ACA: one family, two exchanges. Been there?

[duckcalldan]

We live in VA but my youngest D is off to college in MA this fall. Since we live in VA now, we use the federal exchange. When she heads to MA, I’ll enroll her in the MA exchange and simultaneously remover her from coverage in VA.

My question: do the premium tax credits flow to both exchanges? In other words, right now these credits are paying nearly all of our premium. I want to make sure I will be able to continue this even though our family will be covered on two different exchanges.

Has anyone been through this before? My D’s college auto-enrolls her in their own health plan (and bills me $2K/yr) unless I request a waiver showing that she has a suitable alternative insurance plan. I don’t think there will be any problems but this is a tricky situation.

 

[gauss]

duck,

Do you do your own taxes? If so, you may wish to review the instructions for form 8962 Premium Tax Credit.

This will show how your final PTC will be calculated. You will likely receive multiple 1095-A forms -- one from each exchange.

My understanding is that your net premium (ie after premium tax credit) cost will be similar to a single exchange if spread across two exchanges. This assumes that you select the SLCSP in each exchange. You may wish to create a provisional tax return and 1095-A set to confirm this.

For the "up-front" portion of your question, I would contact the MD exchange. You may wish to review their application process to see if it addresses your concern.

Regards
-gauss

 

[pb4uski]

..... When she heads to MA, I’ll enroll her in the MA exchange and simultaneously remover her from coverage in VA. ...

Why would you do that? As I recall she can stay on your plan until she is 26.

 

[cathy63]

Why would you do that? As I recall she can stay on your plan until she is 26.

We had to do this when our DD went to school in a state where our existing health plan only covered emergency services. The school insisted that she have a plan that was on their list of acceptable plans, even though we were willing to pay cash for any non-emergency coverage she might have needed. We didn't get any premium credits, so I can't help with that part of the question.

 

[Texas Proud]

Most large colleges have their own plan that students can sign up for... covers anything while at school but you can still have them on your home policy...


My son is still in state and we just looked for docs near him in the plan and said to call them if he needed anything or go to a clinic that is in the plan..

 

[duckcalldan]

We had to do this when our DD went to school in a state where our existing health plan only covered emergency services. The school insisted that she have a plan that was on their list of acceptable plans, even though we were willing to pay cash for any non-emergency coverage she might have needed. We didn't get any premium credits, so I can't help with that part of the question.

This is our issue. She needs a local health plan that covers more than emergency services to stay on good terms with her university. Ironically, she gets free health care from the student health center regardless of her insurance situation.

 

[BeachyBound]

Did this over the last month, and it was very unpleasant. Mine was a little more complicated than yours: fam of 5 all in one state (husband/wife/3kids), then 3 moved to another state (husband/wife/1kid) leaving 2 college kids behind. But the end result was one fam on two exchanges in two states.

First off, I'd call the Marketplace help line for advice on the exact mechanics of the move to make sure that you remain the head of tax family on both policies, and don't even get a conversation going with the first person who picks up the phone...ask politely that you'd like to talk to a Supervisor because your situation is complicated, and after the first person verifies your identity, they should send you to someone who has done more than the simple-cases.

Secondly, remember that in order for a policy to take effect on the first of the month (at least on the Federal exchange), you need to apply for it between the 1st and the 15th of the month previous...if you apply in the second half of the month, it doesn't take effect until another month more.

Even after working with a number of supervisors over the course of weeks, the start dates for my kids-left-behind didn't land correctly, and the three who moved-state ended up with two active primary policies (one in each state) for most of July...and it took numerous phone calls to both the Marketplace and the individual insurance companies to get it all straightened out. Hopefully yours will go smoother, since your tax-family head isn't the one moving.

AFA tax credits after the switch, I get them applied on the policy with me/wife/1kid, but the Marketplace didn't show that any were appropriate on the 2kids in the old state. The credits are based on the plan prices in the local areas, so maybe that's correct. This is my first year on the exchanges, but I'm thinking I won't know for sure until I get the 1095-A...

 

[MBSC]

...then 3 moved to another state (husband/wife/1kid) leaving 2 college kids behind.

Hopefully yours will go smoother, since your tax-family head isn't the one moving.

It sounds like you established residency in the new state and the kids left behind maintained residency. The OP has not indicated if their child will become a resident of MA.

We live in VA but my youngest D is off to college in MA this fall. Since we live in VA now, we use the federal exchange. When she heads to MA, I’ll enroll her in the MA exchange and simultaneously remove her from coverage in VA.

It's my experience that some reps pass out SEPs like halloween candy while others follow the recently clarified regulations. I would not decline the student health plan until I had the SEP.


"I’m a college student and will be going to an out-of-state university. Can I qualify for a special enrollment period (SEP) to sign up for a new plan in the state where I’ll be going to school?

It depends. You may be eligible to buy coverage in the state where you attend school as long as you can establish residency; otherwise your residency is determined by your parents or caregivers’ residency. If you can establish residency, then you may qualify for a permanent move SEP."

Reference: Recent Guidance About Marketplace Residency Requirement and Special Enrollment Period When Moving - Center on Health Insurance Reforms

To be eligible to enroll in a Qualified Health Plan (QHP) through the Marketplace, an applicant must meet the requirements outlined in 45 C.F.R. § 155.305(a): 1) be a resident of the service area of the Exchange;

Q9. Does an individual’s residence change when he or she leaves an Exchange service area temporarily?

No. An individual who leaves an Exchange service area temporarily with intent to return to the original Exchange service area continues to be a resident for the purposes of Marketplace coverage during the temporary absence.

Reference: https://www.regtap.info/uploads/library/ENR_FAQ_ResidencyPermanentMove_SEP_5CR_011916.pdf