ObamaCare ACA Tax Penalty for 2015 & 2016

Ah, the old scheduled benefit trick. Can you say Mega Life?

Kidney dialysis, $500 per day, $30k annual max.

Average annual cost of dialysis is $89k.

Annual max for all benefits $150k - $300k. Oops!
 
Scheduled benefit plans were fairly common years ago. A good friend worked in the home office of American Republic Life, then later transferred to the Atlanta regional office.

He came by one day to pitch me on their 100% plan. Thinking it was like the Guardian plan (deductible then 100% to $5M) I agreed.

Turned out it was just another scheduled benefit plan. I tried to explain how it was not major med. He would have no part of it.

I never contracted. Never sold the plan.

But I did sell a fair number of Guardian plans until their pricing became ridiculous.
 
Here's the Freedumb Life/US Health "Premier Choice" 28 page brochure.

Hey Allen I think you had a typo. Oh wait, never mind :nah:

You know, it takes a person of questionable character to even design a plan like this. Same goes for those selling it.
 
CowgoesMoO, you said you were a good agent. I'll take you at your word and give you a chance.

I can't tell you how many good agents got their start with NASE and MEGA, selling limited benefit policies that the agent thought was "good" because his supervisors told him so. Add in the motivation of making higher commissions, and "selling to your inner circle", and you had a lot of people working part-time on the side, putting their dear family and close friends into this thing.

Then the claims happened. And the agent found out more truth than what their supervisors had told them. And then they realized why the supervisors said, "Don't believe other Insurance Agents, don't ask an Accountant, don't seek the advice of a wiser and experienced person..."

Those good agents changed. They left, and started over by selling a much better policy, even if it meant losing all previously earned commission. They learned to educate the client about limitations and exclusions, and why it's better to spend a little bit more for something that covers catastrophic losses better.

So, if you are indeed a good agent, this is your opportunity.
 
They've come up with a way to game the system.

Buy a limited policy, and buy the no underwriting upgrade to STMM, to bridge you to ACA on 1/1. Wonder what that would cost? Both are not ACA compliant, and will be subject to penalty - written on every other page. Agents are relying on the exemption, or being out of the business by the time client is filing taxes a year later.

Where am I going wrong?
 
They've come up with a way to game the system.

Buy a limited policy, and buy the no underwriting upgrade to STMM, to bridge you to ACA on 1/1. Wonder what that would cost? Both are not ACA compliant, and will be subject to penalty - written on every other page. Agents are relying on the exemption, or being out of the business by the time client is filing taxes a year later.

Where am I going wrong?

This is the part where you're reminded that you're not absolved of your responsibilities to clients just because you choose to stop selling or let your license expire.

Even if it says it's not compliant and will generate a penalty, they can easily contest that you told them the penalty doesn't apply to them, and as their expert broker with a license, they accepted that as fact.

Unless it's in writing that they understand it's non-compliant and penalty generating, they're going to have a leg to stand on in court.
 
The issue isn't whether this is compliant or not. It's also not about the penalty.

The only thing that really matters is, will your client have the coverage they need when things get really bad?

The answer is no.

At that point, where do you hide?
 
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