Author Topic: "Temporary eligibility" for Obamacare requires more information  (Read 2406 times)

redrocker

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Hi all, I stumbled across a post on what to do for this and I have been unable to find it in the forum search.

Laid off/retired early in September last year and signed up for health insurance through the ACA exchange. They gave me the 90 day eligibility. Even though my insurance through them started on 1/1/16, when I signed up on 11/18/15 they started counting down on the 90 days which might put me in a time crunch. They're asking for me to verify mine and my wife's income by Feb 16.

My wife's income is straight forward since it won't change from last year to 2016. However, I took a significant step down so all of my records (past returns, pay stubs, W2s) reflect my 2015 income (which wouldn't qualify for ACA subsidies). I don't have a letter from my employer explicitly stating that I no longer work there, which would probably be helpful. My income will come from rents from two properties that I manage (which I'm worried may not help anyway if they look at my overall income on that return).

I can't even submit my 2015 return yet because I'm waiting on 1099-div/int from my brokerage account, and Fidelity only says it will be available by Feb 13, 2016. So I'm trying not to panic because I don't want to lose my subsidy but I might run out of time. I did call and talk to a live person with the healthcare exchange, who despite his best intentions wasn't very helpful (felt like he read a script in response to my various questions). I can't imagine my change of financial situation is that unique to new enrollees.

I've already uploaded my w2 and my final paystub from 2015 which shows a severance payment and no regular pay, as well as my wife's w2. That information has been available on the website for over a week now and I haven't received any notification or seen any change in status.

Any advice from others who have been through this? Is there a "silver bullet" that appeases whoever is reviewing my income and eligibility?
« Last Edit: January 27, 2016, 10:30:07 AM by redrocker »

redrocker

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Re: "Temporary eligibility" for Obamacare requires more information
« Reply #1 on: January 27, 2016, 11:12:28 AM »
Did find this post, although I'm still looking if anyone has personal experience to share regarding proving drastically lower income and proving that you don't work for your old employer without some kind of note.

http://forum.mrmoneymustache.com/ask-a-mustachian/applying-for-aca-with-drastically-different-magi-tell-your-stories/msg910170/#msg910170

seattlecyclone

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Re: "Temporary eligibility" for Obamacare requires more information
« Reply #2 on: January 27, 2016, 11:24:39 AM »
Are you expecting your income to be low enough to qualify for the cost sharing subsidies, or are you just going for the premium assistance subsidies? If it's the latter, can you try asking for them to just sell you a policy at full price? You'll get the subsidy when you file your taxes next year.

redrocker

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Re: "Temporary eligibility" for Obamacare requires more information
« Reply #3 on: January 27, 2016, 11:28:17 AM »
I guess that's a good point, just taking the subsidy at the end although I'd have more peace of mind not paying that the difference out of pocket until then. I do qualify for cost sharing too though.


seattlecyclone

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Re: "Temporary eligibility" for Obamacare requires more information
« Reply #4 on: January 27, 2016, 11:36:23 AM »
I have to imagine they deal with people losing their jobs all the time. Can you try getting a letter from your previous employer explaining that you don't work there anymore, so your previous income is irrelevant?

Altons Bobs

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Re: "Temporary eligibility" for Obamacare requires more information
« Reply #5 on: January 27, 2016, 12:18:35 PM »
You can create a self employment ledger, or income ledger, showing what you made every month last year, and then January this year, and also estimated income this year based on your rental.  Would that work?

Axecleaver

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Re: "Temporary eligibility" for Obamacare requires more information
« Reply #6 on: January 27, 2016, 02:15:51 PM »
This is a very common scenario. Your subsidy will be calculated based on your new earnings, not your old earnings. You should go through the link that is on the site about a change in circumstance, laid off, or change in hours. You will need to submit a termination letter, so get one as soon as possible. You may also want to claim unemployment benefits, which will make it much easier to get your healthcare subsidy. All the benefits systems work together, to some degree (or they should, based on the No Wrong Door policy - it's a work in progress).

Another route is to say that you are now paid hourly, and you have been scheduled for zero hours. You can use your W-2 from last year to document this, and explain that you do not have a pay stub because you have no pay. They will recalculate your benefits based on zero times your old salary. Stupid? Yes, but this is how it actually works.

redrocker

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Re: "Temporary eligibility" for Obamacare requires more information
« Reply #7 on: January 27, 2016, 02:47:19 PM »
You can create a self employment ledger, or income ledger, showing what you made every month last year, and then January this year, and also estimated income this year based on your rental.  Would that work?

Maybe, except I don't think I'm "Self-employed" in the eyes of the government since rental income is passive (ie, I don't file for self employment taxes).

This is a very common scenario. Your subsidy will be calculated based on your new earnings, not your old earnings. You should go through the link that is on the site about a change in circumstance, laid off, or change in hours. You will need to submit a termination letter, so get one as soon as possible. You may also want to claim unemployment benefits, which will make it much easier to get your healthcare subsidy. All the benefits systems work together, to some degree (or they should, based on the No Wrong Door policy - it's a work in progress).

Another route is to say that you are now paid hourly, and you have been scheduled for zero hours. You can use your W-2 from last year to document this, and explain that you do not have a pay stub because you have no pay. They will recalculate your benefits based on zero times your old salary. Stupid? Yes, but this is how it actually works.

I'm going to contact my old HR and see if they'll provide a termination letter. As far as hourly pay, that's an idea but that might over-complicate things as I'm not formally declaring my rental properties a business.

I'm thinking maybe I should fill out a 1040es and send in a payment at least for the first quarter. I started to fill one out, but my tax liability was below the threshold of being required to submit one. Doing this might be seem more legitimate since it would be a signed statement from me to the IRS.
« Last Edit: January 27, 2016, 03:09:48 PM by redrocker »

Axecleaver

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Re: "Temporary eligibility" for Obamacare requires more information
« Reply #8 on: January 27, 2016, 09:19:11 PM »
Sorry I wasn't more clear. The zero hour strategy isn't for your rentals, it's for your nonexistent w-2 income. You need to establish that you have no regular W-2 income, and that will qualify you for better subsidies. You true it all up (including rental income) at the end of the year on your taxes. It's hard to prove you have no income without a termination letter, but it can be done by claiming zero hours scheduled.

I have heard that they were planning to add an "unemployed" category for folks like you who aren't working, but still making passive income. This was a problem in the early days. Not sure what the current status on this is.

redrocker

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Re: "Temporary eligibility" for Obamacare requires more information
« Reply #9 on: January 28, 2016, 10:13:51 AM »
Contacted HR, and in their typical manner of business passed me off to a third party. The Work Number generates an employment data report, which I requested. Interestingly enough, one the front page of the report it says:

"The information provided in this document is an unofficial report, intended for personal use by the employee-recipient only. It is not intended for verification purposes. Using this document for consumer verification purposes could constitute a violation of the Fair Credit Reporting Act and result in a monetary fine. If someone is asking you to provide verification of employment or income, please direct them to www.theworknumber.com."


So I'm not sure if I should upload this to the healthcare.gov website. Another twist is that it shows the last 24 months of data requests and Centers for Medicare and Medicaid Services dba CMS - Federally Facilitated Marketplace is on there 3 times back in November when I applied. Looks like I'm calling them again to figure out my next step...