Opting Out of Employee Coverage

[taterpeeler]

Sorry... All you wrong.... Answer the question truthfully and separate box pops up asking if your plan meets mimmuim value standards... Again answering the question truthfully then another box pops up related to who the employer is... Answer that and keep going, you will get a subsidy providing all else checks out.... My guess on this case there is more to why.... Like a corrupted file or income to low or high... Side note, don't answer yes to the question if their income will be the same as 2012 if you the agent have any reason to feel the client is a little spacey. Enter the correct current income

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My one case with unaffordable employer coverage. Where it asked if she was in or available, when you answer to the affirmative, then it should ask how much the coverage cost, then the program does the math and allows the subsidy.

It doesn't ask how much the coverage is.....at least on the federal exchange... No calculation is done

 

[Nikita]

Sorry... All you wrong.... Answer the question truthfully and separate box pops up asking if your plan meets mimmuim value standards... Again answering the question truthfully then another box pops up related to who the employer is... Answer that and keep going, you will get a subsidy providing all else checks out.... My guess on this case there is more to why.... Like a corrupted file or income to low or high... Side note, don't answer yes to the question if their income will be the same as 2012 if you the agent have any reason to feel the client is a little spacey. Enter the correct current income

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It doesn't ask how much the coverage is.....at least on the federal exchange... No calculation is done

Tater - I have done this a couple of times and there wasn't any separate box that popped up asking any kind of question....ARGGG!!

 

[taterpeeler]

Nik... Ther MUST be something you be missing... No offense intended.... I did one fir with group non confirming coverage... Full subsidy with csr. As yagents would say my getto crowd... But I love each and every one of them.

Are you ffm or state? I can only speak of ffm, not state

 

[ameneses54]

I need assistance with the following:
Client says her employer coverage is not affordable. We filled out all the information on the marketplace but no where did it ask her to send in proof or a letter from her employer that she does not have affordable coverage. She was not given any subsidy at all, even though she is single and her income is only $22,000. Clearly she should get a subsidy. I called the marketplace rep and they said her only recourse is to appeal. This is nuts. There must be thousands of people who are opting out of non-affordable employee coverage. Are they all being denied subsidies and told to file an appeal? Can someone share with me the key to getting these apps through with the appropriate subsidy?

Thanks for all the great guidance this forum offers!

A customer of mine considers her employee coverage unaffordable, so I had to answer yes to available insurance. The eligibility letter clearly stated that she should send the employes tool form verifying that indeed it is unaffordable. When I get this form I will pass it on to the Marketplace.
Here is the statement (sorry in Spanish):
"Janet Caraballo - Tiene que devolver la solicitud y proporcionar información sobre la cobertura de sus
empleadores. El Mercado no puede determinar su elegibilidad para un crédito fiscal y la reducción de
costos compartidos (copagos reducidos, coseguro y deducibles) sin esta información. Si necesita
ayuda, llame al Mercado al número de teléfono que aparece a continuación.: "

 

[RayNY]

Tiene que devolver la solicitud y proporcionar información sobre la cobertura de sus
empleadores. (You must return to the application and provide information on coverage from the employer) El Mercado no puede determinar su elegibilidad para un crédito fiscal y la reducción de
costos compartidos (copagos reducidos, coseguro y deducibles) sin esta información. (The market cannot determine your eligibility for a tax credit and a redution in cost sharing without this information.) Si necesita
ayuda, llame al Mercado al número de teléfono que aparece a continuación. (If you need help, call the market):

Paraphrased, but at least the rest of us know what that message means.

 

[HealthGuy]

Tater: Are you Ratt and Rolling now? Are you selling in the cellar?

 

[G.Gordon]

Tater, I know what it asked when I did it, period. It asked, we answered, it allowed for a subsidy.

 

[BeeSelective]

Is employer insurance available in next 90 days? Is it affordable? Does the EE cost exceed 9.5% of income?

 

[ameneses54]

I need assistance with the following:
Client says her employer coverage is not affordable. We filled out all the information on the marketplace but no where did it ask her to send in proof or a letter from her employer that she does not have affordable coverage. She was not given any subsidy at all, even though she is single and her income is only $22,000. Clearly she should get a subsidy. I called the marketplace rep and they said her only recourse is to appeal. This is nuts. There must be thousands of people who are opting out of non-affordable employee coverage. Are they all being denied subsidies and told to file an appeal? Can someone share with me the key to getting these apps through with the appropriate subsidy?

Thanks for all the great guidance this forum offers!

As this thread seems to be appropriate, I'm going to use it to ask a "what if question".
Yesterday I got bashed by a customer who told me to put that his employer did not offer health insurance although he did. Further more, he said many of his fellow workers did that and that down the road who would know.
So let me insist on who would know. How is the IRS or related entities going to pin you down if you just lied on this issue in order to obtain Obamacare and a subsidy?

 

[russelltw]

I would rather not find out how the IRS is going to pin you down. I can tell you they will outlast your client and they have more time than anyone to wait your client out. I have a brother in law that fought and fought the IRS on taxes owed (his bookkeeper did not pay them for years with his business). IRS slowly keep adding fees and penalties until his business went bankrupt.

The IRS is not something I would "poke" to see what happens. I would tell the client to break the law under someone else's producer number.