Can Marketplace Health Insurance Terminate for Not Sending In Documents?

Discussion in 'Health Care Reform Forum' started by MaryDallas, Mar 11, 2015.

  1. MaryDallas
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    MaryDallas Well-Known Member

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    Yes.

    I just had the first one terminated by the Marketplace for not sending in income verification documentation. This person is self employed; owns a flooring company. His adjusted gross income for 2014 was $50,000. His taxes are with the tax accountant now. He is out of the country with no insurance. He does not know his income for 2015 yet. He thinks it may be higher. I called the Marketplace. They insist they have to have a bank statement; something. They said there was a discrepancy in his income.

    I was wondering how long it would take for this to begin? Now, I know.
     
  2. Yagents
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    Yagents Well-Known Member

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    When was it due???? What date on determine letter?
     
  3. MaryDallas
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    MaryDallas Well-Known Member

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    These people have been getting letters since January, 2014. They told me they sent in a copy of their 2014 tax return which reflected $50,000 adjusted gross income. They got another request for income verification 2015 in January. The guy's taxes are with his accountant. The marketplace terminated them February 28, 2015.

    When I called Cigna they said it came from the marketplace due to 'income discrepancy'. I called the marketplace and they said his income did not match up. Match up to what? They have their tax return. They wanted a bank statement, ledger sheet, something now for 2015.

    The gentleman did tell me he thought he made more in 2015 but it seemed within a range to be eligible for some kind of tax credit. He had no idea yet what he was going to show adjusted gross income: $60,000 plus maybe, which would still be eligible for some kind of tax credits with 3 in the family.

    I've had people send in documents to the address in KY several times. It seems to go in a deep, dark hole.
     
  4. AllenChicago
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    AllenChicago Well-Known Member

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    I've had 3 terminated this year for not sending in documents 6 - 10 months ago. When these clients received notice from the carrier that they're plan was cancelled by the Marketplace, they called me in a panic.

    I directed them to the people who walk on water at HC.gov. Within a few days, each one of them showed up as In-Force once again...and with a new policy date, but same policy number. No back premium due.
    ac
     
  5. MaryDallas
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    MaryDallas Well-Known Member

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    I'm sure I'll be able to get it worked out: these people are out of the country now until the end of the month, though. I've called once for them. I am authorized on their account. I'll try again. (They have a 3-month grace period, too.)
     
  6. FLM2
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    FLM2 Well-Known Member

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    So you are saying that these terminations are for 2014 plans, not 2015?
     
  7. MaryDallas
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    MaryDallas Well-Known Member

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    No; they wanted something for 2015 (proof of income). They had coverage up to 2/28/15.
     
  8. sman
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    sman Well-Known Member

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    Why would they cancel coverage? Why not just terminate the subsidy? The income has zero to do with their health insurance (other than if they receive the cost sharing subsidy).
     
  9. MaryDallas
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    MaryDallas Well-Known Member

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    I'm not sure yet. Still being bounced back and forth from Cigna to marketplace. Cigna says it's marketplace; marketplace says it's Cigna...waiting for marketplace supervisor.

    ANSWER: Although the client is a U.S. Citizen and in the original file I had his naturalization #, A #, and certificate of citizenship # they were asking for 'proof of citizenship'. He sent in a copy of his passport to KY on Feb. 26, 2015, which has not been processed yet (return receipt requested). So every year this has to be sent in. And it goes into a deep, dark hole in KY. The supervisor says there is no way to communicate with the people in KY and they hear this all the time; and that people have sent in the same documents numerous times. It just goes on and on the amount of time, energy, effort on these by everyone.
     
    Last edited: Mar 11, 2015
  10. FLM2
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    FLM2 Well-Known Member

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    They can't terminate coverage, they just remove the subsidy and I would assume the 90 day grace period begins for them to pay or complete an appeal.

    The whole process is disgusting, next year I will only do subsidy apps for people who use their last filed tax year as the basis so this is eliminated.
     
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