Michigan ACA Question

[Lakshmi]

I need a little help.

I have health insurance clients still lingering on old plans. Some who qualify for subsidies; the ones who don't, I keep on other local plans that are easy and not dealing with the Market Place.

I have very little interest in signing people up in the Market Place, but it's coming up a lot. I do want to help the clients I have but I'm not looking for any more JUST health biz.

Obviously, I would be signing these same people up on supplements when possible though.

I basically know how to do most of the Market Place apps, accept for the ones who are like couples who live together and have a couple kids. For instance, here's a case I need to work on next Monday. This is what I need a little guidance on...can anyone help guide me on what to do with this situation.

Male 45 yrs old
Female 35

Two daughters that they had together...he's the father.

They all live under one roof, his gross adjusted income is $57,000. So if they were married they would surely qualify for a subsidy, but what do you do when they aren't married....can I just sign dad and the two girls up on one plan and the mom on her own and still get the subsidies to work out without a big headache and hassle. I find the Market Place a pain in the arse!

 

[AllenChicago]

is Michigan a partnership state? In some states of people live together for a certain amount of time they are covered just like husband and wife.

 

[Lakshmi]

No makes it different We don't recognize common law I don't think

 

[AllenChicago]

In that case, I would follow your suggestion/question and enroll dad/children together on a subsidized plan. The mom/girlfriend would obtain her own plan off-exchange, unless she has income higher than the FPL and files her own tax return. Then, she might qualify for a stand-alone subsidy.

What part of Michigan, Lakshmi? Your ScreenName indicates that you may be in SW Michigan? I was raised in SW Michigan and drive over to visit my 96 y.o. dad every 2 weeks.

 

[Lakshmi]

Thanks Allen.

Not sure its that easy with the girlfriend. She's a stay at home mom, so no income of her own, dad claiming all of them on his taxes.

I live in mid-Michigan. My father lives in Brownstown near Romulus. I go there all the time.

I'll end up calling an agent from the Market Place, but we know how that goes..lol Last year I had a major headache doing MarketPlace. Only did 24 ish, but told myself I wouldn't touch it this year, and here I am getting the calls and saying I'll do it. UGH.

I want the supplement sales I can sell too, so I will do it but damn, I hate the Marketplace. I didn't even get paid for what I did last year...but I did with the supplements I sold with the health..so, that made it worth it.

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I mean yes, I can do it that way, with girlfriend off exchange.

They have coverage now, and it might not work out to even change them if they all aren't getting subsidy together.

I'm sure I will come up with something. I have an idea off the grid somewhat. lol

 

[metrodetroiter]

Thanks Allen. Not sure its that easy with the girlfriend. She's a stay at home mom, so no income of her own, dad claiming all of them on his taxes. I live in mid-Michigan. My father lives in Brownstown near Romulus. I go there all the time. I'll end up calling an agent from the Market Place, but we know how that goes..lol Last year I had a major headache doing MarketPlace. Only did 24 ish, but told myself I wouldn't touch it this year, and here I am getting the calls and saying I'll do it. UGH. I want the supplement sales I can sell too, so I will do it but damn, I hate the Marketplace. I didn't even get paid for what I did last year...but I did with the supplements I sold with the health..so, that made it worth it. ---------- I mean yes, I can do it that way, with girlfriend off exchange. They have coverage now, and it might not work out to even change them if they all aren't getting subsidy together. I'm sure I will come up with something. I have an idea off the grid somewhat. lol

It seems that the father would qualify for the subsidy if he were taking the kids as his dependents. The girlfriend would have to pay full price or apply for Medicaid if she has no income. The fact that they are not married would not allow them to get a subsidy together. In fact when you do the marketplace application there would be no place for her to show up anywhere.

 

[Lakshmi]

UPDATE: Here's what happened.

I was able to sign them up as domestic partners. ALSO, in taking the application, it came out that he was Native American Indian.

I put him on a plan with the two daughters....they ended up with a $167 bronze plan...Native American Indians here (and maybe everywhere, idk), get a ZERO deductible or cost sharing plan, regardless of the plan they choose. WOW!!

I put her on a Silver plan and she got a small break on cost sharing for $91.

Saved them roughly $300 a month...from what I had them on (Him on BC/BS Keep Fit, Her on Health Plus of Michigan with the girls).

Then I added appx. $150 in Assurity Life and Acciflex....BAM!! Win/Win. Managed to eek out about $1000 in commish...Glad for that, bc it took me about 3 hours with getting it done, bc it's so confusing for consumer...Wifey had probs deciding and it was all done over phone...

It was a learning experience, they were awesome with the patience...We were all very happy!!!

I do not wish to do ANY Marketplace...think it's BS with how long the apps are, but I am going to do it when it's a WIN/WIN for us all...otherwise I will simply direct the client to do it themselves...I am not into the marketplace AT ALL!!! Although I now have a great understanding of how it's going to work this year too.

I only did about 20 or so last year...I truly only want to do Life, DI, CI, and no health insurance...takes a lot of time and patience and there's not much commish...

Hope that might help someone else...MICHIGAN DOES DO domestic partnerships, based on total household income. Win Win, and they can be on separate or combined plans.

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Oh yah, the above couple with kids did get an additional $385 in subsidy...on top of dad and the kids having zero out of pocket for anything...