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NYS ACA income verification
Old 07-07-2019, 08:06 AM   #1
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NYS ACA income verification

I retired April 2 at age 63; my plan for health insurance for me and my wife was to stay under the threshold so we would get a subsidy. I knew my income for the months I worked in 2019 and estimated the income from savings that we would be living on; ie, the interest & dividends on that savings. Note the savings itself is already after tax. I successfully signed up with the subsidy included. Today I got a notice that I didn't provide proof of income so they were stopping my subsidy. I always thought we evened up at tax time; plus, what would I provide as income verification in my case?

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Old 07-07-2019, 08:16 AM   #2
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I think that they want income verfication to make sure there is a reasonable basis for granting you advanced premium credits even though it is all trued up based on your actual income when you fie your tax return.

You have a couple choices. One, send them a letter or schedule showing your YTD income from work and investments and projected investment income from now until the end of the year for them to restart the advanced premium credits. Or pay the unsubsidized premium and get the subsidies back when your 2019 tax return.

I think you could provide your last paystub, your June 30 investment statements (black out account numbers and balances) and an explanation of your expected investment income for the second half of the year.
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Old 07-07-2019, 08:45 AM   #3
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My first year using the ACA insurance program, they wanted written proof also. In subsequent years, there wasn't any request of proof until de facto the tax return.
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Old 07-07-2019, 09:06 AM   #4
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Quote:
Originally Posted by jpeter1093 View Post
I retired April 2 at age 63; my plan for health insurance for me and my wife was to stay under the threshold so we would get a subsidy. I knew my income for the months I worked in 2019 and estimated the income from savings that we would be living on; ie, the interest & dividends on that savings. Note the savings itself is already after tax. I successfully signed up with the subsidy included. Today I got a notice that I didn't provide proof of income so they were stopping my subsidy. I always thought we evened up at tax time; plus, what would I provide as income verification in my case?

Thanks
This happened to me in the first 2 years (2014, 2015) I bought HI through the NYS Marketplace. I received repeated requests for income verification because none of my income (like yours) was of the types shown in the Marketplace's list of verifiable income. I even attached copies of my December monthly brokerage statement (1099s hadn't come out yet) which showed YTD income. They were ignored and the requests kept coming in well into the year.

I called the NYS Marketplace and while they understood my problem, they were clueless as to what to do about it other than telling me to ignore the requests (big help!). I simply reconciled it at tax time.

In 2016, I finally began receiving the subsidy on an advanced basis, as a monthly premium tax credit instead of taking the entire amount as a credit against my federal tax bill the following year. Back in 2014 and 2015, my subsidy was small, never more than $500 for the whole year.

In 2017 and 2018, I had the opposite problem. I received a small monthly premium credit but went over the subsidy cliff and had to pay it back. Now, I have become ineligible for the monthly credit again because it is based on my 2017 tax return. If I don't go over the cliff in 2019, the growing subsidy will greatly exceed my tax bill, so I will file early to get a refund.
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Old 07-08-2019, 04:57 PM   #5
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Personal data point. NYS hasn't asked me for documentation, I guess they are doing it electronically or something.
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Old 07-09-2019, 06:58 AM   #6
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I spent an hour on the phone with them yesterday. The (nice) woman said she doesn't see any request for documentation. I asked what should I do - "We'll rerun your application". So, she walked me through the interview process, basically filling in the application with the same information I had back in April when I did it myself online. When done, I asked; do I need to send any documentation, then? She said no, since the application was accepted. Hmmm (I thought it was accepted back in April, too)...so far, it's still showing I get the subsidy on the website. We'll see in 60 days if I get dropped for lack of documentation again.
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