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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.


What is SLCSP on Form 1095-A?

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Question: I have an anthem bronze ppo plan for which I am paying 100 percent of the monthly premium (no subsidy). Reading about the 1095a statement, I NOTICED a column called slcsp. WHAT IS THAT, AND DOES IT APPLY TO SOMEONE IN MY SITUATION? I DON'T QUALIFY FOR ENHANCED SILVER BENEFITS. A WEBSITE I looked at said if the column reads 0 IT IS INCORRECT. I ASSUME IT WOULD READ 0 SINCE I did not get any enhanced silver plan benefits.

Answer: The second-lowest cost silver plan (SLCSP) that applies to you is usually found on your Form 1095-A. If you receive premium assistance during the year, you need to know the SLCSP to figure out your final premium tax credit for the year. If you did not receive any premium assistance during the year, the advance premium tax credit field should be $0. The The SLCSP field may be zero too, since it doesn't matter.

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If your MAGI is less than 400% of the Federal Poverty Line, you will still be eligible for Premium Tax Credits as a reduction of the amount of federal income tax due. So for 1095-A remains important.

On a slightly different note, if you have had any medical expenses in 2016, with your Bronze plan, in addition to the premiums you’re paying, you are also paying 100% of the cost of your health care expenses on top of that until you reach the $6300+ out of pocket limit. Unless you are contributing to an HSA, this makes little sense. By moving up to a Silver level plan, which might cost a couple of hundred dollars more PER YEAR than your Bronze plan, you may greatly reduce your out of pocket costs by more than the difference in premium.

Working with a knowledgeable agent can often avoid making such pennywise mistakes.

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