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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.


January 2017 Archives


Question: My daughter is 18 and on my ex husband's health insurance policy at his work. I claim her as a dependent on my taxes. If he drops her from his policy after open enrollment closes, does that create a special enrollment for her under my Covered california policy?

Answer: Yes. She will be eligible for a Special Enrollment Period (SEP) for 60 days after her loss of coverage. Since she is part of your household, you can add her to your Covered California coverage at that time.


How to Download Form 1095-A?

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Question: How can I get my 1095 A online. I'm trying to do my taxes??

Answer: The Form 1095-A's have already been posted online. Login to your Covered California online account. You will find the 1095-A form in your Documents and Correspondence folder. To get there, click on the Summary checkbox on the home screen and next click the Documents and Correspondence link, select and download CalNOD62A_IRSForm1095A_2016.


Payback All the Subsidy?

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Question: My 20 year old son is a dependent on my covered CA. His income put me over the Max amount of earnings to qualify. My tax credit was approx $1000 a month. Does that mean I have to pay back $12,000.00 dollars?

Answer: When you say "over the max amount of earnings", I assume you mean that your combined household income was over 400% of the Federal Poverty Level (FPL). If that is the case, then you will have to pay back all of the premium assistance (subsidy) you received in the previous year.


Canceling Now Without Penalty?

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Question: I want to cancel my #CoveredCalifornia insurance plan, under the ACA because President Trump used his executive order to repeal the Obamacare mandate. Can I cancel the ACA insurance plan immediately right now without having to be punished with fines for not having insurance or do I have to wait a certain date when the mandate is no longer applied to American citizens?

Answer: The Affordable Care Act has not been repealed or replaced. The mandate is still the law and tax penalties will be enforced until further notice. So you should wait if you want to cancel your insurance without penalty.


Terminating CC for Medicare?

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Question: My wife and I have Covered California coverage for 2017. I am listed as “primary subscriber” with Blue Shield. I will turn 65 in Feb 2017 and will be on Medicare, My wife however needs to remain on our CC plan for 2017. What is the best way to terminate my account with CC/Blue Shield since I will start Medicare but not change my wife’s continuation with Covered California, and then list her as primary subscriber after February?

Answer: Login to your Covered California online account and use the “report a change” feature. Under the “Personal Data” tab, go directly to the healthcare section and select “Yes” to receiving medicare benefits under the recipient’s name. The Covered California system will automatically terminate coverage for that subscriber without removing the required household details. The subsidy will automatically adjust for remaining subscribers.


Married Filing Separately?

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Question: I am married but file separately for taxes. My spouse does not wish to apply for Covered CA for since they are covered by their University's coverage. Do I include them in current monthly household income? We have separate bank accounts. Also, I do not currently work. I am full-time in grad school and only have student loans/grants. Do I include these loans/grants in my monthly household income?

Answer: If you file taxes as "Married Filing Separately", you are not eligible for premium assistance (subsidy). Your grant and student loan income are not taxed as income, so your taxable income appears to be $0, making you eligible for Medi-Cal. If you choose not to enroll in Medi-Cal, you can purchase individual health insurance directly from any insurance company licensed in California.


Question: My 21 year old son was added to our #CoveredCalifornia account with a start date of 9/1/16. He made $12,000 during the last 4 months of 2016. We are having issues with him stating that he is going to claim himself. Which do you think would be the harder hit, taking the $12,000 overage on our income for the year or covering him for 4 months and not claiming him.

Answer: My original answer to this question was wrong. This is the corrected answer. Explain this to your son. If he claims himself, his taxable income will be $12,000 minus his standard deduction of $6,300 minus the personal exemption of $4,050 for a net taxable income of $1,650 resulting in a $165 tax liability. If you claim him as a dependent, he loses the exemption so his taxable income will be $12,000 minus his standard deduction of $6,300 for a net taxable income of $5,700 resulting in a $570 tax liability. So basically, your son will lose $405 if you claim him. However, the tax benefit to you, the parents, will probably be more than $405 because you are probably in a higher tax bracket. I am unable to compute the financial consequences in your 2016 Covered California account without more demographic info. Send another question with your email address, zipcode, ages of family members and income by member and I will be more specific. In 2017, you should no longer claim your son as a dependent. Thank you Ernest for providing this answer.


Question: I wanted to shop for new coverage for 2017, but didn’t get around to it yet. Meanwhile, Covered Cal;ifornia automatically renewed my current policy. Can I still make a change?

Answer: Yes. If you pick a new plan by January 15, coverage under the new plan will take effect on February 1. If you pick a new plan between January 16 and January 31, coverage under the new plan will take effect March 1. In order to avoid a gap in coverage, you will have to pay the premium for your current policy until your new coverage takes effect.

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