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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.


How to Select Multiple Plans for One Household?

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Question: My husband and I are both self-employed so our income varies. Likely we will fall around the $60,000 mark for 2014 and qualify for a subsidy. The problem arises because we would like to choose two different plans based on different medical needs. Both plans are offered on “Covered California.” We want to choose a bronze plan for him, and a platinum plan for me. According to some info on the web, this should be a possibility, if so how would we do it?

Answer: The CC online application allows for multiple plan selections for households with 2 or more applicants when applicants are eligible for CC coverage without subsidies. Ths plan selection screen Plan Selection.png (click image to enlarge) is in the Enrollment Section. This would require overestimating your income on the application so as not to be eligible for advance premium tax credits and getting full tax credit due when your tax return for 2014 is filed.

8 Comments

CoveredCA is turning out to be an expensive and unsatisfying additional layer of bureaucracy on the back of an unwieldy beast. Admittedly, it worked some better than healthcare.gov, but the recent five day disappearance of the enrollment portal leads me to believe something dreadful is wrong. The system was down for a day and a half just a week earlier.

I know for a fact that one of my Medi-Cal eligibles was dropped from my client list about 24 hours after the app was submitted, because I needed to upload a document and was unable to find the applicant in my list. Then the website went down the following day. Yesterday, when the website was “restored” that client was still missing. He did call to ask about the CoveredCA “You’re not eligible” letter that confuses almost every Medi-Cal beneficiary, so his application was received, but now I have no way to upload his document.

I will have to trust the local Medi-Cal agency to do the verification of residency.

What are your thoughts on the processing times of CC? The idea of being “insured” without having ID# or cards and yet still paying for insurance really pisses some people off, especially those who applied for 1/1/14. You make your first payment and then don’t see your ID cards for a month and a half…

After five (5) flippin’ hours on the phone with Anthem today (on the same single phone call), and after repeated Anthem mistake after mistake (applicant has to show Anthem her application before they believe a direct online enrollment actually occurred), usually first suggested that either the applicant or the broker as the cause of error, to then have to prove otherwise and find out it is definitely all on Anthem, I’m done calling them for awhile. Unbelievably unprofessional! Amateurs calling the shots. The carriers themselves make the best case for single payer! They have had years to prepare, and they did not expect the volume only to hire more people late in the game?

David, you probably don’t mean report a change in income the way it sounds, but just in case…only report a change for the big ticket items outlined elsewhere, not just to make Covered CA aware of income fluctuations. Covered CA is unable to tweak an account, a reported change will result in a terminated plan. Income variations should be handled through their back end by them at tax time. It remains to be seen how that is going to work, but the other way is fatal for your current plan.

Thanks Phil. It sounds like the only option to get a tax credit in a split plan scenario is to wait until you file your taxes. I’m curious about something Maxx wrote about taking the insurance premium deduction and then also getting the text credit. I’m not sure you could do both and I’m guessing the calculation will be a bit complex. I know that for small business tax credits for group coverage the amount you can deduct as a business expense is reduced by the amount of your tax credit. Have you heard guidance from the IRS or input from a CPA as to how this is handled on the individual side?

David, Covered California in unable to apportion the tax credit among 2 or more contracts, even within the same household adn with the same carrier. So lowering the income to on an in-force split case won’t provide the result you want.

At $60,000 annual, your premium tax credits will not be very much, so Phil’s suggestion to forego the credits by increasing your reported income now and paying the full premium will likely be more valuable in the long run.

Not only will you have the benefit of being able to choose separate plans, if necessary, but you will have the full value of the premiums you pay to deduct from Adjusted Gross Income, which will affect your ultimate tax credits in a positive manner.

The only reason CoveredCA does not allow individual selection of a health plan for multiple insureds is that either they and/or the IRS refuses to apportion the tax credits among different insurers. Then end result is the same, it’s a six-of-one-half-a-dozen-of-the-other conundrum.

I haven’t seen anything from the IRS that disallows a division of the credits to multiple insurers, so I’m going to point the finger at CoveredCA on this one.

Have you heard anything from CC on how the system will handle a reported change in income under this scenario? I’m thinking you could report your income hi enroll in the two different plans and then report a change in income to gain access to the advanced tax credits.

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