No Subsidy when Over 9.5%????

[sk337sk337]

I have a client who is eligible for an employer plan. The plan is more than 16% ($108.69 a week) of his income ($31,000 for him and $1,000 or less for his wife). The employer plan is only available to him and not his wife. When we applied for coverage his wife is receiving a subsidy but he is not. Anyone know what I'm doing wrong here or am I wrong that he should be receiving a subsidy? When we applied last year BOTH were receiving a subsidy. If it's just something with HC.gov then I'll use HealthSherpa. I just don't want to lose the first month commission since it's $12 pppm.

 

[CHUMPS FROM OXFORD]

Are you using single-only rates?

 

[Ann H]

I have a client who is eligible for an employer plan. The plan is more than 16% ($108.69 a week) of his income ($31,000 for him and $1,000 or less for his wife). The employer plan is only available to him and not his wife. When we applied for coverage his wife is receiving a subsidy but he is not. Anyone know what I'm doing wrong here or am I wrong that he should be receiving a subsidy? When we applied last year BOTH were receiving a subsidy. If it's just something with HC.gov then I'll use HealthSherpa. I just don't want to lose the first month commission since it's $12 pppm.

Call it in to healthcare.gov, with the client on the conference call.

You said the wife is not eligible for the group plan. If there are no children on the policy, then $108.69 per week would be over 9.5% of a household income of $32,000. Make sure that $108.69 is the amount the EMPLOYEE is paying (not including the amount the Employer contributes). If that is correct, I would say call it in to healthcare.gov and let them fix the problem.

 

[sk337sk337]

Are you using single-only rates?

Not sure what that is

Call it in to healthcare.gov, with the client on the conference call.

You said the wife is not eligible for the group plan. If there are no children on the policy, then $108.69 per week would be over 9.5% of a household income of $32,000. Make sure that $108.69 is the amount the EMPLOYEE is paying (not including the amount the Employer contributes). If that is correct, I would say call it in to healthcare.gov and let them fix the problem.

There are no children and the company doesn't pay for ANY of the plan. I have called and talked to multiple reps but I just get the same answer "Well, if it's not coming up then they don't qualify for a subsidy"

 

[Tkruger]

Not sure what that is


There are no children and the company doesn't pay for ANY of the plan. I have called and talked to multiple reps but I just get the same answer "Well, if it's not coming up then they don't qualify for a subsidy"

Try this, rather than explaining anything to the rep at HC.gov about the results of the prior call, have them start fresh with the application.

Also, are you using the new streamlined version of the app process? Are you pulling last years app information in and running the app that way?

 

[sk337sk337]

Try this, rather than explaining anything to the rep at HC.gov about the results of the prior call, have them start fresh with the application.

Also, are you using the new streamlined version of the app process? Are you pulling last years app information in and running the app that way?

I'm just getting the old app. How do I get the new application?

 

[Tkruger]

I'm just getting the old app. How do I get the new application?

New app's are for simple enrollments and we've generally been running into the old apps with clients who had coverage the prior year and the application can be found using the search tool.

Are you pulling in the old data?

 

[sk337sk337]

New app's are for simple enrollments and we've generally been running into the old apps with clients who had coverage the prior year and the application can be found using the search tool.

Are you pulling in the old data?

I don't know what I did but I went in and removed the application. Then went through and everything that was pulling information wise I deleted it and retyped it in. It's giving both of them the subsidy now.

No clue how it happened but I've been stuck on this one for days. I didn't change one number/letter just retyped what I had in there.