Mid-year income increase, how to deal with deductible and moop?

[sam816]

A prospect tells me her husband will double his income this year, from the original estimate of $30k to $60k, they also just had a newborn in May.

If they report this to the marketplace now, the deductible & moop will increase substantially for the same plan.

1. if they report the income change, will the higher cost sharing be applied retroactively to the services they already received from Jan to May this year?

2. if they don't report the income change right away, is the only penalty the PTC clawback when they file tax return in 2023? then doesn't the current system have a loophole that encourages people to estimate low in order to get the lower cost sharing?

TIA.

 

[Yagents]

A prospect tells me her husband will double his income this year, from the original estimate of $30k to $60k, they also just had a newborn in May.

If they report this to the marketplace now, the deductible & moop will increase substantially for the same plan.

1. if they report the income change, will the higher cost sharing be applied retroactively to the services they already received from Jan to May this year?

2. if they don't report the income change right away, is the only penalty the PTC clawback when they file tax return in 2023? then doesn't the current system have a loophole that encourages people to estimate low in order to get the lower cost sharing?

TIA.

1. Don't know about past claims, but future claims yes.

2. Yes and yes.