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ACA subsidy calculation wrong (SLCSP bogus)?
Old 10-29-2015, 12:10 AM   #1
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ACA subsidy calculation wrong (SLCSP bogus)?

Is anyone else seeing subsidies being calculated incorrectly because of a bogus second-lowest-cost silver plan? In my case, both the state website and the actual insurance provider's site are both pricing the policies identically, but then they appear to be using a SLCSP value that is way too low -- like by a factor of 2, or $300/mo less.

I'm looking at SLCSPs for 2015 (readily available through last month, since they have to be, since you need them to file your return) and they are all basically about the same for my family size and location. The silver plans being served up for 2016 are about 10% higher across the board, which is what I expected for Colorado. But for some reason the SLCSP value being used under the hood seems wrong, or I'm misunderstanding something.

I realize the sites are not official yet, and I'm sure there are tons of bugs. But this one seems weird, and when I called the insurer they didn't know, either.

Anybody else observing this?

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Old 10-29-2015, 05:12 AM   #2
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Yes, we've been discussing this in another topic -

2015-16 Healthcare Premiums to be released Sunday

Check the posts by me or rbmrtn, specifically post #88.

From the link he posted it looks like if your 2nd lowest cost silver plan is adjusted to account for a portion being benefits that are non essential (in our case vision and dental) then your subsidy is affected.

In our area the SLCSP is identical to the lowest cost silver plan except for the vision and dental coverage for an additional $77. So that $77 doesn't count in the subsidy calculation. So for us the "benchmark" is now the lowest cost silver plan. Not good.

Married, both 61. DH retired June, 2010. I have a pleasant little part time job.
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Old 10-29-2015, 06:29 AM   #3
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$300 or factor of 2 seems extreme. The only diff between the 2nd and 1st LCSPs for my location is the deductible is lower and the copay/coins is slightly different. Neither one has add on benefits ( vision,dental). Mine is only off a few $, not the numbers you are seeing.

Also this has been there from the beginning, I don't why it would just now show up. Seems you need the EHB portion of a premium for the SLCSP and the plan you choose in order to calculate the tax credit. The issuer should know as they are the ones to report it.
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Old 10-29-2015, 06:42 AM   #4
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My insurance broker here in Colorado told me yesterday that that the exchange is having problems getting the subsidy calculations right.
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Old 10-29-2015, 10:24 AM   #5
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Ah, okay, thanks guys. It looks to me like they just need a working SLCSP lookup table; they're getting the cost-sharing subsidy correct and showing me the higher actuarial value plans.
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