Can anyone Help Me with This?!

solo2013

Expert
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I have a client got laid off from her job and her plan ends on end of this month.
She decided not to sign up for cobra plan. Based on her earned income(Jan -June 2015) and unemployment benefits she is eligible for subsidies.

We submitted an application through healthcare.gov. She was qualified for SEP, but, not the subsidies.

It says "You need to return to the application and provide
information about health coverage from employers. The Marketplace can't determine your eligibility
for a tax credit and cost-sharing reductions (lower copayments, coinsurance and deductibles) without
this information."


Any idea?
 
I have a client got laid off from her job and her plan ends on end of this month.
She decided not to sign up for cobra plan. Based on her earned income(Jan -June 2015) and unemployment benefits she is eligible for subsidies.

We submitted an application through healthcare.gov. She was qualified for SEP, but, not the subsidies.

It says "You need to return to the application and provide
information about health coverage from employers. The Marketplace can't determine your eligibility
for a tax credit and cost-sharing reductions (lower copayments, coinsurance and deductibles) without
this information."


Any idea?
It sounds like there are some answers to questions missing regarding employer coverage. Did you fill in the details of her prior coverage where asked?

you could do a 3 way call to the Marketplace and try to get it resolved, it's already the 13th and if this isn't resolved quickly your client won't have coverage on September 1st.
 
All the questions related to employer coverage was answered correctly. Maybe...

how do you answer these questions when a person got laid off from job and the employer plan ends on end of month.

"Are you currently eligible for health coverage through a job (even if it's through COBRA or from another person's job, like a spouse)? The plan ends on 8/31/15 and eligible for cobra, so we answered yes.

"Will you be eligible for health coverage from a job during 2015 (even if it's through COBRA or from another person's job, like a spouse)?" answered Yes and put 9/1/15 as effective date(cobra)If she decide to sign up for cobra.

"Are you currently enrolled in employer's health coverage?" answered yes. it ends on 8/31/15.

"Are you a current or former employee of this employer? yes

"What is your current work status at Employer?" Answered no longer working at this employer

"Is the coverage from employer COBRA coverage?" answered Yes

"Are you expect COBRA benefits to expire during 2015, or do you expect to drop employer's health coverage in 2015? yes and put 8/31/2015

I would appreciate if anyone could help me.
 
All the questions related to employer coverage was answered correctly. Maybe...

how do you answer these questions when a person got laid off from job and the employer plan ends on end of month.

"Are you currently eligible for health coverage through a job (even if it's through COBRA or from another person's job, like a spouse)? The plan ends on 8/31/15 and eligible for cobra, so we answered yes.

"Will you be eligible for health coverage from a job during 2015 (even if it's through COBRA or from another person's job, like a spouse)?" answered Yes and put 9/1/15 as effective date(cobra)If she decide to sign up for cobra.

"Are you currently enrolled in employer's health coverage?" answered yes. it ends on 8/31/15.

"Are you a current or former employee of this employer? yes

"What is your current work status at Employer?" Answered no longer working at this employer

"Is the coverage from employer COBRA coverage?" answered Yes

"Are you expect COBRA benefits to expire during 2015, or do you expect to drop employer's health coverage in 2015? yes and put 8/31/2015

I would appreciate if anyone could help me.

if she hasn't accepted Cobra she is eligible for a SEP and a subsidy, your answers indicate she has Cobra coverage, that is the source of the problem. Has she chosen Cobra?

I can't tell you how to answer these questions but basically you have to let the Marketplace know she is losing employer coverage at the end of the month, until then she has no Cobra so you can answer No to those questions relating to Cobra as she has no obligation to accept it when she is subsidy eligible through the Marketplace.
 
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Yep, this is the problem:

Is the coverage from employer COBRA coverage?" answered Yes

If she has not accepted cobra should have been no, if she did then there was no sense in taking the app, until Nov 1.
 
Thank you for your input. However, the results are the same.
we went over it again and corrected the answer. they couldn't tell me why it's doing it.
 
Thank you for your input. However, the results are the same.
we went over it again and corrected the answer. they couldn't tell me why it's doing it.

the only suggestion I have is to delete the application and start over, other than that I am out of help other than calling the Marketplace.
 
Interpretations can be different for everyone on these questions. At 12:01am on Sept 1st, these are true:

There is no group plan available.
There is no cobra in place, because it was never activated.
There is a loss of coverage in the next 60 days, eligible for SEP an APTC.
 
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