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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.


February 2016 Archives


Question: I'm in an odd situation where I stopped working around August of last year to return to school, BUT I do try to get some work in during breaks. Since then it's been a non-stop cycle of "submit proof of income">submit last pay stub>"welcome back". What triggers these requests?

Answer: Submitting your last pay stub doesn't really satisfy Covered California (even though they list it as an acceptable form of proof of income). They'll keep requesting proof of income until they get an easily verifiable form of proof such as your last tax return, W2 income, unemployment insurance, or disability income. Self employed income and "other" income such as rental, stocks, 401k etc almost always trigger the proof request. In addition, Covered California has access to IRS records, so if your income estimate for 2015 was more that 10% higher or lower than your 2015 tax return AGI (line 37 of 1040), you will be required to provide proof of current income again.


Question: I provide more than 50% support for my friend/roomate, which means I can now claim her as a dependent on my taxes. We dont want her to loose her insurance, she cant afford her own. If I claim her as a dependent on my taxes would she then have to include me on the household number and my income information for her Covered CA health insurance application?

Answer: Your friend can file a tax return, but not take a personal exemption (Line 6A for IRS Form 1040). That way you can claim a dependent exemption for her on your tax form without affecting her eligibility. She must complete her Covered California enrollment application as a single person household using her income only.


Question: What is the penalty for not having any health insurance?

Answer: In 2016, the penalty is $695 per adult and $347 per child up to a family cap of $2,500 or 2.5% of household income, whichever is greater. In 2015, it was $325 for adults, with a $975 maximum or 2% of household income. Kaiser Family Foundation predicts that in 2016, average penalties will increase, on average, from $1,177 to $1,450 per household. According to Peter Lee of Covered California, “The bigger penalty could be showing up in the emergency room and walking out with a bill in the tens of thousands of dollars,”.

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