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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.


1095-A Dispute, Still No Correction?

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Question: I received my 1095-a from CoveredCA back in January and noticed that it was not accurate. It showed policy dates of 4/1 to 10/1 with subsides for said months. The problem is that it included a subsidy for the 10th month when in fact it should not have. I filed my dispute over 60 days ago... I never heard from them. That said, I have been calling and have been told that they see the error and that the IT department needs to change the end date to the last day of 9th month. I've not been given a time frame with any certainty as to when this will happen. I have been told that the corrected 1095-a can't be issued until it does. So... my question is: Is there anyway I can get this resolved quicker? Is there a way for me to contact a rep that can actually get it fixed?

Answer: Your don't need a corrected copy of the Form 1095-A to file your federal tax return. The Premium Tax Credit form used as part of your federal tax filing is the IRS Form 8962.pdf You know the correct amounts for total premium and premium tax credits from your monthly health insurance bill. Enter those amounts on the Form 8962 and get on with it.

4 Comments

The IRS rejected my return because I did not include my 1095A. I moved out of California and have no idea where it is. Is it possible to get it online?

“Enter those amounts on the Form 8962 and get on with it. “

That is not a satisfactory answer.

The IRS will likely send a letter asking for a copy of the 1095a to confirm the amounts on 8962. and will withhold any amounts to be refunded until received or otherwise disallowed until covered CA sends a corrected 1095a.

This is a fact, because that happened to me personally. The first 1095a form was accurate, and was used to file the return. The second 1095a sent out by covered CA was “corrected” but had errors and higher subsidies that actually taken. The IRS went with the “corrected” version, until I submitted the first 1095 as they requested to substantiate the amounts on 8962. So, by saying go ahead and file, it doesn’t help even to allow a subsidy for the following year unless one files an affidavit of filing a tax return. All can do is File a grievance.

see my comments in the January archives under :How Do I Get My Form 1095-A Online? January 28, 2015 4:03 PM 26 Comments comment by don mcgrete | March 7, 2015 5:05 PM

big surprise it looks like they lied, more and more over and over.

I called them the first week in April to let them know that the 60 days are over and I have not heard about the 1095a dispute. I thought they must not have known the 60 days were up, or else they would have contacted me within the 60 days, as they had promised over and over.

wrong, they did know and said “you are not the only one calling”. call us next week they guessed.

I called the next week, and now magically they could tell that “we got a fax on Feb 7th”.(1095a dispute)

I ask why that was a week after I had sent it and they were not sure.

I ask what happened to the other 5 copies I sent them latter and they were not sure

I ask them if they had any of the proof I faxed them and they were not sure.

I ask how many pages they had and they were not sure.

I ask what they did since Feb. 7th to fix my account, try to contact me, or in anyway try to be accountable and keep their word. They were sure of that!!!! They had determined that my account needed fixing, and the dispute department had forwarded it to the appropriate IT department on 3-27, so therefore they felt they had done their part and completed working on my account within 60 days.

I ask if there was anyway to contact the IT department and they were not sure.

I ask if that IT department was going to issue a corrected 1095a or not, and they were not sure

I ask when I should call again and I was told that the IT department has 30 days to fix the account

I ask if that IT department was going to issue a 1095a after they fixed it, or if they would need to send my account and information to another (third) department after those 30 days were up, and they were not sure

TODAY knowing that I can not trust anything they say, I looked at my account at 8am. It was unchanged. I looked at it again at 4pm, and saw that at 14:00 (2pm in the afternoon) someone at Coveredca had gone into my account, reviewed my eligibility status, and had deselected the last two steps of signing up my account for insurance!!!!

a customer service representative from Coveredca had removed the checkmarks on my account under both eligibility and enrollment. My account said I had to finish choosing a carrier by 4-18 when open enrollment (three days) ended.

I was enraged and once again and had to speak to a manager because of a befuddled representative.

I ask why they would do this. I said if they had not lied to me so many times in the last two months, that I would not now be checking my account twice a day, and would not have caught their latest screwup. I said I knew for a fact my account was fine in the morning, and now after Coveredca made the change I was to be canceled in 3 days if I didn’t respond.

He said they are not authorized to pick a plan for me. I told them that I already had a plan and they took the checkmarks off my account today.

He said that it must have been deselected when someone at Coveredca changed my address on 3-27.

I ask what they changed ON MY ADDRESS AND HE WAS NOT SURE.

I told him that my account was deselected today. (again I told him)

He found another past change that Coveredca had made and told me that was how I was deselected.

again I told them that my account was fine at 8am, and was not ok by late afternoon TODAY.

he ask me what plan I wanted and signed me backup under where I was. He felt that since I was now signed up everything should be ok. there was still no accounting for the change, and therefore no way to tell if, or when, IT COULD HAPPEN AGAIN. He said not to worry, that they wouldn’t cancel me without letting me know. I am not sure that they would ever do anything other than send a letter, three months after the fact, if at all.

The PTC changed to more on my account. there is no effective date shown. He guessed at what it would be.

I asked him won’t my 2015 1095a now be wrong, since you have erased the old data and it looks like you will be issuing a 1095a for 2015 looking like you paid the higher PTC all year when they did not.

I have paid 5 months of the higher rate for my part. Coveredca will issue a 1095a saying they paid more than you did for 2015. They will issue a 1095a saying they paid the new, higher rate all year. I will have to pay for their lie again.

The manager said he will have someone that works for him look into why they made the change and why they didn’t tell anyone, that would have resulted in the cancelation of my insurance, seemingly at random. I stressed that it was important because I didn’t want to loose my house because of some accident that could happen in the future, if it happens after they canceled my insurance without telling me.

He assured me that they will call tomorrow.

I know that if he does not understand the ramifications of randomly canceling someone’s insurance, or the necessity of being trustable when issuing insurance, or the problem of issuing another wrong 1095a in 2015 after so many lies about the first one in 2014, then how can anyone who works for him?

so the only real progress Coveredca has made is :

  1. another bushel of lies

  2. awarding themselves another 30 days, to do what they didn’t do it in the first 60 days that they originally awarded themselves

  3. created the opportunity to involve yet another (third) department after the 30 days in the IT department are up, after the 60 days in the dispute department are up

  4. totally screwing up next years 1095a well in advance

  5. already able to tell me that next years 1095a will be fine, when they already know better

  6. suckered me into sitting around, another time, for another call, I already know won’t come

  7. assured that there will be another year where I will have to use the 1095a dispute form

  8. assured that there will be another year I have to pay my accountant for an amended tax return. (if they ever really do fix anything)

  9. proved beyond any shadow of a doubt they are accountable to no one

    1. proved the penalty for making blatant lies, and never learning from their own mistakes, is nothing

Now that we’re in tax filing season, I’m curious if other agents are hearing from their clients about how accurately they predicted their 2014 income and if the APTC they received through CC was too much/not enough/just right. So far I haven’t had any clients tell me they received too much APTC but I did get a call today from an acquaintance who owes $1500 in taxes. She applied directly with CC over the phone for a May 1, 2014 effective date. It sounds like the CC rep only asked what she was making at the time, and did not include income she made between January and April 2014 at a previous job. She told me that she read somewhere that about 50% of the enrollees in CC received too much APTC.

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