Important Obamacare Tax Return Form 1095-A

By January 31, 2015, some Californians will receive an important Obamacare Tax Return Form (1095-A), who enrolled in individual plan health coverage through Covered California, in 2014. You will need this important statement (Form 1095-A) in order to complete your taxes.

The notice advises Consumers to contact Covered California right away if they think there is a mistake on the Form 1095-A, at 1800.300.1506.  If you want to see what the notice looks like and get a little more detail on this tax form, view it here at Coverage California:  website link.  If you are frustrated and don’t have time for this, consider the suggestion below.

Special note:  If you are a Kaiser Member, see additional information here.

Suggestion:  Did you know you can get free assistance with your insurance policy from a local Certified Insurance Agent…and there is No added cost to your policy?  The only requirement is that you reside in California.  If interested, just email a request to info@covered-ca.com or leave a voice mail or text message at 1.408.475.8219

(Remember:  Open Enrollment Closes February 15, 2015- Refer a Friend!)

Kaiser Permanente and Tax Form 1095-A

Taxes FAQs — On-Exchange Members

(Excerpts from a Kaiser Permanente Northern California FAQ released in January 2015)

Includes: Exchange members, both in state and federal exchanges  Note:  If you are not a Kaiser Member, see our related article written for non-Kaiser members who purchased coverage through Covered California.

What is Form 1095-A? What do I do with it?

If you or anyone in your household enrolled in a health plan through the health insurance marketplace in 2014, you’ll get Form 1095-A, Health Insurance Marketplace Statement from the marketplace. You should receive it in the mail by early February. Keep Form 1095-A with other important tax information, like your W-2 forms and other tax records. You’ll use information from the form to fill out your 2014 federal income tax return.

Consumers use the information included on Form 1095-A, Health Insurance Marketplace Statement, to complete Form 8962, Premium Tax Credit (PTC). Consumers file Form 8962 with their 1040 tax returns if they want to claim the premium tax credit or if they received advance payments (APTC) made to their insurance company.

Suggestion:  Did you know you can get free assistance with your insurance policy from a local Certified Insurance Agent…and there is No added cost to your policy?  The only requirement is that you reside in California.  If interested, just email a request to info@covered-ca.com or leave a voice mail or text message at 1.408.475.8219

1.  I’ve heard that my health coverage may impact my taxes. Is that true?

Yes, your 2014 health coverage affects your income taxes in two ways.

1)  Federal tax law requires everyone to have health insurance or to be eligible for an exemption from this requirement in 2014. If you and/or your dependents did not have qualifying health coverage, then you may owe a penalty.

For more information on exemptions for not having health coverage, visit:
https://www.healthcare.gov/fees-exemptions/exemptions-from-the-fee/.

2)  If you received federal financial assistance, you will need to report the amount you received throughout the year to the IRS on your taxes.

a) If the amount of assistance was less than the premium tax credit that you qualified for, then you should receive a credit.

b) If the amount of assistance you received was more than the premium tax credit that you qualified for, then you may need to pay some or all of the advance payment of the premium tax credit back.

c) You may have to complete one or two new tax forms.

d) You may have to get a health coverage exemption or pay a penalty with your tax return if you didn’t have health coverage in 2014. Some exemptions may not be available now. To learn whether you may qualify for an exemption, you should contact your marketplace.

For more information on how health coverage may impact taxes, contact your marketplace, or visit https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.

2.  How was my federal financial assistance calculated?

The amount of Advance Premium Tax Credit (APTC — also called federal financial assistance for premium payment) that was paid on your behalf to Kaiser Permanente to lower your premiums in 2014 was based on the income and family size you estimated when you applied for health coverage, as well as the cost of the second lowest priced silver plan offered through your health insurance marketplace.

Based on your actual income and dependent information for 2014, your APTC premium tax credit will be recalculated and will be compared to the amount of the advance payments made to Kaiser Permanente for your premiums now that you’re filing your taxes. Keep in mind that any change to actual income or change in dependents from what you estimated could increase or decrease the actual premium tax credit for which you qualify in 2014.

If, based on your final 2014 information, the amount of assistance was

— less than you were entitled to, you may receive a credit on your taxes, or

 more than you were entitled to, you may need to pay some or all of the advance payment back.

3.  What do I need to file my taxes?

If anyone in your household enrolled in a health plan through the marketplace in 2014, you’ll need to use the 1095-A statement, which you will receive from the marketplace, when you file your federal income taxes. You should receive it in the mail by early February. Keep your 1095-A statement with your W-2 forms and other tax records.

Consumers use the information included on the 1095-A statement to complete Form 8962, Premium Tax Credit (PTC). Consumers file Form 8962 with their 1040 tax returns if they want to claim the premium tax credit or if they received advance payments (APTC) made to their insurance company.

For more information on the 1095-A statement, contact your marketplace, or visit https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.

For more information on Form 8962 and Form 1040, visit http://www.irs.gov/ACA. You can also find copies of Form 8962 and Form 1040 on http://www.irs.gov/ACA.

4.  What is Form 1095-A? What do I do with it?

If you or anyone in your household enrolled in a health plan through the health insurance marketplace in 2014, you’ll get Form 1095-A, Health Insurance Marketplace Statement from the marketplace. You should receive it in the mail by early February. Keep Form 1095-A with other important tax information, like your W-2 forms and other tax records. You’ll use information from the form to fill out your 2014 federal income tax return.

Consumers use the information included on Form 1095-A, Health Insurance Marketplace Statement, to complete Form 8962, Premium Tax Credit (PTC). Consumers file Form 8962 with their 1040 tax returns if they want to claim the premium tax credit or if they received advance payments (APTC) made to their insurance company.

For more information on Form 1095-A, contact your marketplace, or visit
https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.

5.  If I’m the main household subscriber, will I get one 1095-A statement or multiple 1095-A statements, for each member of the family?

If you are all on the same plan, you’ll get one statement, which has all the members of your household listed. If you are on separate plans, you’ll get separate 1095-A statements.

For more information on Form 1095-A, contact your marketplace, or visit
https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.

6.  What if I enrolled in a health plan through the marketplace during a special enrollment period? Will I still get a 1095-A marketplace statement?

Yes, you will receive a 1095-A marketplace statement for the period of enrollment in the health plan through the marketplace.

For more information on Form 1095-A, contact your marketplace, or visit https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.
7.  Will I have to pay a penalty if I was covered 10 months in 2014?

For more information, talk to your tax professional if you have one or visit http://www.irs.gov/uac/Am-I-required-to-make-an-Individual-Shared-Responsibility-Payment%3F.

8.  What is Form 8962?

Consumers file Form 8962, Premium Tax Credit (PTC), with their tax return if they want to claim the premium tax credit or if they received advance payments (APTC) made to their health plan. For more information on Form 8962, and to find a copy of Form 8962, visit http://www.irs.gov/ACA.

9.  What does reconciliation mean?

When you file your federal taxes, consumers who received federal financial assistance (also called subsidies) will use the information on Form 1095-A to complete Form 8962, Premium Tax Credit (PTC). You will use Form 8962 to compare how much your health plan received for 2014 premiums that were advance payments of your premium tax credit (based on an estimate of the amount you would be entitled to) to the final premium tax credit you qualify for. For more information, contact your marketplace, or visit https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.

10.  How do I get a copy of my Form 1095-A? (I lost it or never received it.)

Contact your marketplace for another copy of Form 1095-A.

For Georgia and Virginia members: You can download a copy at HealthCare.gov in a new section of My Account.

For Colorado members: you can download a copy of your form under “my documents” in your Connect for Health Colorado account starting Tuesday, February 3, 2015.

For more information on Form 1095-A, refer to the Form 1095-A instructions, contact your marketplace, or visit https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.

11.  Where can I get help filing my taxes?

Consumers may get free assistance with filling out their taxes. This may include free access to tax software programs, or free in-person assistance. For more information, visit http://www.irs.gov/freefile or http://www.irs.gov/VITA.

Consumers can also seek professional tax assistance. For more information about choosing a tax professional, visit http://www.irs.gov/Tax-Professionals.

If you have additional questions about your taxes, visit http://www.irs.gov/ACA.

12.  Why did I get more than one 1095-A?

Just as some households receive multiple W-2s if individuals have multiple jobs, some households will get multiple Form 1095-As if they were covered under different plans or made changes to their income or dependent information during the year. Be sure to keep all the 1095-As you get and keep them with your important tax documents.

Sometimes a consumer may receive a “Corrected” Form 1095-A. You should use the most recent Form 1095-A that you receive when you complete your taxes. For more information on Form 1095-A, refer to the Form 1095-A instructions, contact your marketplace, or visit https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.

13.  What if I think information on my Form 1095-A is incorrect?

For information that you believe is incorrect on Form 1095-A, consumers should contact their marketplace call center for research and resolution.

For more information on Form 1095-A, refer to the Form 1095-A instructions, contact your marketplace, or visit https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.

14. What if I already filed my tax return before I got my 1095-A, or before I got a corrected one?

You may have to file an amended federal income tax return. This means you’ll have to file a corrected version of your return with the IRS.

For more information about filing an amended tax return contact your tax professional if you have one, and/or your marketplace or visit https://www.healthcare.gov/taxes/. The IRS also has information about filing an amended return, visit https://www.healthcare.gov/taxes/marketplace-health-plan/.

15.  Will I get a 1095-A if I’m ONLY enrolled in a stand-alone dental plan or a minimum coverage plan (previously called catastrophic plan)?

No, you won’t get a 1095-A statement if you’re enrolled in a minimum coverage plan. These plans don’t qualify for subsidies. However, if you are enrolled in a stand-alone dental plan and a health plan, you may receive a 1095-A statement.

Suggestion:  Did you know you can get free assistance with your insurance policy from a local Certified Insurance Agent…and there is No added cost to your policy?  The only requirement is that you reside in California.  If interested, just email a request to info@covered-ca.com or leave a voice mail or text message at 1.408.475.8219

Avoid This Mistake During Open Enrollment Before December 15th

California insurance consumers should avoid this mistake during open enrollment before December 15th, in the event their doctor has been dropped by their health plan (see related story about the thousands of California HealthNet plan members who are forced to take action by December 15th).

For everybody else, there are also lot’s of doctors, coming and going from these networks…some accept group plans and others accept individual plans, but the names are confusing for them, too.  We strongly advise you to hook up with a local Certified Agent (it’s a free service from Coverage California) and make sure you don’t make a big mistake for all of 2015.

Remember, Open Enrollment began November 15th:  Changes are coming to certain PPO & HMO networks.  Read a related article about CoveredCA here.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Coverage California and are here to help.

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Covered CA Website Causes Suffering During Open Enrollment

Covered CaliforniaCovered CA website causes suffering during open enrollment this week after being fortified for high utilization.  An interview with a San Jose-based Certified Agent provided the following observation:

Today, I assisted at least 4 different clients on their renewal process and/or to start a new application.  The website directed all of the clients into Medi-Cal, even if their income was well above 140% FPL

Calling Covered California directly is not an option, due to five-hour wait times.  Cases such as these require special handling, which is a free benefit of Certified Agents.  For example:

I had a family of three come in with a total annual household income of $49,666.73 and they were placed on Medi-Cal.

Certified Agents can provide local assistance with such glitches, and often times are willing to meet you in person. Read our related article about avoiding Open Enrollment mistakes.  Open Enrollment is here, changes are coming, and websites are frustrating.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Covered California and are here to help.

Obamacare: Not Easy!   ............  Cake Pop, Anyone?

Obamacare: Not Easy! ………… Cake Pop, Anyone?

Kaiser California Individual Members Pay Twice in December 2014

California Marketplace

The Affordable Care Act hits Kaiser Members hard

Yes, Kaiser California Individual members pay twice in December 2014, in order to help Kaiser Permanente catch up with industry standards.

As explained in a Kaiser Permanente November news briefing to its marketplace partners, Kaiser’s status as a prepaid health plan requires monthly payments before the last day of each month. Apparently, throughout 2014 Kaiser has not been billing its members for prepayment, and now plans to catch up in time for January 2015.  Read our related article about avoiding Open Enrollment mistakes this year.

What Kaiser California Individual & Family members need to know:

  • You will receive two separate bills in December- one for the December 2014 premium and a second bill for the January 2015 premium
  • Both bills must be paid by December 31st.

The news briefing goes on to say certain members may have extra time to pay, based on their Evidence of Coverage or Membership Agreement.  To get free assistance from a California Kaiser agent, send a request to info@coverage-ca.com or phone 1 (408) 641-8950.

Remember, Open Enrollment begins November 15th:  Changes are coming and websites are frustrating. Read our related article about CoveredCA’s problems. If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Covered California and are here to help.

Anthem Blue Cross Doctors & Hospitals

Which Anthem Blue Cross network accepts your plan?

Covered California

Covered California

Deciphering the confusing Anthem Blue Cross Doctors & Hospital networks [This story was updated in December 2014]

California insurance consumers should be extra cautious during open enrollment season (November 15, 2014 to February 15, 2015) that their doctor was not been dropped by their health plan (see related story about the thousands of California HealthNet plan members who are forced to take action by December 15th).

Don’t ask your doctor- he or she probably won’t even know it happened, due to the confusing network games that insurance companies play.  For example, see the confusing Anthem Blue Cross Doctors & Hospital network references in the table below…

Provider Directory Reference Guide

PLAN NAME AT COVERED CALIFORNIAOR IT MAY LOOK LIKE THIS ON YOUR ID CARDOR LIKE THIS ON THE ANTHEM WEBSITE
Anthem Silver 70 PPOAnthem Silver Direct AccessPathway X-PPO via Exchange/Silver Direct Access
Confused?Call for free assistance:1 (408) 641-8950

For what its worth, we are providing a link to the entire directory guide from Covered California:

PROVIDER DIRECTORY GUIDE

There are lot’s of doctors, coming and going from these networks…some accept group plans and others accept individual plans, but the names are confusing for them, too.  We strongly advise you to hook up with a local Certified Agent (it’s a free service from Coverage California) and make sure you don’t make a big mistake for all of 2015.

Remember, Open Enrollment began November 15th:  Changes are coming to certain PPO & HMO networks.  Read a related article about CoveredCA here.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Coverage California and are here to help.

HEALTH NET PPO PLAN CLOSURES AT COVERED CALIFORNIA

Health Net PPO Plans California

Health Net PPO Plans

Open Enrollment 2015 begins November 15th

Open Enrollment 2015

Health Net has shipped 90-day plan closure notices to Health Net PPO members (see related story about Anthem Blue Cross) in Covered California who are currently enrolled in PPO plans (Individual or Family PPO plans).  These notices shipped October 2nd, as Health Net moves its PPO portfolio off-exchange.  For the time-being, Health Net will not offer an individual or family Health Net PPO plan through Covered California.

What can you do to keep Health Net PPO plan coverage?  Fortunately, you have options… If you wish to keep the same doctor and stay on a similar plan directly (i.e. off-exchange) with Health Net, CLICK HERE to request free assistance.

If you wish to talk with someone to get information about the remaining PPO plans at Covered California, CLICK HERE.

Caution should be observed if you purchased a plan during the last open enrollment:  Effective after this Open Enrollment, Insurers are shifting doctor and hospital networks.  Do not take chances with your policy.  Before you renew, talk with one of our representatives for FREE.

See our related story about Covered California Open Enrollment Notices.

Remember, Open Enrollment begins November 15th:  Changes are coming to certain PPO networks.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Covered California and are here to help.

Covered California Open Enrollment Notices

Covered California Notices

Covered California is shipping envelopes by Mail for Open Enrollment season (see above)

Members will receive Covered California open enrollment instructions over the next two weeks, informing them of the Renewal Process.  If you need assistance understanding the 2015 changes, click here to request help.  Read story, If you want to review details about last year’s open enrollment or just get a free quote at this website.

Due to an online systems limitation from October 13 to November 3, 2014 only, you will be unable to login to your account in order to report changes for the 2014 plan year.  Covered California has developed a work-around during this period and you can receive assistance from Certified Insurance Agents here.

Remember, Open Enrollment begins November 15th:  Changes are coming to certain PPO networks.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Covered California and are here to help.

Breaking News: COBRA Coverage California Open Enrollment May 15 – July 15

Beginning Thursday, May 15, Covered California will launch a limited-time special-enrollment period for people who have COBRA health insurance, either Federal COBRA or Cal-COBRA (COBRA Coverage California), and would like to switch to an exchange plan.

People who have health coverage through COBRA (the Consolidated Omnibus Budget Reconciliation Act) will be eligible to shop for and buy coverage through Covered California from May 15 through July 15, including local assistance from Certified Insurance Agents, at no additional charge.  The two-month window mirrors a U.S. Department of Health and Human Services (HHS) ruling announced May 2 that allows COBRA enrollees to buy plans through the federal exchange up to July 1.

Read the full press release here or jump ahead for a Rate Quote, right now!

Open Enrollment Closed March 31, 2014

This article was originally written for the Fall 2013 open enrollment season.  See our related story about Covered California Open Enrollment Notices for the 2015 open enrollment.

Remember, Open Enrollment begins November 15, 2014.  Changes are coming to certain PPO networks.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Covered California and are here to help.

Original Article

We heard the Website is overwhelmed.  CoveredCA put out a message to agents, today that Paper Applications may be completed and signed and faxed to the following phone numbers, BY March 31, 2014:

FAX NUMBERS FOR COVERED CALIFORNIA PAPER APPLICATIONS:  1-888-329-3700 OR 1-916-636-3400.  Frequently, you get the “all circuits are busy” signal.  Unfortunately, the State of California did not plan adequately.

Paper Application

Customer Service:  1.800.300.1506