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Old 08-19-2013, 02:05 PM   #41
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Insurers are not required to use the exchanges. They're free to interact directly with consumers or use other interfaces. Consumers can only get premium assistance or subsidy on an exchange or approved platform.
Since both on-exchange and off-exchange policies have to meet the same set of requirements, why would insurers offer off-exchange policies at all? It seems like policies sold "on-exchange" would be more attractive to customers because they may be eligible to obtain subsidies...
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Old 08-19-2013, 02:17 PM   #42
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Since both on-exchange and off-exchange policies have to meet the same set of requirements, why would insurers offer off-exchange policies at all? It seems like policies sold "on-exchange" would be more attractive to customers because they may be eligible to obtain subsidies...
I guess they might be offering plans to folks who aren't eligible for a subsidy, since they can offer direct and (presumably) not have to pay a "commission" for policies sold on the exchanges (assuming they are allowed to offer a lower price on the same product outside of the exchanges).
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Old 08-19-2013, 03:37 PM   #43
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I guess they might be offering plans to folks who aren't eligible for a subsidy, since they can offer direct and (presumably) not have to pay a "commission" for policies sold on the exchanges (assuming they are allowed to offer a lower price on the same product outside of the exchanges).
But if it's not compliant, then you'll have to pay the tax penalty for not having insurance, unless it's grandfathered in, I think all insurance will need to be compliant, unless premium+tax penalty<ACA premium
TJ
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Old 08-19-2013, 04:51 PM   #44
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I guess they might be offering plans to folks who aren't eligible for a subsidy, since they can offer direct and (presumably) not have to pay a "commission" for policies sold on the exchanges (assuming they are allowed to offer a lower price on the same product outside of the exchanges).
That would be my guess as well. All policies open for enrollment must meet PPACA standards (as of 1/1/14), and a policy sold directly by the insurer doesn't pay commission to anyone.
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Old 08-19-2013, 11:31 PM   #45
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I guess they might be offering plans to folks who aren't eligible for a subsidy, since they can offer direct and (presumably) not have to pay a "commission" for policies sold on the exchanges (assuming they are allowed to offer a lower price on the same product outside of the exchanges).
I wonder if the off exchange policies might have different (better) networks than the exchange policies. I mean logically they shouldn't but let's say I was looking for a policy and was eligible for a subsidy, but all the exchange policies had very limited networks and hospitals I didn't like. And, let's assume that off-exchange policies had the same coverage but had much broader networks and more and better hospitals. I could see that being a tough choice to make which way to go.
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Old 08-19-2013, 11:46 PM   #46
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I wonder if the off exchange policies might have different (better) networks than the exchange policies. I mean logically they shouldn't but let's say I was looking for a policy and was eligible for a subsidy, but all the exchange policies had very limited networks and hospitals I didn't like. And, let's assume that off-exchange policies had the same coverage but had much broader networks and more and better hospitals. I could see that being a tough choice to make which way to go.
Or, even more likely, what if you didn't qualify for the subsidy (you make too much money). In that case, there's no firm advantage to going through the exchange for you as a customer. If this "direct to the customer" plan offers more providers/better access, etc, you might be willing to pay more for it.
The PPACA requires that the non-grandfathered "qualified plans" (either on the exchanges or "direct to customers") all cover theprescribed "essential Health Benefits," but that's not the same as saying you can get in to see a provider in a timely manner.
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Old 08-20-2013, 01:41 AM   #47
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I can't seem to get an answer on what I consider an easy question.......do short term, long term, dividends, investment interest etc; in other words, ant investment income count towards the dollar amount the Federal Government is going to consider for tax breaks or is it strictly 1099's. W2's etc?
Thanks so much.
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Old 08-20-2013, 05:55 AM   #48
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I can't seem to get an answer on what I consider an easy question.......do short term, long term, dividends, investment interest etc; in other words, ant investment income count towards the dollar amount the Federal Government is going to consider for tax breaks or is it strictly 1099's. W2's etc?
Thanks so much.
Kimo
"ALL" income that is reported on your 1040 is included in the calculation. This is something I researched early on as it will require some additional management of taxable versus non taxable sources.
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Old 08-20-2013, 06:37 AM   #49
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I wonder if the off exchange policies might have different (better) networks than the exchange policies. I mean logically they shouldn't but let's say I was looking for a policy and was eligible for a subsidy, but all the exchange policies had very limited networks and hospitals I didn't like. And, let's assume that off-exchange policies had the same coverage but had much broader networks and more and better hospitals. I could see that being a tough choice to make which way to go.
I've seen some informed speculation that limited networks for exchange policies will indeed be an issue in some states.

For all the news and commentary being generated regarding individual policies, it's important to remember that the large majority of people will still be covered by employer or other group plans, under already-established provider networks. There is no doubt quite a bit of arm-wrestling strategic thinking going on between providers and insurers on whether the new, larger cohort of individual policy holders should be added into the existing networks offered to Megacorps.

From the providers' perspective, services to the pool of individuals with exchange policies is likely to have a very different credit profile.
Hospitals May Absorb Risk of Insurers
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Old 08-20-2013, 08:19 AM   #50
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"ALL" income that is reported on your 1040 is included in the calculation. This is something I researched early on as it will require some additional management of taxable versus non taxable sources.
Right. Especially if you are not on a group plan and near one of the sharp cutoffs:
133% of Federal Poverty Level (FPL): Top of Medicaid Eligibility/beginning of Eligibility for Exchange Subsidies (use 100% of FPL if your state isn't going along with the Medicaid expansion*)

400% of (FPL): Top of eligibility for subsidies.

Earning just $1 over either of these limits can change one's situation or costs a lot.

People close to the line may find some advantages in "bunching" their income so that they at least get into the preferred "bucket" every other year. Managing deductions, delaying/accelerating sales of appreciated equities, working any extra hours a few weeks earlier or later to get the income into the proper year, etc. Tracking one's income throughout the year will become more important for many of us. Complexities/sharp cutoffs always encourage fraud, as well.

* Thanks to MichaelB for the reminder on 100% vs 133%
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Old 08-20-2013, 08:29 AM   #51
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Managing deductions, delaying/accelerating sales of appreciated equities, working any extra hours a few weeks earlier or later to get the income into the proper year, etc.
I don't see how managing deductions helps. Don't the subsidies depend upon modified AGI which is before deductions?
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Old 08-20-2013, 08:45 AM   #52
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I don't see how managing deductions helps. Don't the subsidies depend upon modified AGI which is before deductions?
Yes. The deductions can't help you qualify for the PPACA subsidies. But if a person is using other methods to get under the 400% line (e.g. working fewer hours, avoiding sale of appreciated stocks, etc), managing the deductions by taking them in alternate "high income" years (when the person might be in a higher tax bracket) would be better.

If someone writes a computer program ("TurboTax Plus!") to integrate this PPACA "optimization" with the normal tax-time hoop dance, they will make a fortune.
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