Healthcare.gov -Anyone enrolled with subsidy yet?

[John Galt III]

Quote:

Originally Posted by Rpharmer ................... If you realized last year that 2012 1040's would be the "benchmark" and set your MAGI accordingly then, it appears that you're good to go.

I'm concerned about this 2012 "benchmarK" (latest tax return on file). My 2013 and 2014 income will be much lower than my 2012 "benchmark".

In a chat session on HC.gov, I was assured that any tax credit and subsidy would be based on 2014 estimated income. I don't have much faith in the chat session answer, though. Anyone else have the big drop in income from 2012 to 2014 ? What is your understanding of how it affects us?

Thanks, and good luck in your PPACA foray.

[rbmrtn]

Quote:

Originally Posted by audreyh1 Does your son pay taxes? Then the IRS already has a this info. They just don't know what medical insurance he has or what his income might be next year. But they will find that out soon enough anyway.

You give the same info to a Credit card app or a mortgage etc. I didn't enter anything that they didn't already have ( most of it probably public already ). They just verify who you claim to be.

[rbmrtn]

Quote:

Originally Posted by John Galt III I'm concerned about this 2012 "benchmarK" (latest tax return on file). My 2013 and 2014 income will be much lower than my 2012 "benchmark". In a chat session on HC.gov, I was assured that any tax credit and subsidy would be based on 2014 estimated income. I don't have much faith in the chat session answer, though. Anyone else have the big drop in income from 2012 to 2014 ? What is your understanding of how it affects us? Thanks, and good luck in your PPACA foray.

2014 income is what was asked for when I signed up, I think it asked a question if 2014 had changed substantially from 2012.

ACA Subsidies: Determined by Projected 2014 Income? - Medicoverage.com

[mf15]

That is what I keep telling him, the govt already has just about any and all info.
But he believes the govt knows whey too much about everyone.
OM

[MichaelB]

Quote:

Originally Posted by John Galt III In a chat session on HC.gov, I was assured that any tax credit and subsidy would be based on 2014 estimated income. I don't have much faith in the chat session answer, though. Anyone else have the big drop in income from 2012 to 2014 ? What is your understanding of how it affects us?

Here's what the CMS says http://www.healthreformgps.org/wp-co...cation-8-6.pdf

Quote:

The applicant’s inputted projected annual household income is then compared with information available from the Internal Revenue Service (IRS) and Social Security Administration (SSA). If the data submitted as part of the application cannot be verified using IRS and SSA data, then the information is compared with wage information from employers provided by Equifax. If Equifax data does not substantiate the inputted information, the Marketplace will request an explanation or additional documentation to substantiate the applicant’s household income. When documentation is requested, the Affordable Care Act and implementing regulations specify that if the applicant meets all other eligibility requirements, he or she will be provided with eligibility for advance payments of the premium tax credit and cost-sharing reductions based on the inputted projected annual household income for 90 days (which may be extended based on good faith), provided that the tax filer attests to the Marketplace that he or she understands that any advance payments of the premium tax credit paid on his or her behalf are subject to reconciliation. If documentation is requested and is not provided within the specified timeframe, regulations specify that the Marketplace will base its eligibility determination on IRS and SSA data, unless IRS data is unavailable, in which case the Marketplace will discontinue any advance payments of the premium tax credit and cost-sharing reductions.

If your projected 2014 income is lower than your current income you need to document why, and then revisit after 90 days to confirm. Seems to me the biggest potential issue would be if you say you are not working but the SSA reports differently.

[Cedar]

Quote:

Originally Posted by John Galt III I'm concerned about this 2012 "benchmarK" (latest tax return on file). My 2013 and 2014 income will be much lower than my 2012 "benchmark".

I retired last year and my wife retired in June of this year. Our combined income is a forth of what it was working. I signed on last night and it accepted my estimates for 2014 without any verification. Everything went smooth as glass but then again it was 4:00am. It is a very good website format when it works.

[GLM]

Quote:

Originally Posted by Cedar I retired last year and my wife retired in June of this year. Our combined income is a forth of what it was working. I signed on last night and it accepted my estimates for 2014 without any verification. Everything went smooth as glass but then again it was 4:00am. It is a very good website format when it works.

Good to know - DH left full time employ in February and is now working part time as a consultant. (much lower stress) Our Magi in 2014 will be 20-25% of what it was in 2012. Hopefully our application will go through smoothly too , if I ever get our identity verified . I have two applications pending . One in DH name , I scanned his driver's licence for verification a month ago- status pending . The other, in my name I tried going through verbal verification with Experian . They had me thaw my credit then verified me over the phone about two weeks ago but the website still says application pending .

[rbmrtn]

Quote:

Originally Posted by GLM I have two applications pending . One in DH name , I scanned his driver's licence for verification a month ago- status pending . The other, in my name I tried going through verbal verification with Experian . They had me thaw my credit then verified me over the phone about two weeks ago but the website still says application pending .

FWIW, I think they have made some improvements. I was there also pending verification since early Oct. I had to go through multiple accounts, 1st on created back in august when they first put the site up, it stopped working sometime after Oct 1. Next couple got stuck at different spots, then one got to upload ID docs and showed verification pending. That one sat ther for 3 weeks. Stated over with a new account/email this week and it went right through without a glitch. I am still looking and have not enrolled yet.

Start with a clean account, make sure clean your browser each time. It finally worked for me.

[Calico]

Quote:

Originally Posted by rbmrtn FWIW, I think they have made some improvements. I was there also pending verification since early Oct. I had to go through multiple accounts, 1st on created back in august when they first put the site up, it stopped working sometime after Oct 1. Next couple got stuck at different spots, then one got to upload ID docs and showed verification pending. That one sat ther for 3 weeks. Stated over with a new account/email this week and it went right through without a glitch. I am still looking and have not enrolled yet. Start with a clean account, make sure clean your browser each time. It finally worked for me.

And applying at 4:00 am seems to work, according to another poster! For once my night owl tendencies will pay off!

[Cedar]

Quote:

Originally Posted by Calico And applying at 4:00 am seems to work, according to another poster! For once my night owl tendencies will pay off!

Prior to this last run at the exchange, I had tried numerous times just to have the system fail. What surprised me this time was how fast and easy I was able to enter my information and get approval. For me the 3:30-4:00am worked great. The interesting part was when you go to the exchange at that time there is a post stating; "The Health Insurance Marketplace online application isn't available from approximately 1 a.m. to 5 a.m. EST daily while we make improvements".

[Calico]

Quote:

Originally Posted by Cedar Prior to this last run at the exchange, I had tried numerous times just to have the system fail. What surprised me this time was how fast and easy I was able to enter my information and get approval. For me the 3:30-4:00am worked great. The interesting part was when you go to the exchange at that time there is a post stating; "The Health Insurance Marketplace online application isn't available from approximately 1 a.m. to 5 a.m. EST daily while we make improvements".

I'm glad it worked for you finally. I wasn't kidding - if I actually had to apply, I would do it in the wee hours of the morning when most people are asleep! At my j*b our IT folks post a similar message that the site is down (3am - 5 am) just to cover themselves in the event they have to work on the system. It appears that slowly but surely the government website is getting straightened out, thank goodness.

[NoMoreJob]

Quote:

Originally Posted by Cedar I retired last year and my wife retired in June of this year. Our combined income is a forth of what it was working. I signed on last night and it accepted my estimates for 2014 without any verification. Everything went smooth as glass but then again it was 4:00am. It is a very good website format when it works.

I have read that only a 'statistically significant' number of those with income not matching IRS records will be verified. So just because your finances have changed significantly doesn't mean that your estimate will be verified.

Below is a source reference and quote.

HHS Scales Back ACA's Health Insurance Income Verification Process - California Healthline

Final Rule Details
Under the final regulation, federally operated exchanges still will verify such information beginning in 2014, but states operating their own exchanges can wait until 2015 to do so (Morgan, Reuters, 7/7). In addition, exchanges will only have to audit a statistically significant sample of applicants whose self-reported income differs from federal records, as opposed to reviewing all such cases. For applicants not included in the sample, "the Exchange may accept the attestation of projected annual household income without further verification," the rule states.
Individuals caught falsifying their income or insurance status on the exchange applications can face up to a $25,000 fine. Individuals who misrepresented their incomes would also have to pay back any ill-gotten subsidies via their tax returns (Kliff/Somashekhar, Washington Post, 7/5).

[Cedar]

Quote:

Originally Posted by NoMoreJob I have read that only a 'statistically significant' number of those with income not matching IRS records will be verified. So just because your finances have changed significantly doesn't mean that your estimate will be verified. Below is a source reference and quote. HHS Scales Back ACA's Health Insurance Income Verification Process - California Healthline Final Rule Details Under the final regulation, federally operated exchanges still will verify such information beginning in 2014, but states operating their own exchanges can wait until 2015 to do so (Morgan, Reuters, 7/7). In addition, exchanges will only have to audit a statistically significant sample of applicants whose self-reported income differs from federal records, as opposed to reviewing all such cases. For applicants not included in the sample, "the Exchange may accept the attestation of projected annual household income without further verification," the rule states. Individuals caught falsifying their income or insurance status on the exchange applications can face up to a $25,000 fine. Individuals who misrepresented their incomes would also have to pay back any ill-gotten subsidies via their tax returns (Kliff/Somashekhar, Washington Post, 7/5).

Everyone's income is verified and crossed checked every year if you realize it or not by IRS. Earned income has FICA and federal tax withholding verified in the month paid. Quarterly estimated taxes are verified. Pensions are usually fixed and easy to compute. Historical expenses used as an indicator but verified after the fact. No problem here with the govt. verification of my income. Govt. has verified my income every year for the past 50 years. Nothing new here.