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aca max reimbursement
Old 04-09-2015, 04:00 PM   #1
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aca max reimbursement

In filling out the aca tax form there is a maximum amount you are required to reimburse the irs for any premium credit you received. Not that I am suggesting anything dishonest but if you grossly underestimated your income and the amount that you should reimburse is more than the maximum amount on line 28, that would be to your advantage. Am I missing something?
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Old 04-10-2015, 07:52 AM   #2
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It depends on your 2012 actual income and your 2014 estimated/actual income. You estimated your 2014 income when you enrolled in an ACA marketplace plan.

Individual Plan, non-Medicaid Expansion state, Scenario #1:
2012 Actual Income: $15k
2014 Income Estimate: $15k
2014 Actual Income: $22.5k (<200% FPL)
Premium Subsidy repayment capped at $300 (individual)

Individual Plan, non-Medicaid Expansion state, Scenario #2:
2012 Actual Income: $15k
2014 Income Estimate: $15k
2014 Actual Income: $47k
Entire premium subsidy must be repaid since actual income > 400% FPL.

Individual Plan, non-Medicaid Expansion state, Scenario #3:
2012 Actual Income: $20k
2014 Income Estimate: $15k
2014 Actual Income: $22.5k
Your ACA application in early 2014 would have been flagged for review and additional documentation since the 2014 estimate is more than 10% different than the 2012 actual income on file.
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Old 04-10-2015, 08:04 AM   #3
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Quote:
Originally Posted by mn54 View Post
In filling out the aca tax form there is a maximum amount you are required to reimburse the irs for any premium credit you received. Not that I am suggesting anything dishonest but if you grossly underestimated your income and the amount that you should reimburse is more than the maximum amount on line 28, that would be to your advantage. Am I missing something?
That's it. Here's a Kaiser Health paper on reconciliation and repayment https://kaiserfamilyfoundation.files...13/01/8154.pdf

I would only add that not only you underestimate your income. The state exchange validates and accepts your estimate as well.
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Old 04-10-2015, 08:20 AM   #4
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MichaelB, the document you linked to is dated February 2011, and the premium subsidy repayment caps listed in Table 1 are now outdated. The final version can be found here:

Understanding the Affordable Care Act (ACA) Subsidies

Quote:
Income Range Repayment Cap
< 200% FPL $600 ($300 individual)
200% to 300% FPL $1,500 ($750 individual)
300% to 400% FPL $2,500 ($1,250 individual)
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Old 04-10-2015, 08:24 AM   #5
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Got it, thanks. I'll update the FAQ.

Here's another Kaiser link that explains the recomciliation process, beginning on page 7 https://kaiserhealthnews.files.wordp...um-credits.pdf
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Old 04-10-2015, 08:26 AM   #6
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That happened to me this year. Decided taking the capped penalty was better than adding more to my IRA to reduce my income. However, when I efiled, my monthly premium was almost instantaneously raised and I had an increased amount to pay for the very next month. They cancel your policy and you have to pick a new one on the exchange (same policy number however). Things worked out OK and I am happy with the situation.


PS Saver's credit wiped out my penalty.
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