In January, Covered California reported consumers’ health care coverage information to the IRS. This is done to ensure individuals are meeting their health insurance
requirements for the year. Form 1095-A was mailed to consumers who purchased individual coverage though Covered CA marketplace or Exchange.
The form 1095A provides information for the primary tax filer or applicant and includes the “coverage household”. It includes the monthly premium amount, amount of premium for the second lowest cost Silver Plan and the monthly APTC (Advance Premium Tax Credit) received if any, for the 2014 calendar year.
Covered CA acknowledges that many were sent out with incorrect information and while some have received corrections, many have not. On March 20, 2015, the federal government announced that consumers who have already filed their tax returns do not need to take further action to file an amended return. Of course, they may do so if they choose, but it is not required. The decision should be discussed with your tax professional.
Covered CA is advising that consumers should check and continue to check their Covered CA online account secure inbox to see if their corrected IRS Form 1095A has been uploaded. You will see letter NOD-62.
You may also look on your Covered CA account to see your APTC calculation. When you log in to your account, click on the Summary box and you will see how much APTC was applied and your net premium. If you did not receive any 1095-A, you need to call Covered CA immediately.
If consumers do not have an online account, it is critical that they do so. I have advised our clients since the inception how important this is. If you do not have internet access, you may use the local library to access the internet.
As an agent, I am interested in assisting my clients purchase and manage their insurance plans. But it is not my responsibility to manage the Covered CA account. I have advised my clients that they are the ones benefitting from this tax credit, which is often worth thousands of dollars. Everything comes with a cost or responsibility.
When we initially enrolled our clients, an access code was generated. We emailed that code with screen shots and step by step instructions as to how to establish the account. However, the access code does expire. So if you did not establish the account you must call Covered CA to get a new access code.
I cannot stress enough how important it is to be attentive to this account and the process. Remember that you are estimating your income for the current year. Should there be a change (usually about 10%) you are supposed to report the change.
Other changes that need to be reported are address, marital or family status: such as divorce, marriage, new baby. There is a video tutorial on the front page after you log in to your Covered CA account for how to Report a Change. The address changes must also be reported to your insurance carrier. The uploads from Covered CA do not happen quickly and you do not want to miss a premium payment.
Covered CA phones are much more responsive this year. They are open Monday through Friday from 8 a.m. to 8 p.m., so they are able to accommodate working people. They are also open weekends 8 a.m. to 6 p.m. The number is 800-300-1506.
Another issue that has been vexing our clients is when the children are no longer eligible for Medi-Cal. The good news is that the family is making more money. The bad news is that it takes some time for the systems to speak to each other.
Medi-Cal and Covered CA communicate on a different system for this purpose and this information must be uploaded to “release the children”. It can take a few weeks. I have found that it is important that the parents are attentive to getting the release processed and have asked that they follow up with Medi-Cal to do so.
The bottom line is that there is no free lunch. These subsidies and government programs require active participation and attention by the consumer.
Margaret Beck CLU, ChFC, CEBS started her insurance practice in Redding in 1978. As an insurance broker/consultant, she represents businesses and individuals as their advocate. She assists in choosing proper products, compliance with complex benefit laws and claims issues once coverage is placed. All information in her column is provided to the best of her knowledge, subject to final regulation by the respective agencies.
Questions to be answered in this column can be submitted to info@insuranceredding.com.
Beck’s column is also published in the Redding Record Searchlight.
