Sue and Bob received $3,840 in excess Advance Premium Tax Credit for the year. Because their final income is over 400 percent of the federal poverty level, they must repay all the excess health insurance subsidy.
Posts related to the California Premium Subsidy, which is a health insurance subsidy targeted on income of 400% - 600%.
Why Your Covered California Health Insurance Subsidy Dramatically Drops with an Income Increase
When the income estimate was increased in their Covered California application, the subsidy was properly calculated for the remainder of the plan year. The first thing Sandi and Thom notice is that they lost the Silver 87 plan and with the higher income are now only offered a Silver 70. Another disturbing problem for them is that instead of $336.57 monthly premium, their new premium for the Silver 70 is $657.31. They went from paying $16 a month for a great Silver 87 plan to $658 per month for Silver plan that has higher copays, coinsurance, and deductibles.
Tax Credit or Repayment? Health Insurance Subsidies for 2022
Lines 24 through 26 of Part II of form 8962 determine if the household is eligible for an additional Premium Tax Credit. In this situation, the final household MAGI was slightly lower than estimated income amount of the Covered California application. The result is that the household is eligible for an additional $23 in Premium Tax Credit. They were eligible for an annual subsidy of $16,832, but only received $16,809.
Relief for Crippling Employer Health Insurance Premiums – Covered California
The subsidy benefit for families burdened with crippling employer group health insurance premiums can be enormous. Unfortunately, acquiring the necessary employer information and calculating the affordability percentage can be daunting for some families. However, Covered California has created some worksheets and tools to help in the process.
Did Your Covered California Subsidy Suddenly Vanish?
In this particular case, the user ID of System-CW-San Diego alerted us that a case worker at San Diego County Medi-Cal had reviewed the application. I cannot say that the case worker changed the tax filing status. There are instances when the Medi-Cal system does not properly mesh with the Covered California CalHEERS software. There are times when conditional information is just erased or changed because of an incompatibility with the data fields.
Blue Shield PPO Covered California Rate Increase 2022 vs 2023
Where households realize a dramatic increase in Blue Shield PPO Covered California premiums is when the SLCSP has a small increase or negative rate change. Consumers in regions 2, 3, 4, 6, 7, 15, 16 and 18, where the SLCSP rate increases were in the low single digits will see a smaller subsidy. In other words, the Blue Shield PPO plan rate increases in those areas was greater than the SLCSP that the subsidy is based upon. The subsidy did not keep pace with the Blue Shield PPO rate increase like they did in regions 1 and 10.
Will Your Covered California Premiums Increase Next Year?
Of course, if the annual premium for the second lowest cost Silver plan increases more than the other plans, it increases the subsidy for all consumers. In this example, the consumer would see monthly premiums for most plans below the 2022 levels. However, the second lowest cost Silver plan would have no increase from 2022 to 2023, even with the larger annual unsubsidized premium increase.
How To Adjust Your Covered California Subsidy
You are first offered the chance to adjust the APTC subsidy from 100 percent to a lower percentage when you first enroll in a Covered California health plan. After the enrollment has been completed you must fish around in your account to find the APTC slider. The APTC slider allows you to reduce or dial back how much of the monthly APTC subsidy you are receiving from 100 percent down to 0.
2021 California Health Insurance Premium Assistance Repayment
Fortunately, for most California taxpayers, the amount of the California premium assistance subsidy (CPAS) they received was relatively small. For some Covered California households who received large monthly amounts of the CPAS, the repayment could significantly add to their California income tax liability for 2021.
2021 IRS Health Plan Subsidy Calculation With Unemployment Insurance Benefit
Tom received unemployment insurance in 2021. Because of the unemployment insurance, Tom’s household income is 133 percent of the federal poverty level, regardless of his income. That 133 percent of the federal poverty level translates into $0 annual contribution for the second lowest cost Silver plan. Since the second lowest cost Silver plan premiums equaled $15,000 for the year that amount becomes the maximum subsidy allowed. Tom is eligible for an additional $2,318.40 ($15,000 – $12,681.40) in Premium Tax Credit because of the unemployment insurance benefit.
