ACA help (MD) - how to answer income questions

[eyeonFI]

I'm trying to get insurance on the MD State exchange. When I "shopped" (i.e. did not log on), I put in an estimated 2016 income of $29k and it said my kids would qualify for MD's CHIP (i.e., medicaid for kids) and I would get a $187/mo subsidy. This is what I want. So then I logged in and went through the whole process and answered the following questions:

2015 estimated income: $125,000
2016 estimated income: $29,000
currently employed: no
current month income: $0

It then told me that I and the kids were each eligible for either medicaid (effective immediately) OR an eligible plan with NO financial aid for 2016.

It asked me to upload documentation of income and so far I uploaded a letter from my employer that says I am on an unpaid leave of absence from Aug 2015 - June 2016, gives my last day on payroll, and says I lost the employer health insurance on that day. (I am planning to officially retire next June, so I will not actually return from the unpaid leave, and plan to have no earned income in 2016). The document is listed on the site as "provided", which I think means it uploaded successfully but no one has looked at it.

Does anyone have any suggestions for what I might do to get the system to offer the kids CHIP and me a subsidy?

I'm guessing maybe the unemployed/$0 current month income triggered the eligibility for medicaid, which in turn made me ineligible for a subsidy regardless of my estimated 2016 income? If this is the case, should I say my current month income is $29k/12? But then I'm not sure how I would document that. My plan for next year is to get about $20k in dividends/interest and do Roth conversions at the end of the year to get the income up to about $29k. So this income will be lumpy and vary a lot from month to month.

For the moment, I selected medicaid for the kids and the eligible plan with NO aid for me - if I leave this in effect will I be able to get paid back the subsidy for myself when it comes time to file 2016 taxes?

Or, if I go back in and try to put us all on medicaid (and assuming they eventually approve the documentation), would I then be penalized somehow if I generate too much income next year?



Any suggestions appreciated....

Thanks.

 

[Ian S]

I think your problem is your input of zero for current month income. IMHO, you need to divvy up your projected income to a monthly amount and use that. The screeners are not knowledgeable enough to to deal with the complexity of lumpy income. If they ask for more details, perhaps you can provide your most recent tax return (just the 1040 itself) to show dividends/interest then state you will draw $xx from an IRA - which is in effect what you are doing with a Roth conversion. Don't try to explain the latter!

 

[Fermion]

+1 to what Ian said.

They want monthly income. They have no concept of the ability to save money. They figure if you received $100,000 bonus for leaving your job in March you will have spent it all by April.

 

[bingybear]

You may want to be careful with your kids on medicade. It is quite possible that they may want to see all your assets, not just income for that.

if you lost your health insurance several months ago, you may get penalized at tax time for not having insurance.

I in a similar situation as you, but am doing cobra right now. I will end up with just divy and capital gains after this year (only worked Jan - feb this year). I would document your divies for this year to be representative for next year and document that you have do not expect to return to work. If they ask for a monthly income, divide your expected annual income by 12. It is the annual that will be used on taxes.
Are you sure you want your kids on medicaid? Usually the doctors that accept it are few.

 

[jim584672]

The law for ACA subsidies is based on a calendar year while Medicaid law is based on the current month. This creates odd situations sometimes.

 

[eyeonFI]

Thanks for the replies...I just finished going back through the application a second time. Since it specifically asked for "current" month income, I had been hesitant to put in my annual total/12. But this time I found a box to check that I have "other" income. I did not check it before because the examples listed were things not relevant to me like alimony. But once I checked the box it gave a longer list of options, including investment income, and it let me put in annual amounts. Then the system converted my annual amounts into a "current" monthly amount. This resulted in my expected outcome of kids getting CHIP and me getting a big subsidy. And I don't feel like I really misrepresented my "current month" income, since it let me specify it as annual.

I uploaded my employer letter, my 2014 form 1040, and a statement explaining my $29k estimate and referencing the other 2 documents. Now I guess I just wait and see what happens....

You may want to be careful with your kids on medicade. It is quite possible that they may want to see all your assets, not just income for that.

if you lost your health insurance several months ago, you may get penalized at tax time for not having insurance.

I in a similar situation as you, but am doing cobra right now. I will end up with just divy and capital gains after this year (only worked Jan - feb this year). I would document your divies for this year to be representative for next year and document that you have do not expect to return to work. If they ask for a monthly income, divide your expected annual income by 12. It is the annual that will be used on taxes.
Are you sure you want your kids on medicaid? Usually the doctors that accept it are few.

I thought the asset test went away with the ACA medicaid expansion? There were no questions about assets on the website....

I bought private policies to cover us for the last few months of the year, so we have not been without insurance at all.

RE: kids on medicaid, I did check that their current pediatrician and the nearest hospital take it. And there are several hundred other physicians that accept it within 20 miles of us, so I am hopeful it will be OK.

 

[spncity]

1. [PDF]Affidavit of Current Income - Maryland Health Connection
   
   https://www.marylandhealthconnection.gov/.../Affidavit_Current_Incom...
   Page 1. AFFIDAVIT OF CURRENT INCOME.

Downloads a form. Don't know if this is what is needed? If your income is not zero, just put the explanation down.

 

[eyeonFI]

1. [PDF]Affidavit of Current Income - Maryland Health Connection
   
   https://www.marylandhealthconnection.gov/.../Affidavit_Current_Incom...
   Page 1. AFFIDAVIT OF CURRENT INCOME.

Downloads a form. Don't know if this is what is needed? If your income is not zero, just put the explanation down.

Thanks! Looks like it is specifically for zero income, but maybe I will modify it to explain investment income.

 

[spncity]

Thanks! Looks like it is specifically for zero income, but maybe I will modify it to explain investment income.

Since I posted that, I have confirmed that it does work for explaining income, not just zero income.

If you click in the right area, you can type on it and save it as a pdf for submission.


Kindest regards.

 

[spncity]

Since I posted that, I have confirmed that it does work for explaining income, not just zero income.

Well, I guess the affadavit qualifies as the first step. I've gotten "the letter" that now asks for documentation to confirm income.

As last year's and this year's income amounts have no bearing on 2016 income, I'd rather only submit the withdrawal plan for the coming calendar year (from pre-tax retirement account(s). How to do this?

Suggestions solicited.

 

[Fermion]

I put our investment distributions in an Excel spreadsheet and made it look all official with monthly and annual totals. I submitted that.

 

[eyeonFI]

I've gotten "the letter" that now asks for documentation to confirm income.

As last year's and this year's income amounts have no bearing on 2016 income, I'd rather only submit the withdrawal plan for the coming calendar year (from pre-tax retirement account(s). How to do this?

Suggestions solicited.

Hi spncity,
If you don't mind my asking, what does "the letter" say? I can't actually tell if I've gotten "the letter" or not. The same day I re-did the application and uploaded my documents I got an "eligibility re-determination notice."

For each of my kids it says:
"Eligibility is pending due to outstanding verifications. If you do
not respond or cannot confirm the information requested, you
and/or other members of your household may be determined
ineligible or your coverage may end."

But for me, it does not say that. It says how much subsidy I will get based on my application and that it may be higher or lower if my income is different, etc.

Then at the bottom of the notice, not clearly referring to any particular individual, it says, "If you receive the Additional Verification Required notice, you must respond to confirm your eligibility."

The same day I got this "eligibility re-determination notice", I also got a "successful enrollment notice", but that letter refers only to me and not to my kids. It confirms the plan I chose for myself and says I can expect to be contacted by the insurer.

My status shows as "initiated" and my kids both show as "enrollment pending".

So I'm not clear if I am supposed to provide more/different documentation at this point, or if they have not yet decided whether they want different documentation, or what.

The documents I up-loaded were my 2014 form 1040 (to show dividend/interest income), a letter from my employer stating my last day on payroll, and a letter I wrote referring to both of those and explaining that I planned on taking an IRA withdrawal in addition to the dividend/interest income. After you pointed me to the affidavit, I decided to wait and see if they want something in addition to what I already submitted and if so then maybe try the affidavit + a more detailed outline of expected income.

 

[spncity]

Well, it's a good thing we live in a "paperless" society...

I have now received four envelopes from Maryland Health Connection and a bill from the insurer with whom we signed up. Here are some snippets from the Maryland Health Connection letters:

1. Subject - Decision About Your Health Coverage (Based on the information provided in your application, the following household members are eligible for certain health coverage programs and have selected a program.) We are both named.

2. Subject - Additional Verification Required (We are unable to confirm certain information in your application. You must provide documentation for the verification(s) listed below so that we may confirm your and/or a member of your household's eligibility). Only DH is named. Also enclosed in this same envelope: Subject - Special Enrollment Qualification (to let me know that I and/or someone in my household can enroll between 11/1/2015 and 1/31/2016.) These dates are in error. The should both be a month later.

3. Subject - Change Reporting/Final Determination for healthcare Coverage (Based on the information in your application, the following household members may be eligible for certain health programs and must select a program to begin their coverage.) We are listed as Denied Individuals on one page and given instructions for appealing "and" - to be completely confusing - it includes a form that says we are eligible for financial assistance.

4. Subject - Additional Verification Required (This says the same as #2 above, but now we are each listed "twice" as needing income verification.)

I wish us all luck.

Those who are in the know - we will welcome your continued comments.

Kindest regards.

 

[spncity]

About this list....

Well, it's a good thing we live in a "paperless" society...

I have now received four envelopes from Maryland Health Connection and a bill from the insurer with whom we signed up. Here are some snippets from the Maryland Health Connection letters:

1. Subject - Decision About Your Health Coverage (Based on the information provided in your application, the following household members are eligible for certain health coverage programs and have selected a program.) We are both named.

2. Subject - Additional Verification Required (We are unable to confirm certain information in your application. You must provide documentation for the verification(s) listed below so that we may confirm your and/or a member of your household's eligibility). Only DH is named. Also enclosed in this same envelope: Subject - Special Enrollment Qualification (to let me know that I and/or someone in my household can enroll between 11/1/2015 and 1/31/2016.) These dates are in error. The should both be a month later.

3. Subject - Change Reporting/Final Determination for healthcare Coverage (Based on the information in your application, the following household members may be eligible for certain health programs and must select a program to begin their coverage.) We are listed as Denied Individuals on one page and given instructions for appealing "and" - to be completely confusing - it includes a form that says we are eligible for financial assistance.

4. Subject - Additional Verification Required (This says the same as #2 above, but now we are each listed "twice" as needing income verification.)

I wish us all luck.

Those who are in the know - we will welcome your continued comments.

Kindest regards.

Good news. During a phone call, they were able to confirm that all of the above notices were generated before the broker uploaded our income affidavits. Looks like we are good. At least I hope so.

Sorry for any confusion I may have contributed to.

I have also changed to "email" notifications instead of snail mail notifications.

Kindest regards.

 

[eyeonFI]

Hi spncity,

My status shows as "initiated" and my kids both show as "enrollment pending".

So I'm not clear if I am supposed to provide more/different documentation at this point, or if they have not yet decided whether they want different documentation, or what.

The documents I up-loaded were my 2014 form 1040 (to show dividend/interest income), a letter from my employer stating my last day on payroll, and a letter I wrote referring to both of those and explaining that I planned on taking an IRA withdrawal in addition to the dividend/interest income. After you pointed me to the affidavit, I decided to wait and see if they want something in addition to what I already submitted and if so then maybe try the affidavit + a more detailed outline of expected income.

Just thought I'd update this in case the thread is relevant to any other MD folks. I just got off the phone with the MD Health Exchange call center. They said that my status of "initiated" means basically that my app is through their approval process and now I need to deal with the insurance company. I did get a new ID card from carefirst, so it seems all is probably OK. Just have to wait and see if the January bill includes the subsidy or not I guess.

For the kids, they are still "enrollment pending" and this means that they have not verified the documents yet (WTF? I uploaded one set of documents for all of us...). She put me on hold and checked, then said that the 1040 form I uploaded "should" be enough, and she "escalated" my application to the verification department. After they verify it then they will need to process it through the medicaid system and then they will mail out cards and paperwork. Supposedly, this should happen in the next couple weeks and she said the coverage will then be effective as of December 1 (the system says Jan 1. hmm.).

So I'm trying to decide if I should believe this is going to go through now, or if I should pay the January premiums for the private policies I've had the kids on for the last few months...I specifically asked her if I should buy my kids insurance for January, and she said no, their medicaid coverage would be in effect (even though I won't have cards or enrollment documents for them yet).


Oh and just one last FYI in case anyone needs to call the MD exchange: I called at 8am, when it opens. The message that came on told me they have high call volumes and calling back between 3-5pm would be better. I made my way through the menus anyway, and my call was then answered immediately. So the "high call volume" is maybe just a standard message regardless of the actual call volume.