How and when to report changes to Covered CA
It’s mandated that you report to Covered CA and/or Medi-Cal any changes, higher or lower in:
Changes in Circumstances and Advance Premium Tax Credits
-
your
Estimated MAGI income
for this-upcoming taxable year,
- If nothing else, don’t take APTC and just get it when you file taxes Form 8962, note the penalties if you under pay your estimated tax under form 2210 – instructions.
- marriage or divorce
- the birth or adoption of a child — number of people in your household,
- starting a job with health insurance
- gaining or losing your eligibility for other health care coverage
- changing your residence – Address
Reporting these changes will help individuals avoid large differences between the advance credit payments and the amount of the premium tax credit allowed on their tax return, which may affect their refund or balance due.
Covered CA has asked agents not to give tax advice. Here’s their suggestions.
Medi-Cal process to handle reported changes.
FAQ on urgency to report changes in income
Be CAREFUL when you update income… It could cause your coverage to be cancelled!!! InsureMeKevin.com detailed Analysis
9.15.2017 Job Aid (Instructions) written by Covered CA on how to make changes— Including Income
When you are changing the income, please select the event as “None of the above.” Changing the income is not a qualifying event.
***IMHO it can be – See Special Enrollment – Change in Silver Level...
Since you selected “Other qualifying event” it sends the case to review. Email dated 5.18.2017 9:36 AM
#Report changes as they happen - within 30 days!
10 days for Medi Cal
- 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.
- If you've appointed us - instructions - as your broker, no extra charge, we can do it for you.
- Denial of benefits and possible criminal charges if you don't report changes in income!
- Visit our webpage on how to report changes
#Form8962 Premium Tax Credit
Reconciliation Form attaches to 1040
Subsidy is IMHO hocus pocus - smoke & mirrors
it all comes out when you file taxes!
When you complete the application, it’s under perjury and you promise to notify Covered CA of any changes
This is also a reason we don’t do business for competent adults through 3rd parties. Here’s where we wrote someone up with Covered CA and then the person was all mad at us and said we were money hungry, etc. as we didn’t put them in Medi-Cal. Read this ladies comments about how messed up Medi-Cal is.
Mandate to File Tax Return
& Form 8962
Etc. Copied from Covered CA ONLINE application 11.26.2014 – Paper Application Rights & Responsibilities Page 16
I agree to file a tax return before (April 15, ) to claim the Premium Tax Credit. I understand that I am required to submit changes that affect my eligibility, including income, dependency changes, address, and incarceration. These changes could affect the plans I can be enrolled.
I cannot change plans unless I have a life triggering event. Life Events include lost or will soon lose my health insurance, permanently moved to/within California, had a baby or adopted a child, got married or entered into domestic partnership, returned from active duty military service, gained citizenship/lawful presence, Federally recognized American Indian/ Alaska Native, released from jail, and other qualifying life events.
#Withholding W 4
IRS Withholding Calculator
Here’s tools to make sure the right amount is withheld, either for tax refund purposes or to avoid an unexpected tax bill next year.
“It’s a personal choice if you want to have extra money withheld to get a bigger tax refund, but you have options available if you prefer to have a smaller refund next year and more take-home money now.” Advance Premium Tax Credit now or later?
By adjusting your Form W-4, Employee’s Withholding Allowance Certificate, taxpayers can ensure that the right amount is taken out of their pay throughout the year so that they don’t pay too much tax and have to wait until they file their tax return to get any refund. Employers use the form to figure the amount of federal income tax to be withheld from pay. IRS Tax Withholding Calculator
People Working in the Shared Economy
Covered CA Consent for Verification – Income, etc.
Review the Consent for Verification Notice that Covered California sent to consumers last week and the Consent for Verification Quick Guide for more information.
Also, watch the How to Update Consent VIDEO for instructions on updating consumer consent.
Consumers are at risk of losing their Advanced Premium Tax Credit (APTC) and/or cost-sharing reductions for health insurance coverage if their consent form is out of date.
A consumer’s financial assistance may end because of one or more of the following reasons:
- The consumer’s consent to allow Covered California to use computer sources to check their income and family size, including information from tax returns, has expired.
- The consumer may not have filed afederal income tax return for their household to reconcile the Advanced Premium Tax Credit (APTC) used to lower plan premium costs
- The consumer’s household income may be too high.
Covered CA
Right to change plans when a change in Income changes your
Enhanced Silver Level..
One way to to make a change in your Covered CA coverage when it’s not Annual Open Enrollment is if your income changes, so that you qualify for a new or different level of Enhanced Silver Subsidies or income change makes you newly eligible for subsidies. Covered CA’s interpretation of the law is that you must already have coverage through Covered CA, to do this. FN 1
CA CCR Code of Regulations (7)
An enrollee Definition, or his or her dependent enrolled in the same QHP – Qualified Health Plan, is determined newly eligible or ineligible for APTC (Subsidies) or has a change in eligibility for CSR. [Cost Sharing Reductions – Enhanced Silver]
See more detail and discussion in footnotes below.
It just doesn’t seem “Fair” that if someone makes $100k as a single and then loses his job, can’t enroll when that happens.
Yes, I’ve been told that if you want Fair, you have to go to Pomona.
Response By Email (Argelia) (03/26/2018 11:57 AM) Good day Steve Shorr, Thank you for contacting Covered California™. A change in income is not a Qualifying life event. If you select “other qualifying life event,” it puts a hold on the account. In the future, for income changes you need to select “none of the above.”
CFR §156.425 Changes in eligibility for cost-sharing reductions. (Enhanced Silver)
Please start your research into Special Enrollment Periods by reviewing our main page of California Code of Regulations on Qualifying Events
See Full FPL Federal Poverty Level Chart – Income vs Plan and Program you and your family qualify for
(a) Effective date of change in assignment. If the Exchange notifies a QHP issuer of a change in an enrollee’s def eligibility for cost-sharing reductions (including a change in the individual’s eligibility under the special rule for family policies set forth in §155.305(g)(3) of this subchapter due to a change in eligibility of another individual on the same policy), then the QHP issuer must change the individual’s assignment such that the individual is assigned to the applicable standard plan or plan variation of the QHP as required under §156.410(b) as of the effective date of eligibility required by the Exchange.
(b) Continuity of deductible and out-of-pocket amounts. In the case of a change in assignment to a different plan variation (or standard plan without cost-sharing reductions) of the same QHP in the course of a benefit year under this section, the QHP issuer must ensure that any cost sharing paid by the applicable individual under previous plan variations (or standard plan without cost-sharing reductions) for that benefit year is taken into account in the new plan variation (or standard plan without cost-sharing reductions) for purposes of calculating cost sharing based on aggregate spending by the individual, such as for deductibles or for the annual limitations on cost sharing ECFR.Gov
(6) Newly eligible or ineligible for advance payments of the premium tax credit, or change in eligibility for cost-sharing reductions.
(i) The enrollee is determined newly eligible or newly ineligible for advance payments of the premium tax credit or has a change in eligibility for cost-sharing reductions; [Enhanced-Silver]
advance payments of the premium tax credit (subsidies) or is experiencing a change in eligibility for Enhanced Silver – cost-sharing reductions CA Agent Training Page 9 or premiums become unaffordable 155.420 156.425 156.410
determined newly eligible or newly ineligible for advance payments of the premium tax credit or has a change in eligibility for cost-sharing reductions [enhanced silver],
Special enrollment periods no longer will be available for:
Consumers who had signed up for exchange plans with too much in advance payments of tax credits because of redundant or duplicate coverage;
Consumers who were affected by Social Security income tax errors; (Counihan, CMS blog, 1/19). Learn More ⇒CA Health Line – Health Affairs.org 1.20.2016
(ii) The enrollee’s dependent enrolled in the same QHP is determined newly eligible or newly ineligible for advance payments of the premium tax credit or has a change in eligibility for cost-sharing reductions; or
(iii) A qualified individual or his or her dependent who is enrolled in an eligible employer-sponsored plan is determined newly eligible for advance payments of the premium tax credit based in part on a finding that such individual is ineligible for qualifying coverage in an eligible-employer sponsored plan in accordance with 26 CFR 1.36B-2(c)(3), including as a result of his or her employer discontinuing or changing available coverage within the next 60 days, provided that such individual is allowed to terminate existing coverage.
affordable or provide minimum value [bronze plan] for his or her employer’s upcoming plan year to access this special enrollment period prior to the end of his or her coverage through such eligible employer-sponsored plan; Learn More⇒Change Enhanced Silver
(iv) A qualified individual in a non-Medicaid expansion State who was previously ineligible for advance payments of the premium tax credit solely because of a household income below 100 percent of the FPL, who was ineligible for Medicaid during that same timeframe, and who has experienced a change in household income that makes the qualified individual newly eligible for advance payments of the premium tax credit.
Footnotes
1. Covered CA cites their webpage and says change in income is only if you are already enrolled in a Covered CA plan. Email dated 11.14.2016 3:35 PM 45 CFR §155.420(d)(6); 10 CCR – CA Code of Regulations – Special Enrollment Periods § 6504(a)(6). Note that Covered California interprets this to only allow for changes in plan, not to newly enroll based on language in the state and federal regulations referring to the enrollee rather than the individual as in other sections. Thus, if you are already in a plan you can change to a new plan but you can’t newly enroll in a plan when your income decreases. Western Poverty Page 5.215
45 CFR §155.420(d)(6) Newly eligible or ineligible for advance payments of the premium tax credit, or change in eligibility for cost-sharing reductions.
(i) The enrollee is determined newly eligible or newly ineligible for advance payments of the premium tax credit or has a change in eligibility for cost-sharing reductions;
(ii) The enrollee‘s dependent enrolled in the same QHP is determined newly eligible or newly ineligible for advance payments of the premium tax credit or has a change in eligibility for cost-sharing reductions; or
(iii) A qualified individual or his or her dependent who is enrolled in an eligible employer-sponsored plan is determined newly eligible for advance payments of the premium tax credit based in part on a finding that such individual is ineligible for qualifying coverage in an eligible-employer sponsored plan in accordance with 26 CFR 1.36B-2(c)(3), including as a result of his or her employer discontinuing or changing available coverage within the next 60 days, provided that such individual is allowed to terminate existing coverage.
(iv) A qualified individual who was previously ineligible for advance payments of the premium tax credit solely because of a household income below 100 percent of the FPL and who, during the same timeframe, was ineligible for Medicaid because he or she was living in a non-Medicaid expansion State, who either experiences a change in household income or moves to a different State resulting in the qualified individual becoming newly eligible for advance payments of the premium tax credit;
Enrollee means a qualified individual
or qualified employee enrolled in a QHP. Enrollee also means the dependent of a qualified employee enrolled in a QHP through the SHOP, and any other person who is enrolled in a QHP through the SHOP, consistent with applicable law and the terms of the group health plan. Provided that at least one employee enrolls in a QHP through the SHOP, enrollee also means a business owner enrolled in a QHP through the SHOP, or the dependent of a business owner enrolled in a QHP through the SHOP. Qualified individual means, with respect to an Exchange, an individual who has been determined eligible to enroll through the Exchange in a QHP in the individual market. Definitions 155.20 You can completely forget about what federal law has to say when it comes to Covered CA. Since Day 1, they have been making up their own rules without regard to the law when it suits their fancy. So, to Covered CA, decrease in income only allows a change of health plan if already enrolled through Covered CA despite the fact that in just about any other state, it triggers an SEP. MAX Herr Response from Covered CA Income changes so much that a current Covered California enrollee becomes newly eligible or ineligible for help paying for their insurance. For example, if a consumer is already getting help paying for their insurance premium, and their income goes down, they may be able to get extra help. coveredca.com/special-enrollment
This is what it states in Healthcare.gov.If you’re enrolled in a Marketplace plan and your income or household change, you should report the changes as soon as possible. These changes — like higher or lower income, adding or losing household members, or getting offers of other health coverage — may affect the coverage or savings you’re eligible for.
Why it’s important to update your application immediately
If your income estimate goes up or you lose a household member: You may qualify for less savings than you’re getting now. If you don’t report the change, you could have to pay money back when you file your federal tax return. If your income estimate goes down or you gain a household member: You could qualify for more savings than you’re getting now. This could lower what you pay in monthly premiums. You could qualify for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP). healthcare.gov/why-report-changes/
More Info
• Income and Reconciliation Notice
• APTC & Income Talking Points
If you haven’t given Covered CA permission to verify income, you will be renewed, but without the advance premium tax credit and risk cancellation Insure Me Kevin.com
Related Pages in Covered CA & Enrollment Procedures Section
InsureMeKevin.com Molina Memo Cancellation if you lose subsidy for one month
We had to adjust our income again on the covered ca website as we have apparently a very unique (compared to other folks getting insurance through covered ca) income situation.
We spent several hours/days on the phone with them. It was extremely complicated and I’m not sure any insurance expert would even have expected or understood the insanity of covered ca’s process.
I believe/hope we have it sorted out for now.
Thank you for your help again.
Best,
C
If you enjoy waiting on the phone for hours/days rather than just send us an email and we’ll take care of it, then we are probably not the agent for you.
Take a look at the Q & A on this page along with the resources on this website.
Here’s a Q & A about simplifying income when reporting a change to Covered CA https://individuals.healthreformquotes.com/subsidies/report-a-change/
I’d don’t like the word “expert” but I love complicated stuff and I probably know more about Covered CA, than Covered CA does.
See our webpages on:
MAGI Income https://individuals.healthreformquotes.com/subsidies/magi/
IRS Form 8962 Tax Reconcilation at the end of the year https://individuals.healthreformquotes.com/subsidies/intro/premium-tax-credit-8962/
IMHO it doesn’t matter what Covered CA tells you now about your Income. It’s what the IRS says at the end of the year when you file taxes.
FAQ on how to avoid the trap of answering every question on calculating your income
https://individuals.healthreformquotes.com/subsidies/magi/#comment-102936
Details of every kind of income & deduction, on our website including official IRS publications! https://individuals.healthreformquotes.com/subsidies/magi/categories/
See our reference materials:
https://www.irs.gov/pub/irs-pdf/p974.pdf
https://wclp.org/wp-content/uploads/2016/06/Western_Center_2016_Health_Care_Eligibility_Guide_Full_rev.1.pdf#page=4
Don’t forget – Covered CA cannot give you legal or tax advice and even issued a memo on that https://individuals.healthreformquotes.com/subsidies/intro/premium-tax-credit-8962/must-file-tax-return-free-help-vita/
Please note too, that even if you prove in Court that Covered CA gave you the wrong tax advice, too much or too little subsidy or told you Social Security Income doesn’t count – Covered CA doesn’t have to reimburse you! Ask the Polk Family!
https://individuals.healthreformquotes.com/subsidies/intro/premium-tax-credit-8962/must-file-tax-return-free-help-vita/#polk
Thus, I won’t give you tax advice either, but I will show you were it says it in the tax code or an actual Covered CA or Insurance Company brochure
If you find ANY page on any other website that explains something better with a citation to the law or actual regulation than my page, just link to it in the comments are we have a bounty of $5/link!
Check our testimonials where numerous people that we’ve helped with Covered CA intricacies have THANKED us.
https://steveshorr.com/intro/15-reasons/testimonials-2/#comments
Our son has obtained a Anthem policy through his employer with an 11/01 effective date. Seems as if it does not make sense to keep him on our policy and pay both premiums for next two months.
However, you never know with Covered CA-they may charge more with my son off and just my wife on the policy.
Are you able to check this without making a change?
The Tax Subsidy Calculation is a very complicated algebraic formula explained in Section 1.36 b. https://individuals.healthreformquotes.com/subsidies/intro/calculation/ So, I just use the quote engine that I pay around $175/month for. http://www.quotit.net/eproIFP/webPages/infoEntry/InfoEntryZip.asp?license_no=0596610 See the screen shots below. You’re net premium is the same.
Here’s the subsidy, net premium and actual premium you’re paying now for two people.
Here’s the calculation with you on Medicare, Your wife with Covered CA and your son on an employer plan
CCA [Covered CA] already informed me we can either
1. leave it as is or
2. drop him for Dec only.
Nov premium already paid.
Did the Phone Representative:
ever read the material above about the mandate to report changes within 30 days?
Tell you, that you should check out the tax consequences? https://individuals.healthreformquotes.com/subsidies/intro/premium-tax-credit-8962/must-file-tax-return-free-help-vita/
Tell you that the Administrative Law Judge wanted to make Covered CA pay damages when they provided the WRONG advise? https://individuals.healthreformquotes.com/subsidies/intro/premium-tax-credit-8962/#comment-102393
Since your son has MEC Minimum Essential Coverage, sure he can have two policies, he won’t collect twice though https://individuals.healthreformquotes.com/definitions-glossary/dual-coverage/ there will NO LONGER BE SUBSIDIES FOR HIS PREMIUM and you will have to pay those back when you file taxes – Form 8962 https://individuals.healthreformquotes.com/subsidies/intro/premium-tax-credit-8962/
You or a tax family member enrolled in health insurance coverage through Covered CA … not eligible for affordable coverage through an eligible employer-sponsored plan that provides minimum value or eligible to enroll in government health coverage – like Medicare, Medicaid, or TRICARE https://www.irs.gov/affordable-care-act/individuals-and-families/eligibility-for-the-premium-tax-credit
Hi,
I have been on the Covered California insurance (HealthNet) for the last several years.
However, my income level has increased some. So, the premium amounts forecasted through them for 2021 all appear quite high.
Is it less expensive to separate out from Covered California and just find health insurance directly?
Going from paying $187 per month to paying over $400 per month sounds a little steep.
I am not sure that my budget can afford it.
First thing to do is, use our quote engine, put in your income, age & zip code and then you can compare rates in Covered CA with possible subsidies or outside of Covered CA. http://www.quotit.net/eproIFP/webPages/infoEntry/InfoEntryZip.asp?license_no=0596610
When the ACA passed, rates were supposed to be exactly the same in or out of Covered CA, with or without an agent.
Silver Level is different
Due to one of the many lawsuits on the constitutionality of ACA, the funding subsidies for Enhanced Silver went away. https://individuals.healthreformquotes.com/aca/metal-levels/enhanced-silver-cost-sharing-reductions/%c2%a7156-410-cost-sharing-reductions-enhanced-silver/constitutional-extra-costs/ Simple Plain English Explanation
What is your income now?
Are you self employed, it’s a tax deduction! https://employers.healthreformquotes.com/tax-credit/section-106/#selfemployeddeduction
There is no extra charge for us to be your agent, if you stay with Covered CA see the link above to get instructions to appoint us. If you want Silver Benefits and go direct, just use OUR links on our website or the “add to cart” button in our quote engine.
I went on the Covered CA website the other day and tried to update things, but it would not let me.
My husband who was covered by Medicare passed away in April. Should I keep him on still because of tax filing for 2020? 2021,
I will be filing single vs. married, filing jointly.
If he should be removed because of a “qualifying event” and it might change my premium for 2021 for the better, please tell me how to remove him, and I will.
Also, my MAGI for 2020 will be significantly less (probably around $35,000 or maybe less) when I file taxes.
Whatever you think is best.
Thank you again,
Covered CA requires that changes be reported within 30 days See above for rules, documentation, etc.
When you file taxes, the subsidy gets reconciled. You might get back $$$ or you might have to pay back subsidies, if you were not entitled. https://individuals.healthreformquotes.com/covered-ca-tax-credits-subsidies-aptc/intro/premium-tax-credit-8962/
It’s difficult to tell someone how to do something in the Covered CA portal. Instructions are above. I can do it for you. I can do a video and show you want I did.
I’ll send you quotes privately for the premiums currently and next year with lower income and just one person in the household.
Here’s where web visitors can get quotes http://www.quotit.net/eproIFP/webPages/infoEntry/InfoEntryZip.asp?license_no=0596610
Here’s the income chart https://individuals.healthreformquotes.com/covered-ca-tax-credits-subsidies-aptc/magi/income-chart/
Here’s your current premium at $45k married filing jointly
Here’s premium and subsidy at #35k single
Email me privately if you want me to make the changes for you in your account.
Medi-Cal can make a FEDERAL CASE with Criminal Penalties if you don’t report changes!!!
https://medi-cal.healthreformquotes.com/redetermination/#comment-1903
Fudging income to gain advantage is a tax crime.
https://individuals.healthreformquotes.com/covered-ca-tax-credits-subsidies-aptc/magi/categories/fudging-income-deductions/
https://hbex.coveredca.com/toolkit/renewal-toolkit/downloads/Job_Aid_-_Report_A_Change.pdf
2017 job aid version
I changed employers, can I switch from Bronze to Silver?
**********
Only if there is a change in income, that changes subsidies or silver level. See explanation above and the main special enrollment page.
I have lost my job at the ,,, Club, and am unemployed for now.
What can I do regarding my health insurance?
Are you 1099 or W 2?
You could apply for unemployment benefits.
The Governor is waiving the one week waiting period.
The benefits are taxable, so that would raise your expected annual MAGI income.
Under the CARES act, unemployment pays 100% of lost wages!
https://employers.healthreformquotes.com/ab-1672/carrier-requirements/corona-virus-how-does-insurance-cover-it/cares-act/
https://life.healthreformquotes.com/disability-income/disability-alternatives/unemployment-compensation-cant-find-job-corona-pandemic/#stimulus
Flow Chart courtesy of Naked Capitalism
Our page on 1099 workers
Our webpage on PPP Loans
Unemployment Page
Under the new CARES Act responding to the COVID-19 pandemic, all states will be allowed to provide up to 13 additional weeks of federally funded extended benefits to people who exhaust their regular state benefits.
Under the Act, through the end of this year, people who exhaust both regular and extended benefits, and many others who have lost their jobs for reasons arising from the pandemic but who are not normally eligible for UI in their state, are eligible for Pandemic Unemployment Assistance. People can receive a maximum of 39 weeks of benefits this year from all three sources combined. CBPP.org
If you want to go for broke you probably could qualify for Medi Cal under the monthly income rule. We don’t get paid to help you with Medi Cal, so you can either go into your Covered CA Account and change your annual income… If it’s less than 138% and that would be about $18k for a single, Covered CA would get you into Medi Cal. Or, you can apply directly with Medi Cal.
One downside is, that you may have a difficult time getting out of Medi – Cal. They want to grow and write everyone. IMHO it won’t be Medicare for All, but Medi Cal for all. They already write 1/2 of Californian’s. Medi Cal has a “secret” buzzword called Soft Pause, that no one seems to be able to hurdle!
Here’s our quote engine to calculate FPL and subsidies.
We currently have you down for $45k in annual income or let’s just say $4k/month. So, if you drop your annual income to say $40k, that would change your subsidy from $419/month to $468/month.
If you think things will get real tough, you could drop your estimated income lower… When this tragedy is over and you’re earning $$$ again, you have to report to Medi Cal within 10 days or Covered CA within 30.
I recently had someone tell me through their employer (hearsay) that Medi Cal may file criminal charges as they didn’t report the wife got a job. See more on that Q & A
Some people did not take the full amount of the subsidy available, so they wouldn’t have a problem at tax time. One could change that.
The tool to adjust the subsidy can be found my starting at the Enrollment Dashboard page.
Then you would select My Eligibility History on the left hand side.
On this page you will find the Plan Summary button once you select it the next page will display the Adjust Premium Tax Credit button.
Since you are getting subsidies, there is technically a 90 day grace period.
I am NOT in any way shape or form suggesting that you attempt to use it!!! If you get cancelled for non-pay, there is virtually NO F**ing way that you can get coverage till next January. I will NOT be responsible for anyone attempting to do that. IMHO Moses parting the Red Sea was easier than getting someone reinstated who has cancelled non pay.
Sure, I’ve had people claim they just called the Insurance Company and it was no problem, but I don’t listen to hearsay.
If you are not currently getting subsidies or don’t have insurance, check out all the new rules from Covered CA on special enrollment.
If you prefer to listen rather than read, scroll to the top of the page and watch the video.
[youtube https://www.youtube.com/watch?v=ScR039FHeME&w=320&h=180%5D
Here’s another top rated well known experienced agent and his explanation
https://youtu.be/Q36H4TCzojQ
If you had coverage on the job, you could check out Cal COBRA.
https://employers.healthreformquotes.com/cobra/california-cal-cobra/
If you are Medicare Eligible check our main webpage on Employer vs Medicare and the sub – child pages underneath.
One of the issues with Obamacare APTC Advance Premium Tax Subsidy is it does not look at income in arrears, because that would be too simple.
Instead it relies on enrollee’s to guess what they will make in same – future year and oh by the way how much they will have in deductions or if an adult son who’s listed on the plan will find a job or not. Who knows?
The premium assistance relies on MAGI Modified Adjusted Gross Income, do you have a complete list of acceptable deductions allowed for 2018 and for 2019?
You are really asking a tax question here, not Insurance or Covered CA. MAGI is simply your adjusted gross income, line 7 of your 1040 and add back in foreign income, tax exempt interest and Social Security.
So, it’s the IRS rules that allow deductions, NOT Covered CA! Covered CA sent a memo to agents stating that we can’t give tax advice. Here are the links to official IRS forms and publications showing all the deductions and what counts as income.
See Publication 17 Part 5 for deductions
Note too, that you can change your estimated MAGI anytime and that you are mandated to report changes within 30 days.
Please explain the 30 day requirement to notify Covered CA of a change in income. 30 days from what?
Enrollee’s Duty to Report Changes in Circumstances
An enrollee, or application filer on behalf of an enrollee, must report any change of circumstances with respect to the eligibility standards within 30 days of such change. An enrollee, however, who has a change in income that does not impact the amount of the enrollee’s Advance Payments of Premium Tax Credit (APTC) or the level of Cost-Sharing Reduction (CSR) is not required to report such a change. cdss.ca.gov/shd/res/htm/ParaRegs-Covered-California.htm
(45 C.F.R. § 155.330(b);
10 CCR California Code of Regulations § 6496
§ 6496. Eligibility Redetermination During a Benefit Year.
(a) The Exchange shall redetermine the eligibility of an enrollee in a QHP through the Exchange during the benefit year if it receives and verifies new information reported by an enrollee or identifies updated information through the data matching described in subdivision (g) of this section.
(b) Except as specified in subdivisions (c) and (d) of this section, an enrollee, or an application filer on behalf of the enrollee, shall report any change of circumstances with respect to the eligibility standards specified in Sections 6472 and 6474 within 30 days of such change. Changes shall be reported through any of the channels available for the submission of an application, as described in Section 6470(j).
(c) An enrollee who has not requested an eligibility determination for IAPs shall not be required to report changes that affect eligibility for IAPs.
(d) An enrollee who experiences a change in income that does not impact the amount of the enrollee’s APTC or the level of CSR for which he or she is eligible shall not be required to report such a change.
(e) The Exchange shall verify any reported changes in accordance with the process specified in Sections 6478 through 6492 before using such information in an eligibility determination.
Cal. Code Regs., tit. 10, § 6496, subds. (b), (d).)
Shouse Law.com VIDEO Medi Cal Fraud https://www.shouselaw.com/medi_cal_fraud.html
Q & A on our website about Medi Cal fraud
https://www.merriam-webster.com/dictionary/change
Definition of change (Entry 1 of 2)
transitive verb
1a : to make different in some particular : ALTER
never bothered to change the will
b : to make radically different : TRANSFORM
can’t change human nature
c : to give a different position, course, or direction to
changed his residence from Ohio to California
2a : to replace with another
let’s change the subject
b : to make a shift from one to another : SWITCH
always changes sides in an argument
c : to exchange for an equivalent sum of money (as in smaller denominations or in a foreign currency)
change a 20-dollar bill
d : to undergo a modification of foliage changing color
e : to put fresh clothes or covering on change a bed
intransitive verb
1 : to become different some things never change
2 : to undergo transformation, transition, or substitution winter changed to spring
3 : EXCHANGE, SWITCH
neither liked his seat so they changed with each other
4 : to put on different clothes need a few minutes to change for dinner
5 : to shift one’s means of conveyance : TRANSFER
on the bus trip he had to change twice
6 of the voice : to shift to lower register : BREAK
His voice started to change when he turned 13.
7 of the moon : to pass from one phase (see PHASE entry 1 sense 1) to another change hands
: to pass from the possession of one owner to that of another money changes hands many times
change noun
Definition of change (Entry 2 of 2)
1 : the act, process, or result of changing: such as
a : ALTERATION
a change in the weather
b : TRANSFORMATION
a time of vast social change going through changes
c : SUBSTITUTION
a change of scenery
d : the passage of the moon from one monthly revolution (see REVOLUTION sense 1a) to another also : the passage of the moon from one phase (see PHASE entry 1 sense 1) to another
e : MENOPAUSE
2a : money in small denominations received in exchange for an equivalent sum in larger denominations
b : money returned when a payment exceeds the amount due
a cashier quick at making change
c : coins especially of low denominations
a pocketful of change
d : a negligible additional amount only six minutes and change left in the game
e : MONEY sense 1
cost a large chunk of change
3 : a fresh set of clothes
4 British : EXCHANGE sense 5a
5 : CHANGEUP
6 : an order in which a set of bells is struck in change ringing
Last month I left my job and now I am freelancing.
Not sure what to do about reporting my income since I really don’t know what it will be – I am transitioning to 1099 project work.
I can continue to cover my premium if best option is to leave as is and settle up at tax time.
See the information above on estimating income for self employed.
Note also, that Self employed can deduct premiums on line 29 of your tax return.
Here’s our page on what’s better to take advance credits – subsidy now or at tax time.
When you do have an idea of what your income will be, you have 30 days to report it. In the meantime, I don’t see that you have to do anything.
I’m not clear as to when and how to update/verify my income for this year based upon my last year’s tax return.
Can you please advise?
1040 Income – Line 37 + Foreign Income + Tax Exempt Interest + Social Security
The question is NOT what you earned last year. It’s what do you expect to earn in 2018. That’s what form 8962 is, to reconcile your taxes and what was advanced to you as a subsidy.
In a private email, we sent you your 2016 tax return. Please advise how you think your numbers will look for 2018.
If your estimate changes, see above, on our webpage about reporting that within 30 days.
I will qualify for Health Insurance through my employer and don’t need my Covered CA coverage anymore.
How do I cancel coverage?
Do I need proof of new coverage?
What is the deadline so that I don’t have to pay for two policies?
The important thing to remember with Covered CA is that you must do it 15 days in advance. Thus the deadline to cancel for 4.1.2017 is TODAY!!! Learn More
Instructions on Covered CA website
Covered California only checks federal hub not tax return
https://insuremekevin.com/covered-california-cant-see-your-tax-return/
1. I went through you to get assistance with the subsidies. Which you told me I was unable to qualify for due to projected income in 2018.
2. I have since spoke with other agents that have assured me that I could have qualified.
1. As I recollect, you said you were disabled and would not have any income for 2018 or if you did it would be below the amount the IRS needs to get subsidies. See our Covered CA income chart or use our instant calculator and proposal quote engine.
While past income might be accepted as an indicator of future income, it’s what you file on your taxes at the end of the year for 2018 that counts. See forms 8962 Premium Tax Credit and 1040.
Even if you were to get on board with Covered CA and got advance subsidies, you are mandated to report any change in income within 30 days. See above for details. The application is under penalty of perjury. If you get subsidies you are not entitled to, you have to pay them back, when you file your taxes.
Our agent contract, CA Law and Federal Law – Tax Code prohibits us from helping people obtain tax benefits they are not legally entitled to.
If you want to submit and application to Covered CA, you are welcome to do so. The main problem I told you was that they would put you into Medi-Cal and you said you didn’t want that.
2. It’s nice that you spoke to someone, but I don’t see any citations for why they think you can get subsidies with zero income. We do not pay attention to hearsay.
Don’t forget – President Trump said health care is very complicated and President Obama didn’t even know ACA changed employer plans too.
One advantage to applying for Medi-Cal either direct or through Covered CA would be that if you do get a job that qualifies for subsidies, you could use a special enrollment event at that time, as you would be losing coverage.
If I recollect, you said if you did get a job, you would have Health Coverage there, thus no point.
Open Enrollment lasts till 1.31.2018
Employer Question from Covered CA ONLINE Application – If one isn’t working, how would you fill this out?