Eligibility Notice APTC Match

Dec 4, 2015

  1. saintstigers
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    saintstigers Guru

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    Have you ever had the amount of APTC on the eligibility notice letter NOT match the actual APTC that was applied to the premium.

    I have a client where the eligibility letter says she qualified for $549, then when it is applied to the plan (showing on the hc.gov site) it is 524???
     
  2. mwoodbrid
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    mwoodbrid Expert

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    This can be caused by a plan offering "extra" benefits above and beyond the essential health benefits. We had a bunch of plans in Oregon last year that did this, and APTC would only apply to the percentage of the premium that was calculated to be for the "normal" benefits in the plan.
     
  3. ActuaryGuy
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    ActuaryGuy Expert

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    Any part of premium that is for tobacco use is also not subsidy eligible.
     
  4. saintstigers
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    saintstigers Guru

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    no the plan doesn't offer any extras and the client was s non smoker.
     
  5. pbbaseball
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    UHC had tons of those last year. I've seen a few with our local Blue. UHC said it was because they offered more than the EHB's. When I asked what else, they said extra chiropractic, helicopter rides for emergencies, etc. They can stretch a lot out of $0.44 a month, when they can't offer dental for less than $40.
     
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