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No. VA disability pension benefits generally are not subject to federal income tax and so are not counted as income in determining eligibility for premium tax credits.
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Yes, Social Security benefits are counted as income in determining eligibility for premium tax credits in the Marketplace.
Written by Hummingbird Insurance on . Posted in Frequently Asked Questions.
Large employers must offer health insurance to their full time workers or pay a penalty. These employers also must provide their employees with Form 1095-C to document that health coverage was offered. Every employee of a large employer who was eligible for health coverage this year should receive a form 1095-C next year in January. Even if you declined to sign up for your health plan at work, you will still receive a form 1095-C. Information on this form will also be reported to the IRS.
Form 1095-C will indicate your name and the name of your large employer, the months during the prior calendar year when you were eligible for coverage, and the cost of the cheapest monthly premium you could have paid for coverage under your employer’s health plan. If you worked for a large employer that did not offer its full time employees health coverage, Form 1095-C will also indicate that.
Keep this form with your tax records. You may need this form if you were offered health coverage by your employer and you did not sign up for it. If you signed up for Marketplace coverage instead and received a premium tax credit, information on Form 1095-C will help you determine whether you were eligible for the tax credit (for example, if the cost of your employer health plan was more than 9.56% of your income in 2018.)
If you were uninsured during the year even though your employer offered you health coverage that year, you will be eligible for an exemption from the tax penalty in 2018 if you experienced a hardship that prevented you from enrolling in coverage. You can claim the hardship exemption directly on your 2018 tax return when you file. You will not be required to submit documentation of the hardship with your tax return, though you should retain any documentation for your own tax records.
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Yes, most group health plans offered by an employer are considered “minimum essential coverage.” Some limited benefit plans (for example, dental only plans) are not considered minimum essential coverage. Your group health plan materials should indicate whether the plan is considered “minimum essential coverage.” If it is and if you enroll in the plan, you will have met the requirement to have coverage and won’t owe a tax penalty. However, the plan you described probably does not meet the standard for “minimum value.” If this is the only plan your employer offers, you may be able to qualify for premium tax credits to help pay for Marketplace coverage. The premium tax credits could help you afford coverage that would be more comprehensive.
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You can apply for coverage in the Marketplace and you may qualify for premium tax credits if your employer plan doesn’t meet the Affordable Care Act’s standard for minimum value. If your employer plan only covers preventive services and a few doctor visits, it probably doesn’t meet the minimum value standard, and so you could be eligible for premium tax credits to help buy a Marketplace plan. However, if the mini-med plan is only one choice that your employer offers, and if another plan your employer offers would be affordable and meet the minimum value standard, then you will not qualify for premium tax credits in the Marketplace.
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If you are considering applying for premium tax credits for coverage in the Marketplace, the test for whether your employer coverage is affordable is based on the cost of self-only coverage in the lowest cost plan your employer offers, compared to your household income (and not just your salary).
Written by Hummingbird Insurance on . Posted in Frequently Asked Questions.
If you missed your opportunity to enroll in your employer plan during the company’s open enrollment season, you can still apply for coverage in the Marketplace during open enrollment. You can also apply for subsidies but you will have to provide information on the health coverage you are eligible for at work, even if you’re not enrolled in the plan. If the plan employer offered meets standards for affordability and minimum value, you will not be eligible for premium tax credits or cost-sharing reductions.
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No, Just being eligible for COBRA doesn’t affect your eligibility for premium tax credits or cost-sharing assistance if you enroll in a Marketplace plan.
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Yes, leaving your job and losing eligibility for job-based health coverage will trigger a special enrollment opportunity that lasts for 60 days. You can apply for Marketplace health plans during that period. If you enroll in COBRA coverage through your former employer, however, you will need to wait to the next Marketplace Open Enrollment period if you want to switch to a Marketplace plan.
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No, voluntarily dropping your COBRA coverage or ceasing to pay your COBRA premiums will not trigger a special enrollment opportunity. You will have to wait until you exhaust your COBRA coverage or until the next Open Enrollment (whichever comes first) to sign up for other non-group coverage.