Need help with CoveredCA.com

[rodi]

I'm trying to enroll in family coverage on CoveredCA (state exchange) for 2015.

I did not qualify for any subsidies in 2014 because I worked half the year. So I've been paying COBRA. $1247/month. Comparable insurance outside of COBRA looks to be around 1500-1600/month. We're switching to a BRONZE/HSA plan for 2015, and should qualify for a subsidy based on our projected budget.

I'm having trouble with the income section. The first page of the income section says:

When you apply for health care coverage, you will be asked about your taxable income. If you apply between April 1, 2014 and November 14, 2014 you will report the income information for the current year, 2014. If you apply during the 2015 open enrollment (November 15, 2014 – February 15, 2015), the income you report on the application will be the income you expect to receive for the upcoming year, January through December 2015.

So I should enter the income I expect to have next year. Good. I get that. But it doesn't seem to make that easy.

When you enter the income it asks for start dates, and optional end dates.
If you have a start date in the past with no end date it shows in your current income. It does not seem to carry over to the next year.
I plan on including things that happen once a year like a RMD I take from an inherited IRA. I'll take that once a year - not monthly. I can't figure out how to include that. My husband will have some continuing work with his old employer as he wraps up a project that just won't die... He expects about $10k for the year. I cannot for the life of me figure out how to enter that.
I've got a good estimate/guestimate for cap gains and dividends... but I can't figure out how to have that carry forward into the projected income.

He also has SS - and even that is weird... is there a way to show next years SS amount (which is 1.7% higher than this years.)

No matter how I figure it out - I cannot get the projected income correct. It keeps making it lower, excluding things and will definitely push us into medicaid area... but we WON'T be in medicaid levels - our budget is just over $80k for a family of four... within the subsidy range, but well above medi-CAL range.

Has anyone else had to deal with this?

I'm on hold with the help line - but figured I'd ask here, in parallel.

 

[Jackanory]

I lumped everything into other income. When I went to the Income Summary page, everything showed as zero, it was as if I hadn't anything. Later in the process, the amount I'd entered resurfaced, and I got the appropriate subsidy amount. 'Twas most confusing.

 

[rodi]

Thanks Jackanory.

I got through to CoveredCA - and the rep said put in *this* month's income what I expect to be the monthly income going forward. I should have hung up at that point but he then started doing the whole application - and now I have NO access to go back and tweak the numbers (I had been playing with them to try and get the projected income to show something that made sense... ) They're close (within the 10% limit) but I want it to be accurate.

Now I can't get back to that section and edit and apparently can't delete the app from the website.

I'm on hold again - with an expected wait time of 2 hours.

What's extra weird is it shows a total income of 76k - which is well under the premium assistance limit - but says we don't qualify.

I'm kind of amused... My older son has a first name that is a family Italian name, but also is used by hispanics. Our last name is Italian - but similar to a common hispanic last name - that son has an eligibility flag saying we have to upload proof of citizenship. I'm ok with it - but it's clearly profiled on his name and the other 3 of us aren't flagged.

What's weird is the income shows $

 

[rodi]

Ok... This is a learning process for me.

Apparently I accidentally clicked that I had "low cost" insurance available... because we have COBRA coverage... Turns out that was a mistake - because COBRA is not low cost/affordable. One the coveredCA guy fixed that - I had premium assistance.

While I was on hold the phone I was playing around selecting plans. Since the above issue wasn't fixed yet - I was able to make two "groups" - one with me and the boys and a different one with my husband. He is thinking of changing insurers.

So - when the guy fixed my premium assistance - he mentioned I'd be good to go - and to sign the family in one plan....

Wha ? ? ? ? Turns out if you get a subsidy, on CoveredCA (vs federal exchange or any other exchange) - you need to all be lumped together in the same insurance. CoveredCA doesn't support being in separate plans.

Now we need to come to agreement whether I switch out of Kaiser (I like my doctor and the pediatrician the boys use) or whether my husband stays in Kaiser.

Since the subsidies are about $800/month for our family of 4... it's not a question of giving them up to gain the flexibility.... not when our income/spending/budget puts is at this level.

 

[photoguy]

Wha ? ? ? ? Turns out if you get a subsidy, on CoveredCA (vs federal exchange or any other exchange) - you need to all be lumped together in the same insurance. CoveredCA doesn't support being in separate plans.

I'm not surprised that CoveredCA cannot handle this properly (I was thinking about this since my wife and I are on separate plans). However, if you don't want/need the in advance premium assistance won't everything be trued up at tax filing time?

I think it should be possible since the assistance is income based and does not vary by plan.

 

[photoguy]

I'm kind of amused... My older son has a first name that is a family Italian name, but also is used by hispanics. Our last name is Italian - but similar to a common hispanic last name - that son has an eligibility flag saying we have to upload proof of citizenship. I'm ok with it - but it's clearly profiled on his name and the other 3 of us aren't flagged.

I'm surprised this type of profiling is allowed or even legal. This seems to cross the boundary of discriminating on the basis of national origin or ethnicity. Which is a big no-no as I have learned from taking hours of CA mandatory "ethics" classes.

 

[rodi]

Interesting idea photoguy.

I'll have to figure out how to get the system to NOT give me the credit, but still qualify me for it.

Off to go research.

 

[rodi]

I'm surprised this type of profiling is allowed or even legal. This seems to cross the boundary of discriminating on the basis of national origin or ethnicity. Which is a big no-no as I have learned from taking hours of CA mandatory "ethics" classes.

I asked the first phone rep I talked to yesterday - he said it wasn't name based... but that they look up in a federal database of some kind - and sometimes the database doesn't respond back so it gets flagged for software lag.

 

[MichaelB]

While I was on hold the phone I was playing around selecting plans. Since the above issue wasn't fixed yet - I was able to make two "groups" - one with me and the boys and a different one with my husband. He is thinking of changing insurers.

So - when the guy fixed my premium assistance - he mentioned I'd be good to go - and to sign the family in one plan....

Wha ? ? ? ? Turns out if you get a subsidy, on CoveredCA (vs federal exchange or any other exchange) - you need to all be lumped together in the same insurance. CoveredCA doesn't support being in separate plans.

Now we need to come to agreement whether I switch out of Kaiser (I like my doctor and the pediatrician the boys use) or whether my husband stays in Kaiser.

Separate or group has been an ongoing issue here. The Q&A's all make it clear that families do not all need to be on the same policy, individual family members could clearly have unique healthcare needs that require completely different policies. This post details one way it was resolved. My guess is the difficult is with navigator training and system shortcomings.

 

[rodi]

Separate or group has been an ongoing issue here. The Q&A's all make it clear that families do not all need to be on the same policy, individual family members could clearly have unique healthcare needs that require completely different policies. This post details one way it was resolved. My guess is the difficult is with navigator training and system shortcomings.

That's on the federal exchange. That thread clued me into the idea of groups.

On the CA state exchange you can set up groups ONLY if you are not getting a subsidy. If you are getting a subsidy, the software option to set groups is not present.

I know this from first hand experience because I had mis-filled out the form the first time and had no subsidy. I was able to set up groups. I called to get the eligibility fixed (and get subsidy) - and when I went back in to select plans the option to select groups was not on the screen anywhere.

In other words - CoveredCA's software won't allow it.

Another thing I may try is two separate applications. On one I put all our family info and mark myself and the kids as not needing insurance... that should allow my husband to get his plan. Then a create a second application and show that my husband does not need insurance, and put us in a group.

I'll report back if I find out if that works.

 

[Jackanory]

... upload proof of citizenship. ...

I was unaware of a citizenship qualification ... everybody keep mum!

 

[rodi]

Update:
I decided to use Photoguy's idea of not even trying for the tax credit up front. I put in a higher income, and it can work out in early 2016 in the form of a refund. In the meantime I'll have better documentation of our income in retirement. (My husband should *not* be working at that point... Hopefully he won't flunk retirement the second time around.)

Once I figured all this out, withdrew my initial application, and started over - I was able to get my husband on the plan he wanted and me and the kids on the plan we wanted. I'm hoping the groups/subsidy/glitch will be resolved by next open enrollment.

 

[MichaelB]

Update:
I decided to use Photoguy's idea of not even trying for the tax credit up front. I put in a higher income, and it can work out in early 2016 in the form of a refund. In the meantime I'll have better documentation of our income in retirement. (My husband should *not* be working at that point... Hopefully he won't flunk retirement the second time around.)

Once I figured all this out, withdrew my initial application, and started over - I was able to get my husband on the plan he wanted and me and the kids on the plan we wanted. I'm hoping the groups/subsidy/glitch will be resolved by next open enrollment.

Good move. Is the total of all the premiums the same as if it were one single policy?

 

[wolf]

Good. Seems you were able to enroll. A suggestion to others, there are places you can go, and speak to a "live" person. Sometimes, this route is better than using the computer.

Also, worse, case, If your income is over or under your best guess, when you file your income tax returns, you will either get a refund or have to pay additional dollars. ( what you would have owed, if your income was to high).

Still can figure, how the IRS is going to be able to compare the what if's.
Too many data basis to compare.

In any case, used Covered CA, for 2014, and received a subsidy.
For 2015, will not use Covered CA. Not eligible for subsidy, according to the Covered CA website. Income did not change.

To complicated to explain all of the issues. For 2015, will just buy insurance direct.