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ACA April_2021

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Volume 3, Number 19

Latest News and Updates

The first article in this month’s newsletter explains the major changes to Affordable Care Act plans made as a result of the passage of the American Rescue Act (ARPA) signed into law on March 11 and the extension of the COVID 19 special enrollment period to August 15, 2021 announced on March 25.

The second article summarizes changes to COBRA being made for those who either suffer involuntary loss of health coverage or reduction of hours , and it explains the new rules applicable to those who receive unemployment compensation some time during 2021.

The third article presents a high-level overview of all the changes being made by ARPA.

Further details will be provided concerning some of the health insurance provisions of ARPA, and we'll be updating our website at www.getinsuranceanywhere.com and/or communicating clarifications in upcoming newsletters or special newsletter announcements. Clarifications to some of the rules are being made daily, and this newsletter is based on our understanding as of March 30, 2021

Please contact us at 561-734-3884 or 786-970-0740 for further details or for help in updating your application and possibly changing your present plan.

AMERICAN RESCUE PLAN (ARPA) CHANGES REGARDING TAX SUBSIDIES AND INDIVIDUAL AND FAMILY HEALTH PLAN COSTS

ARPA’s major change regarding Affordable Care Act plans concerns eligibility for tax credits (which reduce total premiums) and how tax credits are calculated. These changes are temporary and at this time apply ONLY to 2021 and 2022.

Prior to passage of ARPA individuals and families were eligible for tax credits based on their income falling between 100 and 400% of what is called the Federal Poverty Level (FPL). Individuals falling between 100% in Florida (and other states that have not expanded Medicaid) or 138% (in Medicaid expansion states) and 400% of the FPL in most cases could qualify for tax credits. Individuals falling above 400% of the FPL were not eligible for tax credits.

These tax credits could be applied to reduce the premium cost of ANY plan offered through the health insurance marketplace (healthcare.gov). People falling between 100% and 250% of the FPL could also qualify for what is called a cost share reduction plan (CSR). A CSR reduces the deductibles, copays, and maximum out of pocket costs at what is called a silver plan FOR NO ADDITIONAL cost. Here is the FPL schedule for 2021:

Affordable Care Act plans fall into one of what are called “metallic” levels ranging from bronze, to silver, gold, and platinum. Bronze plans offer the least overall coverage, and the coverage level increases as one goes from bronze, to silver, then gold, and finally to platinum levels.

Tax subsidies are calculated based on a person’s age and zip code of residence. They're calculated based on how their family income relates to the cost of the second lowest cost silver plan offered in their zip code. The cost of the plan differs according to age, zip code and family size, and the calculation assumes that all family members are non-smokers.

ARPA has made two major changes:

1. Individuals making over 400% of the Federal Poverty level are now eligible for tax subsidies for the first time.

2. The % of income calculation has been lowered for ALL poverty levels, and those making over 400% are NOW limited to paying 8.5% of their income for the second lowest cost silver plan in their area (this is referred to as the “benchmark” plan). Here is a comparison of the calculation tables previously used, and the calculation levels that will apply starting 4/1/2021:

The effect of these changes is that the amount of tax subsidies will be increased for those who previously qualified for tax subsidies. Many people making over 400% of the FPL—particularly those 50 and over—will NOW be eligible for subsidies for the first time, and these subsidies may be very significant.

Individuals in states (e.g. Florida) that participate in healthcare.gov can update their tax subsidies and retain their present plans beginning today (4/1).

On March 25 President Biden extended the COVID special enrollment period from May 15 to August 15 for those in states (e.g. Florida) that participate on healthcare.gov. (The President originally established this special election period starting February 15, and this permits individuals and families to enroll in Affordable Care Act plans without having to provide proof of a qualifying life event life such as a birth, marriage, moving between different counties and states, etc.)

People currently receiving tax subsidies (or those applying for ACA plans for the first time) can update their applications and remain in their current plan or change to a different plan.

People who did not previously qualify for tax subsidies can apply for on-exchange (also called marketplace) plans starting today.

Changes made during a month will be effective the first of the following month.

Individuals continuously enrolled in an on-exchange plan since January 1, 2021 will be able to take tax credits retroactively to January 1, 2021 if they are enrolled in a subsidized plan by 8/15. Their premiums will be adjusted to reflect their new subsidies as of the month following updating their application or changing to a subsidized plan, but they will receive credits for having the new subsidy retroactive to January 1 when they reconcile their income on their tax return. Individuals enrolled in off-exchange plans who enroll in an on-exchange subsidized plan will only be able to take tax credits for the period they're enrolled in a subsidized plan

If you live in a state that operates its own state exchange, that exchange (e.g. Covered California in California) may have different rules re enrollment dates and eligibility. For example, Colorado will not permit people to change plans; only those who did not enroll previously will be able to enroll during their COVID 19 special enrollment period. California will permit enrollment through the end of the year. Please contact your local state exchange for details.

We've already contacted our clients to alert them to these changes and will be re-contacting them starting today to help them update their applications and make any further changes.

There is one other significant change that was made in the law. For 2020 (only) those who underestimated their earnings will be exempt from having to pay back the government the difference of the subsidy based on the earnings they projected and the lower subsidy that would have been applicable based on their actual earnings. The IRS understands that some people who had underestimated their subsidies (and hence received higher subsidies) have already filed tax returns and paid back any overpayments as part of their tax return. The IRS has told these people to await IRS guidance before filing amended returns; it's possible the IRS may be able to make adjustments automatically and make refunds on that basis.

We're happy to help anyone already on or eligible for an Affordable Care Act plan enroll in an on-exchange plan for the first time or update their application so they can receive higher subsidies. We can help people not eligible for subsidies enroll in off-exchange plans, as well. Please contact us at 561-734-3884 or 877-734-3884.

HEALTH PLAN CHANGES DUE TO UNEMPLOYMENT

ARPA contains two other significant changes:

1. Individuals who have received unemployment compensation in 2021 will be considered as making 133% of the FPL when making subsidy calculations. Note: the government has indicated that guidance on this provision will not be issued until early July. Meanwhile, those with unemployment compensation who can project earnings to at least 100% of the FPL should make application as soon as possible if they have not already done so.

2. People who were involuntarily terminated or who lost coverage due to a reduction in hours will be eligible to receive COBRA at government expense through September 30 even if they have passed the 60-day period to sign up for COBRA or previously refused COBRA. This provision is effective today and ends the earlier of September 30 or when the individual's COBRA eligibility ends. Beginning today, employers will have until May 31 to provide notice to affected individuals. Employers must also give advance notice to individuals before their free COBRA period ends.

The free COBRA rules are very complicated. Please call us at 561-734-3884 or 786-970-0740 if you have any questions.

Note: the government has not yet issued any guidance as to whether these people will be able to apply for an Affordable Care Act plan if their COBRA subsidy ends after August 15. (They can clearly apply for an Affordable Care Act plan up to August 15. However, if their free COBRA subsidy expires between August 16 and September 30, it's unclear as of this writing whether they can apply for an Affordable Care Act plan at that time. We'll include additional information on our website at www.getinsuranceanywhere.com and include updates in this newsletter as well as soon as guidance on this issue is published.)

AMERICAN RESCUE PLAN ACT (ARPA) SUMMARY

Please see this article published by the Tax Foundation that provides a high-level summary of the changes made by the ARPA legislation signed into law by President Biden on March 11.

In addition to making major changes to the Affordable Act for 2021 and 2022 (see the above two articles), the Act includes provisions for making $1400 stimulus payments for individuals making up to $80,000 (and joint filers making up to $160,000).

The American Rescue Plan also extends the federal unemployment insurance expansion first created by the CARES Act through September 6, 2021. The law maintains the federal supplement at $300 per week for weeks beginning after March 14 and before September 6, 2021.

The law also retroactively provides an exemption of up to $10,200 of unemployment compensation received in 2020. The law was enacted after a significant number of people had already filed their 2020 returns. The IRS has advised these people not to file amended returns at this time; they’ve indicated that they soon will be issuing guidance on this.

Finally, ARPA greatly expands the Child Tax Credit by allowing households with children to claim up to $3,600 for younger children or $3,000 for children age 6 or older regardless of earned income.

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HEALTH

DENTAL

MEDICARE

DISABILITY

LIFE

2022 Schedule
Affordable Care Act Open Enrollment

Unless changed by the Biden Administration, Open Enrollment begins
November 1, 2021 and ends December 15, 2021
on the federal facilitated marketplace for plans to start January 1, 2022.

Between February 15 and August 15, 2021 you can enroll in a plan
during the COVID-19 special enrollment period. The plan will be effective
the first of the following month.

Otherwise, before the next open enrollment period starts you can only enroll
for an Affordable Care Act plan if you have a qualifying life event.

You may be eligible to enroll for another type of plan.
Call us at 561-734-3884 or 877-734-3884 for details.

2022 Schedule
Medicare Annual Enrollment Period

Annual Enrollment begins October 15, 2021
and ends December 7, 2021 for a January 1, 2022 effective date.

You’re eligible to enroll now if you’re first becoming eligible for
Medicare or are eligible for another type of enrollment period.
Enrollment rules differ between Medicare Supplement plans and
Medicare Advantage, Medicare Advantage Prescription Drug,
and stand-alone Prescription Drug Plans.

Call us at 561-734-3884 or 877-734-3884 for details.

Get Rates & Plans Now

We offer a comprehensive set of Affordable Care Act (“Obamacare”) plans

to individuals and families qualified to buy health (tax- and non-tax subsidized) insurance and dental/vision and/or hearing plans through the Federal marketplace (this is called buying “on-exchange” or “on-marketplace”) or directly from insurance carriers (this is referred to as buying “off-exchange or -marketplace”). Our Affordable Care Act policies comply with the Affordable Care Act and contain all of the “essential health benefits” required by that law.

The dental/vision and/or hearing insurance

products are available both on an insured or discount basis

We offer short-term health insurance policies

for those who are looking for more inexpensive coverage and shorter term alternatives.

We offer Medicare Supplement, Medicare Advantage, and Part D Drug plans

to Medicare beneficiaries. Our site is compliant with federal, state, and carrier guidelines in selling these policies. See the Medicare section of this site for details.

We represent many carriers that offer supplemental benefits

to both individuals and families and Medicare beneficiaries, and the site contains information about hospital indemnity, cancer, critical illness, gap, accident, and international medical insurance offered by many different carriers. This section of the site also contains valuable information and tools about lowering the cost of prescription medications. Call us if you want more information about or would like to enroll in one of these products.

We also offer Short- and Long-Term Disability products

and can also help you meet the costs of long-term care, nursing home, or short-term (recovery) care needs.

Finally, we have a complete array of Life, Final Expense, and Annuity products

and offer pre-need services in Florida, as we have both life insurance and pre-need licenses in that state.

You pay nothing for our services:

we’re paid directly from the carriers we represent, Premiums are NEVER EVER marked up to include paying us for our services: you pay the same whether you order directly from the carrier or the marketplace on your own or directly through us or from our site.

We ONLY offer alternatives that are suitable for you and for which we feel meet YOUR needs.
When or if we feel a product or service is not appropriate for you from either a cost or benefit point of view we will tell you so.

We’re fully compliant with privacy and security guidelines, have signed all required privacy and security agreements, have developed a privacy and security policy, and take extraordinary steps to safeguard your protected health and personal information.
In short, we’re experts in all aspects of health and life insurance and also have relationships with professionals who can help you with very specialized situations.

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