On March 3, 2017, Department of Health Care Services sent a letter to all County Medi-Cal administrators informing them of the new 2017 federal poverty levels. The new federal poverty levels went up approximately 2%. This means that individuals applying to Covered California will have to have a higher income if they want the Advance Premium Tax Credits subsidy. The single adult annual income amount to qualify for the Covered California subsidy is now $16,644. It was $16, 395 in 2016.
Covered California Certified Enrollers entering consumer income into the online application (CalHEERS) need to report the correct date in the First Date Paid field in order to get the correct eligibility results. Consumers applying for 2017 coverage may incorrectly receive Medi-Cal eligibility if they do not report their current income for 2016.
Covered California has updated and changed various parts of their online health insurance enrollment website for 2017. These changes, launched with the release of the CalHEERS 16.9 build, will affect new enrollments and individuals and families renewing their health insurance for 2017. A high level overview was published by Covered California in their 2017 Consumer Renewal Journey & Features Release 16.9. The slides of the presentation are available for download.
Covered California has released a table of sources of income and whether they are countable toward the Modified Adjusted Gross Income (MAGI) for the monthly health insurance subsidy. The foundation for the table is the federal 1040 income tax return. The Countable Sources of Income table includes income for the monthly subsidy and whether the income is considered for MAGI Medi-Cal.
Covered California has released guidance on reporting self-employment income. The 2016 Special Enrollment Quick Tips has not only income guidance for self-employed and season workers, but also information about qualifying events for the Special Enrollment Period outside of Open Enrollment and reconciling Advance Premium Tax Credits on the federal tax return.
Covered California has updated their income table for qualifying for either the premium assistance or Medi-Cal. The new income amounts reflect the modest increase to the federal poverty levels (FPL) which is the foundation for premium assistance. The new income amounts only apply to individuals and families who will apply for health insurance through Covered California for 2016. Households who renewed their coverage in 2015 or enrolled during open enrollment for 2016 are not affected by the higher income levels in most situations.
The purpose of this letter is to provide counties with guidance regarding fluctuating or self-employment income, and the use of projected annual income when transmitting income to the California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) to calculate MAGI. Self-employment or fluctuating income may include income received from self-employment, partnerships, s-corporations, royalties, estates, trusts and real estate rentals.
You are allowed a premium tax credit only for health insurance coverage you purchase through the Marketplace for yourself or other members of your tax family. However, to be eligible for the premium tax credit, your household income must be at least 100, but no more than 400 percent of the federal poverty line for your family size. An individual who meets these income requirements must also meet other eligibility criteria.
Consent for Verification August 25, 2015 On August 14, Covered CA sent letters to members who currently receive subsidies. The letter advised them that they must give their consent for Covered CA to verify their income and family size to determine their subsidy eligibility for their health plan in 2016. IMPORTANT: Authorizing Electronic Consent to […]
Covered California provided some very important training to insurance agents on determining ACA MAGI for clients…twelve months late. The information offered on household income for tax credits should have been offered months ago before we started the first open enrollment. While the maxim of “better late than never” is apropos, content was at times needlessly […]