Can Marketplace Health Insurance Terminate for Not Sending In Documents?

[AllenChicago]

Based on the documents that I am receiving from some of my clients it is very clear that most of the lower income subsidy recipients who enrolled directly through the Marketplace are going to lose their subsidies and maybe coverage because they have absolutely no clue as to what to send in.

If someone's subsidy is terminated, does that create a SEP for the person to immediately re-enroll?

Does the subsidy termination automatically terminate the policy at the carrier at the end of that month, or does it go into a 3 month grace period?

 

[FLM2]

If someone's subsidy is terminated, does that create a SEP for the person to immediately re-enroll?

Does the subsidy termination automatically terminate the policy at the carrier at the end of that month, or does it go into a 3 month grace period?

The answers to those questions and more are contained in the new Obama autobiography, "How to Get Elected President, Gain Access to Great Golf Courses, and Introduce Some Really Bad Legislation", coming to your local bookstore on January 22, 2017.

On another note, I got an email from a client today-we submitted her green card as proof of residency, now they want 'Extra Proof'. I know someone will post that two forms are required but my question is WHY?

 

[RayNY]

If someone's subsidy is terminated, does that create a SEP for the person to immediately re-enroll?

Does the subsidy termination automatically terminate the policy at the carrier at the end of that month, or does it go into a 3 month grace period?

Loss of subsidy eligibility is only an SEP when due to a change in income. When due to a misrepresentation or inaction on the part of the client, it is not.

AFAIK, if you can't prove subsidy eligibility, you lose the subsidy but can stay on the plan. According to MaryDallas's post, it seems like they might be terminating both when ineligible (although, it might be that specific client, or a detail we're overlooking).

 

[sman]

If someone\'s subsidy is terminated, does that create a SEP for the person to immediately re-enroll? Does the subsidy termination automatically terminate the policy at the carrier at the end of that month, or does it go into a 3 month grace period?

It\'s been my experience that they terminate the coverage and reissue the same plan, but without the subsidy. Not sure of the timing of it though. I have one currently terminating at the end of March and the new plan starts April 1.

 

[RayNY]

It\'s been my experience that they terminate the coverage and reissue the same plan, but without the subsidy. Not sure of the timing of it though. I have one currently terminating at the end of March and the new plan starts April 1.

Wouldn't that result in a reset of the deductible, new ID #'s, etc?

 

[sman]

Wouldn't that result in a reset of the deductible, new ID #'s, etc?

One would think. Especially if they also qualified for a cost sharing reduction.

 

[AllenChicago]

It\'s been my experience that they terminate the coverage and reissue the same plan, but without the subsidy. Not sure of the timing of it though. I have one currently terminating at the end of March and the new plan starts April 1.

I'm not sure how all carriers react, but BCBS steps out of the way when the Marketplace cancels a plan. No letters, e-mails, or calls to the insured from BCBS. Marketplace is in complete control..which can be good, or bad, depending on the insured's circumstances.

I've only had one cancel for not sending in proof of income. A CSR plan. Insured called and re-enrolled. Same CSR plan, and premium.

 

[taterpeeler]

I'm not sure how all carriers react, but BCBS steps out of the way when the Marketplace cancels a plan. No letters, e-mails, or calls to the insured from BCBS. Marketplace is in complete control..which can be good, or bad, depending on the insured's circumstances.

I've only had one cancel for not sending in proof of income. A CSR plan. Insured called and re-enrolled. Same CSR plan, and premium.

same agent???..............................

 

[tonyisme]

Well holiday week is upon us... I'll take some of that Don Julio 1942 and I'll pass on the kool-aid ....thank you

Don Julio is something I can believe in... And my CPA

 

[russelltw]

Marketplace told my business partner that losing the subsidy would allow them to re-enroll in a subsidy plan provided they go back thru marketplace. They guy said to use the existing account and report as a life change (losing coverage). The eligibility notice even says they get a new 60 day period to re-enroll.