Open Enrollment Begins - ACA Individual Coverage

[ziggy29]

Question for folks using the exchange. How do you go about estimating capital gains as income from investments since who knows where the stock market will be in 2016?

I don't know that you really can (not using the exchange for 2016, but did in 2014 and the first part of 2015). Stock market returns are not in your control, but the decision to buy and sell is, so if the market rises a lot, don't sell. And if the market falls a lot, capital losses only offset capital gains and up to $3,000 of ordinary income per year. So you do have some control in "engineering" something close to the income level you are seeking to be just below (or just above in terms of getting over 138% of the poverty line).

 

[Alan]

Just completed my application through healthcare.gov but haven't selected a plan yet. Pretty smooth process but then I'm single with no dependents. Only glitch I encountered was they assume the number you put in for self employment income is monthly rather than offering you a choice of monthly or yearly so be careful with that or you'll find your estimated income may be way off.

P.S., I did not get asked whether I was natural born or naturalized citizen. Odd. Could it vary by state?

Does Arizona have a State Exchange by chance? Texas doesn't so I had to go through Healthcare.gov.

 

[AllDone]

I don't know that you really can (not using the exchange for 2016, but did in 2014 and the first part of 2015). Stock market returns are not in your control, but the decision to buy and sell is, so if the market rises a lot, don't sell. And if the market falls a lot, capital losses only offset capital gains and up to $3,000 of ordinary income per year. So you do have some control in "engineering" something close to the income level you are seeking to be just below (or just above in terms of getting over 138% of the poverty line).

Remember that if your income changes drastically, you can also report it to them at any time and adjust your subsidies.

 

[Ian S]

Question for folks using the exchange. How do you go about estimating capital gains as income from investments since who knows where the stock market will be in 2016?

Really what they are looking for I believe is an estimate of TOTAL income to get your MAGI number and really just have the different categories to help you to that end. My understanding is they will compare what you estimate to your latest tax return numbers and if it's significantly different, then they will ask for documentation. But the key ultimately is that total number which then establishes your MAGI used for determining premium support and cost sharing assistance. As ziggy29 stated, you have control of capital gains to the extent of when you sell the assets.

 

[Ian S]

Does Arizona have a State Exchange by chance? Texas doesn't so I had to go through Healthcare.gov.

No, it's through healthcare.gov. But I filled out an application for 2014 coverage but ultimately cancelled my plan and stayed on a grandfathered one. There was no asking for naturalization papers then either. Perhaps components of that application have held over to later ones.

 

[Neill]

I have only been a layabout for a few months and already my health plan got canceled.
Now that I look at plans for 2016 I was surprised to see that HSA compatible plans are more expensive than the cheapest.
I believe I have to pay for pretty much anything close to expect-able medical expenses out of pocket since paying an insurance company to pay it adds addition friction. So cheapest plans that protect me from the big stuff.
Looking at HSA vs non-HSA plans (me + wife + 2 kids) it seems so long as my marginal tax rate is above ~8% I should go HSA. Roth conversions will force me way above that. Looks like HSA plans have limits on the deductible (that seems strange to me).

 

[Alan]

No, it's through healthcare.gov. But I filled out an application for 2014 coverage but ultimately cancelled my plan and stayed on a grandfathered one. There was no asking for naturalization papers then either. Perhaps components of that application have held over to later ones.

No worries, a minor irritation in the grand scheme of things. I got what I needed which were policy quotes and since I won't be signing up to a plan I won't have to later prove my US citizenship.

 

[easysurfer]

Really what they are looking for I believe is an estimate of TOTAL income to get your MAGI number and really just have the different categories to help you to that end. My understanding is they will compare what you estimate to your latest tax return numbers and if it's significantly different, then they will ask for documentation. But the key ultimately is that total number which then establishes your MAGI used for determining premium support and cost sharing assistance. As ziggy29 stated, you have control of capital gains to the extent of when you sell the assets.

Ian, Ziggy, thanks to help clearify. Makes more sense when explained this way.

 

[Fermion]

I tried to change our income so it would be correct for 2016 and it funneled me into a special enrollment period and asked what health plan I wanted for December 2015 and told me to wait for 2016

I think this is going to require a call to a real person. I just purchased an extra 1000 minutes for my phone.

 

[MBSC]

I tried to change our income so it would be correct for 2016 and it funneled me into a special enrollment period and asked what health plan I wanted for December 2015 and told me to wait for 2016.

Updates made between 11/1/15-11/15/15 without going thru the 2016 application process will create a 2015 SEP. Wait until after the 15th to make those kind of updates. It's easier than going thru the entire 2016 application process to just update one item.

 

[Fermion]

Updates made between 11/1/15-11/15/15 without going thru the 2016 application process will create a 2015 SEP. Wait until after the 15th to make those kind of updates. It's easier than going thru the entire 2016 application process to just update one item.

Wish I had known that. Actually I thought I was updating 2016 information.

I wonder if there is any way to undo the update? I would rather not wait until Nov 16th to get this going since we might be busy during December.

 

[easysurfer]

Seems to me that since ACA open enrollment started, BCBS by me is trying to do a fast pitch and have me hurry up and go with their watered down replacement plan as my last year's PPO plan is no longer offered.

By default, I'm in the new plan, if I just keep paying the premiums. I also got an email today reminding me to log on to confirm the new plan.

I'm leaning towards of going with the [-]headache?[/-] option of getting my coverage through the exchange this year. Either a more comprehensive plan or that same watered down BCBS plan but not at the discounted marketplace rate.

My question is, if I go from off market to marketplace, is there a change I'd get a decline when applying saying that BCBS already has me enrolled by default?

 

[CRLLS]

I'm a BCBS(IL) customer here too. My PPO plan has also been eliminated for 2016. WTH? I don't want to, but we will have to go with another insurance co. since our Dr's or hospital are not in the new plans. I will wait to the last moment hoping maybe they will change their minds. If not then Bye-Bye BCBS. The good news is next year's subsidy will be $400 more than last year's.

 

[pb4uski]

....Going to need pinpoint precision on Roth conversions to bring income to exactly $22,000 (any less and you are on Apple health).

Can't you just put in more than enough and then recharacterize any excess?

That's what I do to make my TI exactly equal to the top of the 15% tax bracket.

After browsing this thread I am so thankful that we are healthy and have access to affordable bronze-like catastrophic health insurance that protects our finances from an expensive health event and access to negotiated rates for health care services and is affordable enough to have allowed us to forgo subsidies in favor of Roth conversions so we don't have to deal with healthcare.gov or our state portal.

 

[MichaelB]

My question is, if I go from off market to marketplace, is there a change I'd get a decline when applying saying that BCBS already has me enrolled by default?

Probably not. When I faced this situation I was concerned BCBS would continue the policy despite not renewing it, but that didn't happen.

 

[MBSC]

My question is, if I go from off market to marketplace, is there a chance I'd get a decline when applying saying that BCBS already has me enrolled by default?

For BCBSSC, if the enrollment system finds a match on personally identifiable information (SSN, birth date, etc.) the new policy automatically cancels the old one on the effective date.

 

[easysurfer]

For BCBSSC, if the enrollment system finds a match on personally identifiable information (SSN, birth date, etc.) the new policy automatically cancels the old one on the effective date.

Thanks. The answer I like to read .

 

[easysurfer]

Probably not. When I faced this situation I was concerned BCBS would continue the policy despite not renewing it, but that didn't happen.

Thanks. All these varibles to consider.

 

[easysurfer]

I'm still on the fence about signing up with coverage from the marketplace or not.

Since FIRE'ing, I have so little income that paying insurance premiums definitely get me above the 10% limit for a tax deduction. For example, say one only makes $20,000 income a year. 10% of $20,000 is $2,000. A premium of $400 a month is already $4800. In otherwords, in my case is there a real benefit to get a premium tax credit through the markeplace, and then reconcile at tax time or does that just add more number crunching and possible hang ups with applying?

 

[Nunthewiser]

Depends on how many dependents you have, but $20k may be too little to qualify for subsidies- you may be on Medicaid.

Check this out:

Health Insurance Marketplace Calculator | The Henry J. Kaiser Family Foundation

 

[ziggy29]

Depends on how many dependents you have, but $20k may be too little to qualify for subsidies- you may be on Medicaid.

And if you're in a state that didn't expand Medicaid, you could be screwed on both ends.

 

[easysurfer]

Depends on how many dependents you have, but $20k may be too little to qualify for subsidies- you may be on Medicaid.

Check this out:

Health Insurance Marketplace Calculator | The Henry J. Kaiser Family Foundation

I like that calculator site. Thanks.

$20K (remember, family of 1) at my state would qualify for a subsidy.

 

[easysurfer]

And if you're in a state that didn't expand Medicaid, you could be screwed on both ends.

I feel for those folks.

 

[Ian S]

I like that calculator site. Thanks.

$20K (remember, family of 1) at my state would qualify for a subsidy.

Remember, it's not just a premium subsidy you get at that level of income but also cost sharing reduction subsidies if you buy a silver plan. This can result in dramatically lower out of pocket costs if you get sick e.g. deductible of $250 instead of $2500, lower coinsurance and lower maximum out of pocket. You really should check out the exchange plans for your income level.

 

[easysurfer]

Remember, it's not just a premium subsidy you get at that level of income but also cost sharing reduction subsidies if you buy a silver plan. This can result in dramatically lower out of pocket costs if you get sick e.g. deductible of $250 instead of $2500, lower coinsurance and lower maximum out of pocket. You really should check out the exchange plans for your income level.

Thanks. The lazy part i me was kinda hoping you'd say not worth the effort .

Looks like more homework for me .