pay a penalty on their IRS federal tax return. This penalty is also known as Affordable Care Act Shared Responsibility Payment. The ACA has given taxpayers who went without having health insurance for a period during […]
One of the confusing aspects of the Affordable Care Act is the interchangeable tax terms people use when defining a household. The federal and state exchanges use the terms children or dependents when describing members of a household. The IRS uses the more accurate, but confusing terminology, of personal exemptions as the true test for […]
Ms. B had been faithfully making her premium payments for her Kaiser health plan she purchased through Covered California during open enrollment in 2014. When she went to use her health plan, Kaiser told her that the plan was not active. But the enrollment summary of her Covered California account shows she is enrolled. It […]
Covered California and the IRS have been encouraging individuals and families that have purchased health insurance through the state or federal exchange to update their household income whenever there is a change. The simple act of reporting this change of income through Covered California is considered a qualifying event for a Special Enrollment Period. Once […]
The IRS has released drafts of the tax forms that will be used to reconcile the amount of Advance Premium Tax Credit (APTC) received from an insurance exchange against how much the individual or family was entitled to based on their modified adjusted gross income. The various components used to determine the APTC (income, household size, dependents, employer sponsored insurance, […]
Different interpretations of monthly verses annual income estimates on the part of Covered California and county Medi-Cal administrators have the potential to leave many Californians who are drawing unemployment benefits without any health insurance. At least one person has been denied the ability to purchase a private health plan with ACA tax credits while being simultaneously excluded enrollment in the ACA expanded Medi-Cal health plan. The conflicting interpretations can leave many people ineligible for either ACA tax credits or Medi-Cal.
Individuals and families who have enrolled in health plans through Healthcare.gov, or a state exchange like Covered California face new challenges as they report income and household changes. Families reporting changes to household size and income may also be triggering changes to their health plan. These changes may result in the entire family becoming eligible for Medicaid, being shifted into a different Enhanced Silver plan or losing the Advance Premium Tax Credit all together.
In what has become routine for Covered California, they alerted agents to another CalHEERS enrollment website problem late on a Friday afternoon. The latest email notified agents that the system has been calculating the wrong Advance Premium Tax Credit (APTC) on submitted applications. While the Covered California email blast wasn’t real specific, it sounds like the APTC number is wrong when the applicant confirms the health plan purchase, but correct in the “Eligibility Results” page.
In an effort to dull the impact of the bad news, Covered California released a statement late on a Friday afternoon detailing how many applications were effected by the previous week’s crash of their website. Covered California estimated that 14,500 applications that were started before the CalHEERS enrollment website went dead for five days may have to be resubmitted. Agents and consumers that started applications on February 17, 18, and 19, while the site was functioning but experiencing problems, before it completely crashed on the 20th may need to resubmit or start a whole new health plan application.
With more working Americans eligible for expanded Medicaid health insurance there is also a growing fear that some government agency will want to seize a recipient’s assets to pay for the health care expenses. Fortunately, the expanded Medicaid, Medi-Cal in California, works under slightly different rules and provides some protection against “claw back” of assets to satisfy health care debt. However, one age group may be subject to Medi-Cal estate recovery rules under expanded Medicaid.
