Advance Payments of the Premium Tax Credit APTC
The American Rescue Plan Act ARPA
2021 Federal Stimulus Package
The Coronavirus bill represents the biggest expansion of Federal Help – Subsidies, since ACA/Health Reform/Obamacare started in 2010!
Use our Quote Subsidy Calculator Engine, to see how ARPA works for you.
There are way more subsidies and there is no upper income limit chart (FPL) for 2021 and 2022.
- Those enrolled in Covered California health plans will not have to pay more than 8.5% of their household income for the second lowest cost silver plan – Get Quotes
- If you are not in Covered CA, there is a special enrollment period to apply. If you stay with the same insurance company, your deductibles & co pays will transfer over!
- Any person in 2021 who received unemployment insurance for one week or more, and their total income qualifies for coverage through Covered California, will receive federal premium tax credit available for 138% of FPL Silver 94? for the duration of the Public Health Emergency in 2021.
- In California, individuals making between 138 percent and 150 percent of the federal poverty level — between $17,776 and $19,140 per year — will see their already-low premiums eliminated. San Diego Union * Covered CA FAQ for Brokers *
- 100% federal premium subsidy for COBRA coverage Blue Shield *
Get quotes to see how ARPA would work for you.
ARPA is funded to the tune of $34 Billion for only two years and would change the formulas for health insurance tax credits to make them more generous for most people, and also allow a wider number of individuals to qualify.
Covered CA will automatically check if clients get more subsidies. BUT! your consent to allow Covered CA to check your finances in the Federal Hub, etc. must be up to date. Here’s their quick guide on how to do that.
ARPA is comprehensive and there are several provisions that we are watching closely that would affect how people pay for their health insurance coverage:
- Removing the cap on subsidies for people earning more than 400% [600% in CA] of the Federal Poverty Level (FPL) –Currently those with a Modified Adjusted Gross Income (MAGI) of more than 400% of the FPL are not generally eligible for Advance Premium Tax Credits (APTC). Additionally, there is legislation that would make the removal of the 400% cap permanent.²
- Lower the maximum a person has to pay for the Benchmark Plan from 9.83% of MAGI to 8.5% of MAGI – This provision would drop the amount the insured person has to pay for insurance from 9.83% of his MAGI to 8.5%.
- Provide no-cost Silver Plans for people receiving unemployment insurance – Americans on unemployment insurance during 2021 would receive the Benchmark Silver Plan in their market for a $0 premium contribution while they are receiving unemployment insurance.⁴
- APRA COVID Stimulus bill will also pay your COBRA and Cal COBRA premium.
All ages will be affected, but this bill will have the greatest impact on near-seniors, or those aged 55-64 because of the cost of their ACA coverage. Stephens Mathews Email 3.11.2021 *
Resources & Links
- HR 1319 on Congress.Gov
- Insure Me Kevin.com
- Kaiser Foundation Analysis & Summary 3.15.2021
- Cal Matters.org
- HHS Fact Sheet
- IRS Overview
- Covered CA Website on ARPA
- CC March 18th 22 page slide show
- Federal Data Services Hub
- Covered CA FAQ’s for Brokers Rev 5.12.2021
- Target Strategies
- Covered CA Broker Briefing April
- Covered CA says subsidies are too big to ignore
- Blue Shield tools & explanation
- Sample – Messaging for on-exchange members with a subsidy
- Sample – Messaging for on-exchange members without a subsidy
- Sample – Messaging for switching to an identical plan on-exchange
- Blue Cross Power Point Presentation
- Word & Brown Insurance Wholesaler Summary
- Unemployment Compensation Enhancements Silver 94
- Extensive FAQ from Anthem Webinar
Steve Shorr VIDEO on subsidies
Health Care Reform
CMS VIDEO explains the advance premium tax credit and the different ways in which you can apply it to lower the cost of insurance for you and your family.
Introduction to Subsidies – Premium Tax Credit
To make this all “simple” just use our quote engine and/or watch our video on using the quote engine.
what is MAGI Income or does this or that count as income.
How do you get the premium tax credit?
Check out our quote engine, to get a preliminary indication of the amount of subsidies you’ll qualify for. There is no extra charge for our services,
In a lot of ways subsidies are hocus pocus smoke & mirrors as you have to file Form 8962, Premium Tax Credit, with your tax return at the end of the year. So, at the end of the year if you make too much $$$ you might have to give it back. If you make less, you get money back on your taxes.
Failing to file your tax return will prevent you from receiving advance credit payments in future years and can cause MAJOR PROBLEMS and coverage CANCELLATION!
The premium tax credit is refundable so taxpayers who have little or no income tax liability can still benefit. The credit also can be paid in advance to a taxpayer’s insurance company to help cover the cost of premiums. IRS Website on “The Basics“
Links & Resources
No Health Care Expenses, Depending on Income
Federally recognized American Indians and Alaska Natives who earn less than 300 percent of the federal poverty level will not have to pay certain out-of-pocket medical costs, such as copays and deductibles, if they purchase health insurance coverage through Covered California. (Click here for information about federal poverty levels.)
No Cost-Sharing for Covered Services Provided by an American Indian Health Provider or Clinic, Regardless of Income
There are no copays or deductibles for any covered services received directly through the federal Indian Health Service, tribes, tribal organizations or urban American Indian organizations.
Ability to Buy Insurance Anytime
American Indians and Alaska Natives can buy or change health insurance plans once a month through Covered California and are not subject to open-enrollment periods. Our webpage on special enrollment
Exemption from the Shared Responsibility Payment
All members of federally recognized tribes and all American Indians and Alaska Natives who are eligible for services through an Indian Health Service provider are eligible from an exemption from the shared responsibility payment (the tax penalty consumers pay if they do not have minimum essential health coverage). Click here for more exemption information. Our webpage on CA Penalty * Exemptions from CA Mandate Penalty
Additional information that may be of interest to American Indians and Alaska Natives is available below:
- The Centers for Medicare and Medicaid Services’ “Outreach & Education Resources” page
- Information about the Affordable Care Act from the Indian Health Service
- The Centers for Medicare and Medicaid Services’ information page for special populations
- The California Rural Indian Health Board’s website about Covered California and the Affordable Care Act
- The California Consortium for Urban Indian Health
- Covered California Tribal Consultation
USA Today – ACA hard sell for Native Americans 10.15.2013
What tribe are you a member of?
Check out these links:
mwgoe.org Many Winters Gathering of Elders – San Pedro, CA
No extra charge for complementary assistance
- Appoint us as your broker
- VIDEO on ARPA Stimulus and more Covered CA Subsidies
- Set Consultation Meeting via Phone, Skype or Zoom
- Get Instant Health Quotes, Subsidy Calculation & Enroll
Videos on how great agents are
Technical Links for
Premium Tax Credits §136 B
|Kaiser Foundation Subsidy Explanation|
CFR 155.305 HTML Eligibility Standards
§1.36b-0Table of contents
§1.36b-1 Premium tax credit definitions
final regulations on the reporting requirements for Marketplaces.
#Report changes as they happen - within 30 days!
10 days for Medi Cal
Our webpage on ARPA & Unemployment Benefits - Silver 94
- Our VIDEO on how to report changes to Covered CA
- Lost your job? How to keep your Health Insurance. Shelter at Home VIDEO
- References & Links
- Here's instructions.
- Our opinion & short cut * 6 pages of questions - way too complicated, easy to mess it up, lose subsidies and/or go into Medi-Cal - Just give the bottom line in MAGI Household Income
- If you've appointed us - instructions - as your broker, no extra charge, we can do it for you.
- Voter Registration
- Task Guide Phone - Voter Registration
- Denial of benefits and possible criminal charges if you don't report changes in income!
- Visit our webpage on how to report changes
- Interactive Tax Assistant (ITA)
- Am I eligible to claim the Premium Tax Credit?
- IRS FAQ on Premium Tax Credit
- Learn More About Your Health Insurance Tax Documents | Covered California VIDEO
- turbo tax.com
- H & R Block
- E file.com
- Estimate the Subsidy for Health Insurance, benefits, premiums, etc.
- 8962 ONLINE Calculator
- Tax Form Calculator.com
- e tax.com
- Marriage Higher or Lower Taxes?
Child & Related Pages
- 8962 Premium Tax Credit APTC Form attaches to Form 1040
- Affordable Employer Health Coverage? Employee ONLY 9.86% Family Glitch
- Age 65 – Can you get Tax Credits Subsidies Covered CA?
- Premium Subsidy to 600% FPL + Mandate Penalty?
- Mandate Penalty California – MEC – QHP – 5000 A
- 10 Reasons that you need Health Insurance
- Employer Mandate for Health Insurance ACA 4980 h
- Health Sharing Ministries – Not Protected by Insurance Guarantees
- Lawfully Present – Public Charge – Immigration Status
- Mandate Penalty California – MEC – QHP – 5000 A
- Subsidies Upheld – King v Burwell