Reporting Changes to the Marketplace
Written by: Rachel Cullor
Date: May 14, 2015
You did it! You successfully enrolled in coverage from the Marketplace, paid your premium, and received your ID cards. Now, there is nothing else to worry about until the next Open Enrollment (which, by the way, is November 1, 2015 through January 31,2016). And I would agree that the hard part is over. But, just like with a car, there is a little bit of upkeep required for your Marketplace plan – reporting any changes that occur throughout the year.
Reporting changes to the Marketplace is like getting an oil change for your car. It is the that “little”, inconvenient thing that takes 15 minutes to do, but neglecting to get it done can cause some serious problems later on.
So, here are the five biggest changes to report:
Involuntary Loss of Coverage. The key word here is INVOLUNTARY. And, no, losing coverage because you did not pay your premiums does not count. (Trust me, we’ve asked.)In this case, involuntary losing coverage can mean you turned 26 and you were kicked off of your parent’s plan, or your current plan is not being offered anymore by your carrier, or you became ineligible for Medicaid. When you involuntarily lose coverage, you have a 60 day window from the date your coverage ended to get signed up on a new plan.
Becoming Eligible for Other Insurance. On the flip side of involuntarily losing your coverage, you also need to report if you become eligible for coverage outside the Marketplace. Getting a new job that offers insurance, turning 65 and becoming eligible for Medicare, or getting approved for Medicaid are all examples of gaining access to other insurance, and thus, are reasons you need to report the change.
Moving. Pretty self-explanatory, right? Moving across town, state, or the country could render your current insurance plan obsolete. Plus, subsidies are based off the cost of the second lowest priced silver plan option in your region, so even small moves like getting a new apartment in the next county over can have an impact. So, whether you move to a new state for that an exciting opportunity or you finally follow through on your threat of living off the grid and cutting ties with everyone you find annoying, don’t forget to report your new address to the Marketplace.
Income Changes. You get a big pay raise, and go up in income about $15000 for the year, or you start a new job earning about $10000 less than you what you had originally expected. Income changes will happen. It is almost impossible for some consumers to try to make a guess about what they may make for the year. That is why it is a great thing that the Marketplace allows income changes to occur as many times and as often as necessary.
Family Status/Size. Just like income, family dynamics change as well. Things like getting married, losing a spouse, adding or losing dependents on your tax return are all things that need to be reported to the Marketplace. And again, 60 days from the event is the magic number.
Why Report Changes
The main reason that you should be reporting these changes all comes down to one word: reconciliation. During tax time, you are required to report any tax credits you received from the Marketplace. If the household income on your tax return is different than what your tax credits were based on, one of two things will happen. If you make less money than you thought, your tax credits will be recalculated using your actual income, and as long as you made enough to qualify, you will be refunded the difference of the tax credits you should have been receiving all along. If you made more than you put on your application, then you will owe back some of those tax credits because you wouldn’t have qualified for all of them based on your actual income.
And, that last paragraph really shows how most consumers that deal with insurance and the Marketplace feel about it: it’s confusing. So, I encourage you to call American Exchange with any questions regarding health insurance. We have licensed health insurance agents that are certified with the Marketplace ready to help. And, unlike that mechanic giving you an oil change, our service is absolutely FREE!