Can Marketplace Health Insurance Terminate for Not Sending In Documents?

[kgmom219]

"Could not say"??? Bull! HHS is lying, and Kaiser must be owned by ObamaCare tree huggers.

They cant read documents that are uploaded.

They aren't lying. They are incompetent.

 

[MaryDallas]

They cant read documents that are uploaded.

They aren't lying. They are incompetent.

Oh, I get it now: they can't read; period.

 

[FLM2]

I guess it is true.......if Kaiser finally reports on it.

Paperwork Inconsistencies Causing Thousands To Lose Obamacare Subsidies | Kaiser Health News

The paperwork processing problem, however, persists.

In 2015, the number of consumers who had their tax credits adjusted or lost due to an income inconsistency rose as enrollment went up. According to a recent report from CMS, 223,000 households had their tax credit or cost-sharing reductions adjusted for their 2015 coverage.

HHS could not say how many consumers overall saw their tax credits revoked because of an inconsistency in their documents, nor could it say what percentage of those people turned out to have been wrongly denied subsidies.

I would estimate that about 25-50% of the people who have been asked to provide documents have lost coverage, most through no fault of their own.

One of the primary challenges for all of us for 2016 is to 'break the code' regarding what triggers a request for documents-my initial thought is that using the exact income from the last filed tax return will provide a 'clean' subsidy without a request for documents-anyone else have any thoughts?

 

[kgmom219]

I would estimate that about 25-50% of the people who have been asked to provide documents have lost coverage, most through no fault of their own.

One of the primary challenges for all of us for 2016 is to 'break the code' regarding what triggers a request for documents-my initial thought is that using the exact income from the last filed tax return will provide a 'clean' subsidy without a request for documents-anyone else have any thoughts?

1. Not have any self employed clients
2. Use 2015 income (so its close to tax return)
3. Lets clients know that if they file an extension, it creates havoc

 

[FLM2]

1. Not have any self employed clients
2. Use 2015 income (so its close to tax return)
3. Lets clients know that if they file an extension, it creates havoc

#3 is interesting because so many self employed file extensions and they are the ones most at risk.

I just went through my Marketplace application records-about 50% of my clients had requests for documentation and of that about 20% have had issues with their subsidy and/or policy.

Overall, for me, that is 10% of my clients with Marketplace plans with problems, it just seems like way more than that given how difficult the resolution of these is.

 

[kgmom219]

#3 is interesting because so many self employed file extensions and they are the ones most at risk.

I just went through my Marketplace application records-about 50% of my clients had requests for documentation and of that about 20% have had issues with their subsidy and/or policy.

Overall, for me, that is 10% of my clients with Marketplace plans with problems, it just seems like way more than that given how difficult the resolution of these is.

Exactly.............

 

[healther]

#3 is interesting because so many self employed file extensions and they are the ones most at risk.

I just went through my Marketplace application records-about 50% of my clients had requests for documentation and of that about 20% have had issues with their subsidy and/or policy.

Overall, for me, that is 10% of my clients with Marketplace plans with problems, it just seems like way more than that given how difficult the resolution of these is.

That is exactly where I am.

I have recognized one problem with the Social Security segment. No matter how clear I make it, they forget they need to file their taxes. It's just not at all a natural process for them.

The appeals process is too slow for many of my clients. Some can make up a months worth of tax credit redactions, but to many that means a cancelled policy.

 

[AllenChicago]

Sometimes HC.gov shows the prior year's income and asks, "Is this what you expect to earn in 20__?" If you're able to say "YES", that client will not have a request for income proof on the eligibility letter, or from HHS that policy year. As FLM2 said, using a prior-year income is the safest route to take, whenever possible.

Why HC.gov only pulled up the prior year's income for just some people is probably because 60% of the IRS tie-in system was still not finished during 2015 O.E.. Hopefully 2016 will be better.

 

[FLM2]

Sometimes HC.gov shows the prior year's income and asks, "Is this what you expect to earn in 20__?" If you're able to say "YES", that client will not have a request for income proof on the eligibility letter, or from HHS that policy year. As FLM2 said, using a prior-year income is the safest route to take, whenever possible.

Why HC.gov only pulled up the prior year's income for just some people is probably because 60% of the IRS tie-in system was still not finished during 2015 O.E.. Hopefully 2016 will be better.

If that remains the same then anyone who has a subsidized plan that has not been cancelled for documents should be able to just answer yes to that question during OEP and not have to deal with this again, that is going to be the approach I take.

 

[Yagents]

It should work, as there's no wage inflation in O's economy.