ACA Subsidy Eligibility Notice--how to prove income

[dirt_dobber]

I am going to jump into the pool of ACA this weekend and the info I have
read and the links provided in this thread will be a great help. I am worried
about the income discrepancy I will be stating.
In 2015 I made $475k (due to a year year in advance salary layoff package) and am
now retired but with only expected total income to be approx $40k.
This is a very helpful thread for me. Thanks for all who posted thus far.

 

[GTFan]

GTFan what file format were the uploads submitted in? In my example I uploaded my files in pdf format.

Both pdf's. I uploaded the same docs again on Thursday just to see if would trigger a new review. I'll probably do it over and over until they respond.

 

[ARB57]

When I went through the application process, it indicated that I would need to provide income verification. I uploaded an income summary that I had prepared along with bank/investment statements from 2016 (so far...with projections for the remainder of the year). That was on Wednesday. On Friday (yep just 2 days later) I got an email indicating that I was in the clear. Totally blew me away (not that I was approved, but that it took only 2 days).

I'm wondering if the fact that I used an ACA "Navigator" expedited the process in anyway. Regardless, I'd highly recommend using a "navigator". It's free and they tend to know the ropes.

 

[sengsational]

What I put in for an estimate this time is exactly what I put in last time. And the actual AGI turned out to be 20% less than my input.

 

[RunningBum]

When I went through the application process, it indicated that I would need to provide income verification. I uploaded an income summary that I had prepared along with bank/investment statements from 2016 (so far...with projections for the remainder of the year). That was on Wednesday. On Friday (yep just 2 days later) I got an email indicating that I was in the clear. Totally blew me away (not that I was approved, but that it took only 2 days).

I'm wondering if the fact that I used an ACA "Navigator" expedited the process in anyway. Regardless, I'd highly recommend using a "navigator". It's free and they tend to know the ropes.

By "Navigator" do you mean you went through an insurance agent? That's what I did, mostly because I wanted advice the first time I was on my own for health insurance, before ACA. I've kept with him since, mostly to confirm I was getting the right policy. He didn't have anything to do with the income verification though, as I did that on my own. I suppose it's possible they handle issues with the ones done through an agent before the ones done by individuals.

 

[wmc1000]

Navigators are not an insurance agent

From the Healthcare.gov website:

Navigator
An individual or organization that's trained and able to help consumers, small businesses, and their employees as they look for health coverage options through the Marketplace, including completing eligibility and enrollment forms. These individuals and organizations are required to be unbiased. Their services are free to consumers.

In my case did not use a navigator for any of the processes of signing up and uploading verification docs.

 

[GTFan]

Got a note this morning that they had accepted my second submission of same docs (2015 1040 with an explanation letter) and my income was now verified. Whew!

 

[wmc1000]

GTFan, glad to hear you are now verified!

 

[Wheel]

Following the success of others who have posted (THANK YOU SO MUCH!), I put together a simple 1 page letter and outlined what I expected my family income to end up at for 2016. I listed cap gains, dividends/interest, a small RMD and DW's income from her part time job. Created a pdf and uploaded it Friday afternoon. I heard back yesterday evening (email at 9:40PM) that my submission had been verified and I was good to go.

Yes!

 

[Sojourner]

I signed up for an ACA plan recently and also got the notice that income verification docs will be required. In my case, the deadline for submitting the docs is the first of March 2017, so would it be better to wait until, say, early February, when I can submit the first two pages of my actual 2016 1040, which will show precise income and deduction figures? I would accompany the two-page 1040 with a letter stating that my income for 2017 will be essentially the same as 2016.

 

[brucethebroker]

Got a notice during first year on ACA and forgot about it. Lost tax credit (on paper) for one month's premium, then hustled and got the report in. Received a new (modestly increased) credit based on updated projections. I kind of panicked about the "lost" month, until I remembered that the credits are only estimated and are finally reconciled at tax filing. Slept better, knowing I hadn't blown it and lost some money.

 

[wmc1000]

True if it is only tax credits - if you qualify for cost sharing it makes a big difference!

 

[Fermion]

Honestly, they really seem to be ok with spreadsheets and numbers, especially if you make it look all official and techy. Put in words and columns like adjusted, amortized. Have subtotals, totals. Remember, you are dealing with a government worker with 2 weeks of training making about $30k a year.

 

[street]

I have been through this same ordeal and finally my BCBS agent is helping me out. My question is I was given a credit amount. Now if I don't use all of the credit that I was entitled too and paying more will this be a cushion if for some reason my income would go up through the year of 2017.

 

[RunningBum]

I have been through this same ordeal and finally my BCBS agent is helping me out. My question is I was given a credit amount. Now if I don't use all of the credit that I was entitled too and paying more will this be a cushion if for some reason my income would go up through the year of 2017.

I don't follow what you are asking. It sounds like you got a credit to reduce your insurance premium. I don't understand how you didn't use all of the credit you were entitled to. If you mean you had a lower income level than expected, this will get resolved when you do your taxes for 2016, as you'll get a credit for the additional subsidy amount. Nothing gets credited for 2017.

 

[street]

Sorry it was hard to understand. Yes I was given a credit amount and then I picked a plan. The plan I choose less then what my credit was. So if plan cost 1500 I got a credit of 1800. I opted to pay 500 for my plan a month. This is an example. My agent said I can pay for some of the plan or have it paid in full from ACA. I choose to pay some and not use all the credit I was awarded too.

 

[DEC-1982]

Navigators are not an insurance agent

From the Healthcare.gov website:

Navigator
An individual or organization that's trained and able to help consumers, small businesses, and their employees as they look for health coverage options through the Marketplace, including completing eligibility and enrollment forms. These individuals and organizations are required to be unbiased. Their services are free to consumers.

In my case did not use a navigator for any of the processes of signing up and uploading verification docs.

Are these navigators available for advice and consultation year around or are they available just during the regular sign-up season (Dec/Jan)?

 

[MBSC]

I don't understand how you didn't use all of the credit you were entitled to.

When you apply for an exchange plan and qualify for Premium Tax Credits (PTC) you are presented a screen in which you can choose to have none of the PTC applied to the premium, all of the PTC applied to the premium, or an amount you choose applied to the premium.

Yes I was given a credit amount and then I picked a plan. The plan I choose less then what my credit was. So if plan cost 1500 I got a credit of 1800. I opted to pay 500 for my plan a month. This is an example. My agent said I can pay for some of the plan or have it paid in full from ACA. I choose to pay some and not use all the credit I was awarded too.

Assuming your actual income matches the estimate provided to the exchange, you will receive $6,000 of the PTC when you "true up" your tax return. This is the $500/month you chose not to receive in advance. You will not receive the $300/month difference since the plan is less than the PTC.

Are these navigators available for advice and consultation year around or are they available just during the regular sign-up season (Dec/Jan)?

You will need to request an appointment outside Open Enrollment to be sure a Navigator is there.

 

[RunningBum]

Ah, I see, basically whatever credit you don't take is like making an estimated tax payment. You'll still get the credit, up to the amount of the insurance, as it gets resolved at tax time. Good explanation. Thanks MBSC.

 

[scrabbler1]

Ah, I see, basically whatever credit you don't take is like making an estimated tax payment. You'll still get the credit, up to the amount of the insurance, as it gets resolved at tax time. Good explanation. Thanks MBSC.

That's how I treated the credit in 2014 and 2015 when I paid the entire premium without any reduction due to the credit. This year, I have my premium reduced due to the credit but I will probably be able to claim a little more of the credit against my tax bill when I file my 2016 taxes.

 

[street]

I have one more question for now. Lol I am asked to work for a local fair for the county each year. I make about 200 dollars for the 4 day doings. I do it because it is fun but the 200 is nice also.
My question>>> so I forgot to add this to my projected income for 2017 for my ACA subsidy. So this summer when this happens do I need to notify HC.Gov and tell them of this change

 

[MichaelB]

I have one more question for now. Lol I am asked to work for a local fair for the county each year. I make about 200 dollars for the 4 day doings. I do it because it is fun but the 200 is nice also.
My question>>> so I forgot to add this to my projected income for 2017 for my ACA subsidy. So this summer when this happens do I need to notify HC.Gov and tell them of this change

Well, that's a tough one.

If it were me I'd just assume that an extra $200 does not constitute a meaningful change vs the estimate and let it go. It will be included in the final reconciliation, so your total subsidy will reflect that extra income, it's just a matter of time.

 

[scrabbler1]

Street, I agree with MichaelB. I'd say it's pretty common for one's early estimate of MAGI to be off a little bit from the final tally.

 

[street]

Thank you again for the help.