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Old 10-27-2015, 04:20 PM   #81
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In some localities, I get the correct after subsidy premium using the 2016 income percentages (8.18% for 250% FPL) for the SLCSP. In other localities, I only match the Healthcare.gov "preview" using the LOWEST Silver premium.

My calculations for Individual: $11,770 (FPL) * 250% = $29,425
$29425*8.18% = $2,406.97 annual premium or $200.58 per month rounded to $201.

For some localities, the SLCSP is $200-$201 but in others it's the lowest Silver plan listed at that premium.
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My hand calc also seems to match the LOWEST cost silver plan.( still a little off but not much ) for my location.
Yes, that's what I'm seeing too. In my case the lowest cost silver plan is the same plan (same provider, same deductible and copays) as the second lowest, except that the second lowest includes dental and vision coverage which I'm sure is not part of the essential benefits.

So using the second lowest cost silver plan and eliminating the non-essential dental and vision component means that our subsidy is based on the lowest cost plan. That right there costs us $77/mo.

Just shaking my head at how this is all panning out for this year for us.
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Old 10-27-2015, 06:22 PM   #82
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When I was contemplating retirement I checked into individual plans and our COBRA. At the time (4 years ago) our COBRA was $900/month and individual insurance was about the same (in both cases... for a couple).

At the time I viewed the $900/month as just part of the price of freedom. Luckily I was able to find more affordable coverage.... and while DW sometimes laments at the cost of health insurance I simply view it as part of the price of freedom... well worth it.
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Old 10-28-2015, 03:21 PM   #83
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www.HealthSherpa.com is now updated for the 2016 plans. There is a nice new feature where you can tell it your provider and it will only search for plans that include that provider.

Also, for those of us questioning the healthcare.gov subsidy formula earlier in this topic, HealthSherpa has what I hope is the correct subsidy.

I'll keep my fingers crossed that HealthSherpa is right and HealthCare.gov is wrong.
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Old 10-28-2015, 04:03 PM   #84
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Is anyone have a similar issue like this ? Our son (22 yrs old) is still trying to find himself and will not be attending college in 2016. He lives with us and works 30-35 hrs. per week but does not earn the minimum salary (16,200) to go thru the exchange. Is his only alternative medicaid? Open Market?

I put his particulars in the sherpa site and plans came up showing $0 annual premium. This can't be correct?
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Old 10-28-2015, 04:13 PM   #85
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Is anyone have a similar issue like this ? Our son (22 yrs old) is still trying to find himself and will not be attending college in 2016. He lives with us and works 30-35 hrs. per week but does not earn the minimum salary (16,200) to go thru the exchange. Is his only alternative medicaid? Open Market?

I put his particulars in the sherpa site and plans came up showing $0 annual premium. This can't be correct?
It depends on their own dependent status in some cases, and whether or not you can cover them under your own policy until age 26:

https://www.healthcare.gov/young-adu...dren-under-26/
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Old 10-28-2015, 04:16 PM   #86
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It depends on their own dependent status in some cases, and whether or not you can cover them under your own policy until age 26:

https://www.healthcare.gov/young-adu...dren-under-26/
+1

If you can't cover him on your policy, or choose not to, Illinois is a Medicaid expansion state, so he would be eligible for Medicaid.
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2015-16 Healthcare Premiums to be released Sunday
Old 10-28-2015, 04:22 PM   #87
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2015-16 Healthcare Premiums to be released Sunday

Probably need to research what Ziggy said also... I had a similar situation that includes part yours and part Ziggys. Daughter decided to drop out of college this year less than 20 credits short... So she is on her own. She was on her mothers insurance paid by me. Premium was going to shoot up considerably since she wasnt in college anymore. We found out she doesn't have to be on parents plan since she is now going to be independent. We got her registered to be able to sign up for Jan. after present insurance expires. She would have paid $5.62 for a zero deductible $1500 max OP. Probably wont be much higher when January rolls around. We signed her up as making $18k a year.
From what I have read you can estimate salary for following year. If you make LESS you do not have to reimburse the tax credit. Several sources sited this but here is one. Your individual state may matter on this though.
Tax credits are offered based on your projected household income as compared to the Federal Poverty Level. If your income ends up being lower at the end of the year, you won't have to pay back tax. If you take tax credits you'll have to file taxes for the year you take them. You'll need to file form 8962 to adjust your premium tax credits. If you make more than expected you may owe back tax credits.
http://obamacarefacts.com/questions/...for-obamacare/



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Old 10-28-2015, 08:54 PM   #88
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Originally Posted by Sue J View Post

Also, for those of us questioning the healthcare.gov subsidy formula earlier in this topic, HealthSherpa has what I hope is the correct subsidy.

I'll keep my fingers crossed that HealthSherpa is right and HealthCare.gov is wrong.
I did find the basis for what was referenced earlier , in 26CFR1.36B-3

https://www.law.cornell.edu/cfr/text/26/1.36B-3

(j) Additional benefits
(1) In general. If a qualified health plan offers benefits in addition to the essential health benefits a qualified health plan must provide under section 1302 of the Affordable Care Act (42 U.S.C. 18022), or a State requires a qualified health plan to cover benefits in addition to these essential health benefits, the portion of the premium for the plan properly allocable to the additional benefits is excluded from the monthly premiums under paragraph (d)(1) or (d)(2) of this section.


My SLCSP doesn't have non-EHBs ( that I can see ) so don't know why it did not match for 2016. But this might explain your issue.
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Old 10-29-2015, 08:01 AM   #89
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I'll keep my fingers crossed that HealthSherpa is right and HealthCare.gov is wrong.
Sue J, thanks for sharing this site. In a trial run, I got 4.54% more subsidy in Sherpa (than Healthcare.gov) for my doctor. I wonder why there is a subsidy difference.
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Old 10-29-2015, 08:29 AM   #90
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I played around with the updated Healthsherpa plans and cant believe how much age is a factor. My 3 person family plan will be $680 per month next yr. If we were 5 yrs older it would be $880. Do people really use 30% more healthcare when only 5 yrs older?
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Old 10-29-2015, 08:42 AM   #91
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I played around with the updated Healthsherpa plans and cant believe how much age is a factor. My 3 person family plan will be $680 per month next yr. If we were 5 yrs older it would be $880. Do people really use 30% more healthcare when only 5 yrs older?
The age factor is 3X between age 26 through age 65. That works out to around 3% per year.
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Old 10-29-2015, 09:42 AM   #92
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The age factor is 3X between age 26 through age 65. That works out to around 3% per year.
It obviously escalates as age progresses then.
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Old 10-29-2015, 11:04 AM   #93
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It obviously escalates as age progresses then.
The graph is based on SLCSP data for my locality. It is comparable to what I've seen for the specific plan we had in 2015, with a spike at ages 26-30. From age 40 to 60 they persist. Good news is that they appear to decline after age 60, but with the combined effects of annual premium hikes and compounding of age increases - well, I'm preaching to the choir here.
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Old 10-29-2015, 01:59 PM   #94
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www.HealthSherpa.com is now updated for the 2016 plans. There is a nice new feature where you can tell it your provider and it will only search for plans that include that provider.

Also, for those of us questioning the healthcare.gov subsidy formula earlier in this topic, HealthSherpa has what I hope is the correct subsidy.

I'll keep my fingers crossed that HealthSherpa is right and HealthCare.gov is wrong.
I think you are right their numbers look more believable to me too.
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