Reporting From the Front Lines - 2015 ACA Open Enrollment

By the Numbers - Open Enrollment for 2015 Affordable Care Act (ACA) Health Insurance

Earlier today, I joined on the conference call with U.S. Department of Health and Human Services (HHS) Secretary Sylvia Burwell.   After graciously thanking the audience for contributing to the success of this year's Open Enrollment Period, Ms. Burwell provided the following ACA and Health Insurance Marketplace updates:

* 11.4 Million Americans selected or were auto-enrolled into a 2015 ACA plan

* Of the 11.4 Million, 8.6 Million enrolled through the Federal Marketplace and 2.8 Million through State-based Exchanges

* Florida came in first-place for Federal Marketplace enrollments, with 1.6 Million Americans enrolling in a 2015 plan so far

The figures above reflect all consumers completing an application and selecting a health plan, without regard to whether the premium was paid.  Ms. Burwell stated that the federal government's goal for 2015 open enrollment had been 9.1 Million actually paying the plan premium, and it appears that the 2015 goal is likely to be met or exceeded.

Ms. Burwell noted on the call that the 10 Million drop in uninsured Americans from 2013 to 2014 is the largest drop in the uninsured since the 1970s.

Below are additional numbers released on February 11th by HHS:

There has been an increase in coverage choices:

25%              The increase in issuers competing for business in the 2015 Marketplace as compared to last year.

40                 The average number of plans consumers can choose from this year.

It has become easier to navigate the web site or seek help in another language:

76 to 16       The reduction in the number of screens on HealthCare.gov that typical consumers need to click through when completing an application online this year as compared to last year.

200+              Languages in which consumer assistance is provided at the Marketplace Call Center.

60%               Percentage of consumers who visited CuidadodeSalud.gov through a mobile device or tablet.

Help for folks to sign up without the need for their own Internet, cell phone or tablet:

23,000+        Certified application counselors, navigators and in-person assisters on the ground in communities across the nation working to educate and enroll individuals in Marketplace coverage.

74,000+       Agents and brokers on the ground in communities across the nation working to educate and enroll individuals in Marketplace coverage.

Another government date soon approaching is the 2014 Federal Income Tax payment deadline.  Many folks may be interested to know about these just released income tax related numbers:

$268             The average monthly tax credit for people who qualify for financial assistance in the 37 states using Healthcare.gov through January 30.

87%              The percentage of Marketplace consumers who qualified for tax credits to make their monthly premiums more affordable in the first two months of open enrollment.

Until next time,

Andrew Herman

Certified Agent on the Marketplace

Do I Have to Pay an ACA Tax Penalty for 2014?

Were you covered under Affordable Care Act (ACA) or Grandfathered Health Insurance during 2014?  If not, you may have to make an individual shared responsibility payment (SRP) on your 2014 federal tax return.

The annual penalty for not having health insurance in 2014 is $95 or 1% of your 2014 income, whichever is greater.  This amount is for each person - if you have a family, you must pay this amount for you, for your spouse, and for each child ($47.50 per child under 18), up to the maximum annual penalty shown in the chart below. The penalty amount increases in future years:

From Kaiser Health News

The penalty amount each year is capped at the national average premium for a Bronze-level plan.  For 2014, the annual national average premium is $2,448 per individual ($204/month per individual) or $12,240 for a family of five or more members ($1,020/month).

If you are uninsured for a portion of a year, 1/12 of the yearly penalty applies to each month that you are uninsured.  If you are uninsured for less than three months of the year, you do not have to make an SRP.

How does the federal government count income for purposes of calculating the SRP?

- Start with all gross income reported on your 2014 return that is not exempt from tax

- Include any income from the sale of your main home in 2014

- Include only the taxable part of any social security benefits

- Include any gains (but not losses) from Form 8949 or Schedules C, D or F

- Then subtract the filing threshold amount (see table below for your filing status)

 

For example, a single person under age 65 with 2014 taxable income of $100,000 would subtract $10,150 to arrive at an adjusted income amount of $89,850.  Without any health insurance in place during 2014, that person must pay an SRP of $898.50 (this amount equals the greater of $95 or $89,850 x 1%).

Click here for a handy ACA Tax Penalty Calculator

Who qualifies for an exemption from the SRP?

If you did not have minimum essential coverage in 2014 required by ACA, review the following list to see if you can qualify for an exemption from the SRP:

• You’re uninsured for only 1 or 2 consecutive months of the year
• You enrolled in a health plan that started no later than May 1, 2014, but were uninsured any number of months before that in 2014
• The lowest-priced coverage available to you, through either an individual or job-based plan, would cost more than 8% of your household income
• You don’t have to file a tax return because your income is below the level that requires you to
• You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider
• You’re a member of a recognized health care sharing ministry
• You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare
• You’re incarcerated (serving a term in prison or jail), and not being held pending disposition of charges
• You’re not lawfully present in the U.S.
• You’re a U.S. citizen living abroad, or one of certain types of non-citizens
• You qualify for a hardship exemption.

To learn more about how to apply for any of the exemptions shown above, visit the official government website at the following link:

https://www.healthcare.gov/fees-exemptions/exemptions-from-the-fee/

Until next time,

Andrew Herman