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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

Any Safeguards Against Subsidy Fraud?

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Question: What’s to stop anyone from lying about their income to claim a subsidy?

Answer: The system has two safeguards: (1) During the application process, the applicant’s income will be compared to tax filings, social security data, and income reports; (2) the IRS already has mechanisms in place to recollect subsidies that were overpaid.

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Will there be any mechanism for a refund of premiums paid if actual income for a year is actually lower than what a person claims during the application process? Meaning, if a person does not receive a subsidy but their income would have actually allowed for one, will the person receive a refund at the end of the year?

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