Proving Estimated Income for ACA Subsidy

[scrabbler1]

Good luck scrabbler!

A few years ago I had something that maybe could be in the similar vein. We had coverage all year, with a subsidy, no issues with payments, nothing looked amiss.

But we never got the 1095-A form and it wasn't in our Marketplace account. I wanted to file our taxes in January and had no 1095-A so I called the Marketplace and they said our insurance had been cancelled in January and that we weren't insured all year. I knew that was not the case, I had invoices, payment receipts and all our claims had been paid as expected!

The folks at the Marketplace issued a ticket to look into the discrepancy and after a few months they were able to issue us our 1095-A. In the meantime I figured out what the 1095-A would show and verified that with an agent at the Marketplace. I filed our taxes using those numbers.

After filing I got an IRS letter stating that there was a discrepancy. Very soon after that I got the official 1095-A and sent it off to the IRS with an explanation note. It all worked out in the end, even though it didn't complete until late May or early June.

Yes, you are dealing with a huge complicated bureaucracy but I found the Marketplace to be competent and they did follow through. Of course, this was in a year without a pandemic, so I wish you luck!

Did your insurance company assist you in getting data to your state's marketplace to confirm your coverage for the year? I have found the bureaucracy at my IC more adept than the bureaucracy at my state's Marketplace, so getting my state's Marketplace more tools to work with from the outside (my 2021 re-enrollment and my IC already telling them I was insured for all of 2020) should advance the process better.

 

[Sue J]

It was the Marketplace that contacted the insurance company. I don’t think I did anything except periodically call to make sure someone was handling it and we weren’t being forgotten.

 

[scrabbler1]

Good news! After resubmitting the document under a different category, the NYS Marketplace approved my subsidy effective February 1st. My IC is pretty quick in sending out revised premium notices when they get new information, even though I haven't received a February one yet. So, that's one more item on my fix-it list done. What remains is making sure my 1095-A form is correct so I can file my 2020 taxes to get an expected refund. I'll the NYS Marketplace today or in another day or two to see how that is going.

 

[scrabbler1]

As I wrote in another thread.....

After some minor wrangling with both my IC and with my state's exchange (NYSOH), it appeared I was getting a runaround between them. My IC told me they had no such request, and the NYSOH couldn't verify the tracking number I was given last week.

But...in a dramatic turn of events, after finding a special number for inquiries about 1095-A forms, the rep there looked up my file which would be used when they create the 1095-A forms and told me my data was updated for the entire year and read back to me the key data I expected to see on the form in a few weeks, including for the missing months where they said I had no coverage. Wow, I am quite relieved. I'll be able to file my 2020 federal tax return right away and get a refund (for a change).

So how come nobody else (at the IC or the main NYSOH help line) seemed to know this had been done? Not an issue I need to pursue.