Serenade Posted November 17, 2015 Share Posted November 17, 2015 My husband recently left his job (as of the end of October). We had planned to finish out the year for healthcare via Cobra, and then switch to the exchange. However, his company is being very slack about sending the Cobra materials. I don't think they want to deal with it. They told my DH it was retroactive, but here it is the middle of November, and we're hesitant to go to the doctor because we have not yet received the Cobra paperwork. Which also makes us wonder if we should just go ahead and switch directly to the exchange and forget about Cobra. My husband is leaving a job he was at for 14 years and is going to try to consult for a living (electrical engineer). He has done consulting work here and there over the years, but he's going to try to make a go of it full time now, with full time meaning at least 30 hours a week or so. A reasonable projection is that in his first year consulting he will maybe make half of what he made in his former job. What does he put for his income when applying for the exchange -- what he made this year, or what he expects to make next year? I read some articles that explained if you end up making more than what you initially start out as, you can be back-billed for the difference. We're OK with that, but we're wondering if there is a fine on top of that. My husband seems to think there is a fine, but it seems odd to me that someone who starts out without a job and an income would be fined when he or she eventually makes more money. And what about if the consulting gig doesn't work, and he decides to find another company job sometime in the middle of the next year? Would that result in a fine, or just a back charge for any difference in the cost of the healthcare. It's all very confusing, and I can't seem to find any information online. Quote Link to comment Share on other sites More sharing options...
kewb Posted November 17, 2015 Share Posted November 17, 2015 I would call the number at healthcare.gov. They can tell you what you need to know. I can tell you that we were able to get a lower rate through the exchange then cobra. 1 Quote Link to comment Share on other sites More sharing options...
Serenade Posted November 17, 2015 Author Share Posted November 17, 2015 I would call the number at healthcare.gov. They can tell you what you need to know. I can tell you that we were able to get a lower rate through the exchange then cobra. Well, that is what DH's company told him, too. I think they are kind of hoping we will go that route because they don't want to deal with the paperwork. I can't believe it's been over two weeks since he left and we still have not gotten it. Quote Link to comment Share on other sites More sharing options...
Paula in MS Posted November 17, 2015 Share Posted November 17, 2015 When you apply online, just put his current income. When his income drops, you can send them proof of the new income, and, I believe, they will adjust the premium. 1 Quote Link to comment Share on other sites More sharing options...
Lolly Posted November 17, 2015 Share Posted November 17, 2015 So, you are applying for 2015 and 2016 at the same time? For 2015, I would probably use his full income since he is so close to working the whole year. For 2016, put down whatever you estimate it will be for that year. They will accept the 2015 because it will be the same as the 2014 tax return. They will send you a request for documentation of income for 2016. You just send them a copy of 2014 return along with a note explaining why it will decline, and they take that amount for the next year. You can adjust during the year if you find your estimate to be off. If you turn out to make more, you have to pay the difference. If you make less, they refund the difference. (At least, that is what we are doing for this year. We did estimate a higher amount than we anticipated making, but it was well below what last year's total was.) No fine involved. 1 Quote Link to comment Share on other sites More sharing options...
Lanny Posted November 17, 2015 Share Posted November 17, 2015 You may want to speak with an Independent Agent who sells Major Medical Insurance. I seem to remember reading post(s) here where people wrote they got a better deal that way than through an Exchange. Your income will probably fluctuate wildly, so if you can get your insurance off the exchange, it may be less complicated for you than trying to explain your income fluctuations to them. GL 1 Quote Link to comment Share on other sites More sharing options...
Scarlett Posted November 17, 2015 Share Posted November 17, 2015 You may want to speak with an Independent Agent who sells Major Medical Insurance. I seem to remember reading post(s) here where people wrote they got a better deal that way than through an Exchange. Your income will probably fluctuate wildly, so if you can get your insurance off the exchange, it may be less complicated for you than trying to explain your income fluctuations to them. GL I wish someone could tell me if this is true. I don't believe it is. I believe the rates are the same whether you go through the exchange or not. 2 Quote Link to comment Share on other sites More sharing options...
Scarlett Posted November 17, 2015 Share Posted November 17, 2015 So, you are applying for 2015 and 2016 at the same time? For 2015, I would probably use his full income since he is so close to working the whole year. For 2016, put down whatever you estimate it will be for that year. They will accept the 2015 because it will be the same as the 2014 tax return. They will send you a request for documentation of income for 2016. You just send them a copy of 2014 return along with a note explaining why it will decline, and they take that amount for the next year. You can adjust during the year if you find your estimate to be off. If you turn out to make more, you have to pay the difference. If you make less, they refund the difference. (At least, that is what we are doing for this year. We did estimate a higher amount than we anticipated making, but it was well below what last year's total was.) No fine involved. This. I had to pay back some of my tax credit when Dh made more than I estimated. But there was no fine. If you are unsure of the income for next year I would caution against choosing an expensive plan. Everyone has a different idea of how they want insurance to work for them. I prefer the simple one I have...it is a $6000 deductible, but once that is met it pays 100%. Needless to say I don't depend on it to cover normal stuff...I just have it in case something big happens. But of course like every plan is required by law it pays 100% ( no deductible) for Pap test, Mammo and some blood work along with some other screenings depending on age. As far as going through the exchange if you currently have no income it will definitely be worth it. However, I will warn you that they whole system is a pain to deal with. I have spent hours on the phone with them over simple matters. Dh got insurance through his work this fall and so I removed him from the plan I bought through the exchange. We already were getting zero tax credit because he got a job and we didn't qualify. So after I removed him I got a letter demanding his proof of income under threat of me losing coverage. Just for kicks I called and asked them why they needed this info? They couldn't tell me. It is a very cumbersome system I can tell you that. As soon as I pay my December bill I am disentangling myself from the marketplace and buying my policy directly from the insurance company. 2 Quote Link to comment Share on other sites More sharing options...
Guest Posted November 17, 2015 Share Posted November 17, 2015 I wish someone could tell me if this is true. I don't believe it is. I believe the rates are the same whether you go through the exchange or not.We buy from the exchange through an insurance agent and I wouldn't do it any other way. He is much more knowledgable and really helped us navigate the exchange. 1 Quote Link to comment Share on other sites More sharing options...
Scarlett Posted November 17, 2015 Share Posted November 17, 2015 We buy from the exchange through an insurance agent and I wouldn't do it any other way. He is much more knowledgable and really helped us navigate the exchange. What specifically did he help you with? Did he do it for you? And how does he get paid for his work? 1 Quote Link to comment Share on other sites More sharing options...
Guest Posted November 17, 2015 Share Posted November 17, 2015 He took our information and emailed us several plans to pick from. He understands the subsidies and was able to help us navigate if we wanted to take it or not. He knows more about the different companies and was able to quickly tell us that the cheapest plan wasn't the best because the area children's hospital was out of network (just in case something terrible happened). DH and I spent many hours on the exchange website and never felt like we understood what we were doing. Our agent was able to look at our situation and help us feel like we were making the right choice. Eta--he is paid by the insurance company and he did it all for us. I just gave him names and SSNs and waited for the bill from the company. 1 Quote Link to comment Share on other sites More sharing options...
Scarlett Posted November 17, 2015 Share Posted November 17, 2015 He took our information and emailed us several plans to pick from. He understands the subsidies and was able to help us navigate if we wanted to take it or not. He knows more about the different companies and was able to quickly tell us that the cheapest plan wasn't the best because the area children's hospital was out of network (just in case something terrible happened). DH and I spent many hours on the exchange website and never felt like we understood what we were doing. Our agent was able to look at our situation and help us feel like we were making the right choice. Eta--he is paid by the insurance company and he did it all for us. I just gave him names and SSNs and waited for the bill from the company. I see. I was able to do my own research on what plan was best for me.....I wanted my doctors back home in another state to be covered....so I did a lot of checking. It was a pain but I would pay a higher premium to have someone do it for me. As long as it was free it might be the way to go. Quote Link to comment Share on other sites More sharing options...
Kimberly in IN Posted November 17, 2015 Share Posted November 17, 2015 My dh also left his last position to do consulting (supply chain.) He has been able to maintain full time (avg. 40 - 55 hrs per week) We HOUNDED his previous employer for the COBRA info. Writing letters, sending emails and calling multiple times a day at the end. Dh also knew the name of the company that handled their COBRA & started the process on that end also. For us, COBRA was over $500 less per month than the exchange AND included more coverage, with a smaller deductible. We needed COBRA. Adding this info just in case you haven't compared one to the other. We also talked with an insurance agent to learn more about the options with the exchange. After reviewing our COBRA option and options with the exchange, she highly encouraged us to stay with COBRA. (of course, I am not a good supportive wife & am hoping my dh returns to a full time job soooooooon, but that is another topic .... :lol: ) 1 Quote Link to comment Share on other sites More sharing options...
zoobie Posted November 17, 2015 Share Posted November 17, 2015 I wish someone could tell me if this is true. I don't believe it is. I believe the rates are the same whether you go through the exchange or not. The exchange plans will be the same prices. The insurance companies may offer other plans that you would qualify for which are not offered on the exchange that would be a better deal. Insurance agents are paid like travel agents. Fee comes directly from the business whose product they sell you. 1 Quote Link to comment Share on other sites More sharing options...
Scarlett Posted November 17, 2015 Share Posted November 17, 2015 The exchange plans will be the same prices. The insurance companies may offer other plans that you would qualify for which are not offered on the exchange that would be a better deal. Insurance agents are paid like travel agents. Fee comes directly from the business whose product they sell you. I don't understand how there could be other plans that aren't listed on the exchange. 1 Quote Link to comment Share on other sites More sharing options...
TechWife Posted November 17, 2015 Share Posted November 17, 2015 I don't understand how there could be other plans that aren't listed on the exchange. Not all insurance plans are required to be on the marketplace. There are many insurance companies that aren't on the marketplace at all. In addition, the insurance companies that do have plans on the marketplace also have other plans available. 1 Quote Link to comment Share on other sites More sharing options...
Scarlett Posted November 17, 2015 Share Posted November 17, 2015 Not all insurance plans are required to be on the marketplace. There are many insurance companies that aren't on the marketplace at all. In addition, the insurance companies that do have plans on the marketplace also have other plans available. But how could you get a plan through the market place that isn't on the marketplace? 1 Quote Link to comment Share on other sites More sharing options...
TechWife Posted November 17, 2015 Share Posted November 17, 2015 But how could you get a plan through the market place that isn't on the marketplace? You don't. You go to an insurance agent and purchase through him/her. You aren't required to participate in the marketplace. 1 Quote Link to comment Share on other sites More sharing options...
Scarlett Posted November 17, 2015 Share Posted November 17, 2015 You don't. You go to an insurance agent and purchase through him/her. You aren't required to participate in the marketplace. Well yes, I know that. But I thought we were talking about using the marketplace. Quote Link to comment Share on other sites More sharing options...
Serenade Posted November 17, 2015 Author Share Posted November 17, 2015 When you apply online, just put his current income. When his income drops, you can send them proof of the new income, and, I believe, they will adjust the premium. Well, his last day of work was at the end of October, so his income has already dropped. Although this year he will make close to what he normally makes, due to his consulting work throughout the year. I wonder how you officially establish an income with a highly variable job like consulting. I guess you just make your best guesstimate and change as needed. It sounds like it's not too hard to change. Quote Link to comment Share on other sites More sharing options...
Serenade Posted November 17, 2015 Author Share Posted November 17, 2015 So, you are applying for 2015 and 2016 at the same time? For 2015, I would probably use his full income since he is so close to working the whole year. For 2016, put down whatever you estimate it will be for that year. They will accept the 2015 because it will be the same as the 2014 tax return. They will send you a request for documentation of income for 2016. You just send them a copy of 2014 return along with a note explaining why it will decline, and they take that amount for the next year. You can adjust during the year if you find your estimate to be off. If you turn out to make more, you have to pay the difference. If you make less, they refund the difference. (At least, that is what we are doing for this year. We did estimate a higher amount than we anticipated making, but it was well below what last year's total was.) No fine involved. This is very helpful. Thank you. Good to know there is not a fine. Quote Link to comment Share on other sites More sharing options...
Serenade Posted November 17, 2015 Author Share Posted November 17, 2015 However, I will warn you that they whole system is a pain to deal with. I have spent hours on the phone with them over simple matters. Dh got insurance through his work this fall and so I removed him from the plan I bought through the exchange. We already were getting zero tax credit because he got a job and we didn't qualify. So after I removed him I got a letter demanding his proof of income under threat of me losing coverage. Just for kicks I called and asked them why they needed this info? They couldn't tell me. It is a very cumbersome system I can tell you that. As soon as I pay my December bill I am disentangling myself from the marketplace and buying my policy directly from the insurance company. This is the part I'm not looking forward to. Quote Link to comment Share on other sites More sharing options...
Scarlett Posted November 17, 2015 Share Posted November 17, 2015 Well, his last day of work was at the end of October, so his income has already dropped. Although this year he will make close to what he normally makes, due to his consulting work throughout the year. I wonder how you officially establish an income with a highly variable job like consulting. I guess you just make your best guesstimate and change as needed. It sounds like it's not too hard to change. I don't think it is that easy to change. I would just do your best guess and if you see it going higher plan on having to pay back the credit. 1 Quote Link to comment Share on other sites More sharing options...
TechWife Posted November 17, 2015 Share Posted November 17, 2015 Well yes, I know that. But I thought we were talking about using the marketplace. The initial question was about the marketplace, then some people recommended that the OP talk to an agent about other plans that are available instead of relying on the marketplace. You asked how there are plans available that aren't listed on the exchange, I explained that there are plans available outside the marketplace. Quote Link to comment Share on other sites More sharing options...
Serenade Posted November 17, 2015 Author Share Posted November 17, 2015 We buy from the exchange through an insurance agent and I wouldn't do it any other way. He is much more knowledgable and really helped us navigate the exchange. This is something I hadn't even considered, so good to know it's a possibility. Now I seem to remember a while ago getting an e-mail about health coverage from USAA. I didn't pay attention to it though -- that was just the headline. Maybe I should search my e-mail trash. Quote Link to comment Share on other sites More sharing options...
Scarlett Posted November 17, 2015 Share Posted November 17, 2015 This is the part I'm not looking forward to. They are seriously incompetent. But dealing with them is the price you pay for a subsidy. 1 Quote Link to comment Share on other sites More sharing options...
Lanny Posted November 17, 2015 Share Posted November 17, 2015 I wish someone could tell me if this is true. I don't believe it is. I believe the rates are the same whether you go through the exchange or not. If you do a search on WTM, hopefully you can find one or more threads that I refer to. Quote Link to comment Share on other sites More sharing options...
Scarlett Posted November 17, 2015 Share Posted November 17, 2015 The initial question was about the marketplace, then some people recommended that the OP talk to an agent about other plans that are available instead of relying on the marketplace. You asked how there are plans available that aren't listed on the exchange, I explained that there are plans available outside the marketplace. I understood Moxie to be saying she used an agent to navigate the exchange for her. At any rate, I believe this OP expects to qualify for a subsidy. Quote Link to comment Share on other sites More sharing options...
Scarlett Posted November 17, 2015 Share Posted November 17, 2015 If you do a search on WTM, hopefully you can find one or more threads that I refer to. Well, yes, I have seen the threads. I guess I just don't belive it is true. LOL... Quote Link to comment Share on other sites More sharing options...
Serenade Posted November 17, 2015 Author Share Posted November 17, 2015 Thanks, all, for your help. You've given me some new things to consider, and at least I know we won't be fined if our financial situation changes. That is one of the main things I was worried about. Quote Link to comment Share on other sites More sharing options...
Serenade Posted November 17, 2015 Author Share Posted November 17, 2015 I guess I have one more question -- how do you even go about finding a reputable agent? Quote Link to comment Share on other sites More sharing options...
Scarlett Posted November 17, 2015 Share Posted November 17, 2015 You may want to speak with an Independent Agent who sells Major Medical Insurance. I seem to remember reading post(s) here where people wrote they got a better deal that way than through an Exchange. Your income will probably fluctuate wildly, so if you can get your insurance off the exchange, it may be less complicated for you than trying to explain your income fluctuations to them. GL Ok, I apologize. I misread this post. And I agree that unless one qualifies for a subsidy it is better to buy independent. Quote Link to comment Share on other sites More sharing options...
Scarlett Posted November 17, 2015 Share Posted November 17, 2015 nm Quote Link to comment Share on other sites More sharing options...
TechWife Posted November 17, 2015 Share Posted November 17, 2015 I understood Moxie to be saying she used an agent to navigate the exchange for her. At any rate, I believe this OP expects to qualify for a subsidy. She did, and the agent also knew about the subsidies. Others have indicated that they went outside the exchange to get another plan. There are some plans out there that cost less than the marketplace plans even when taking into account the marketplace subsidies. An overly simple example: Marketplace Plan = $100 premium - 20% subsidy = $80 premium private plan = $60 premium The marketplace isn't going to tell you about the private plan. The private insurance agent will tell you about both. 2 Quote Link to comment Share on other sites More sharing options...
zoobie Posted November 17, 2015 Share Posted November 17, 2015 I don't understand how there could be other plans that aren't listed on the exchange. The exchange has say 3-5 plans that each insurance company has decided to offer at set prices to *everyone* in that state. The insurance companies can have unlimited numbers of plans that not everyone would be eligible for or not at the same price point that they sell to corporations or private individuals. Ok, I apologize. I misread this post. And I agree that unless one qualifies for a subsidy it is better to buy independent. We don't qualify for subsidies, but last year, there was an exchange plan that was a better deal than we were able to find on the private market. We are still shopping this year. I think that the exchange may work out better because we have 4 kids, and the exchange plans have a capped kid price. That was what an agent told us, but I haven't priced enough to be sure. Letting DH handle it because my brain is full right now. 1 Quote Link to comment Share on other sites More sharing options...
TechWife Posted November 17, 2015 Share Posted November 17, 2015 I guess I have one more question -- how do you even go about finding a reputable agent? First, ask your personal friends. Just a "Hey, I'm looking for an insurance agent, know any good ones?" is a great place to start. Then, move on to professional acquaintances and ask the same general questions. If you don't get any suggestions there, then expand your audience to a neighborhood Facebook page, etc.. 3 Quote Link to comment Share on other sites More sharing options...
Guest Posted November 17, 2015 Share Posted November 17, 2015 I understood Moxie to be saying she used an agent to navigate the exchange for her. At any rate, I believe this OP expects to qualify for a subsidy. Yes, that is what we do. But, you are right, dealing with the marketplace is a nightmare. They kept wanting verification that my middle child is a citizen? It was so random. And I would call and they would have no record of requesting more information. So, in that regard, the marketplace sucks. 2 Quote Link to comment Share on other sites More sharing options...
Scarlett Posted November 17, 2015 Share Posted November 17, 2015 She did, and the agent also knew about the subsidies. Others have indicated that they went outside the exchange to get another plan. There are some plans out there that cost less than the marketplace plans even when taking into account the marketplace subsidies. An overly simple example: Marketplace Plan = $100 premium - 20% subsidy = $80 premium private plan = $60 premium The marketplace isn't going to tell you about the private plan. The private insurance agent will tell you about both. Ok I see what you are saying. Sorry to be so dense. Quote Link to comment Share on other sites More sharing options...
zoobie Posted November 17, 2015 Share Posted November 17, 2015 I guess I have one more question -- how do you even go about finding a reputable agent? Our financial advisor referred us to a life insurance agent who referred us to the health insurance agent. Who saw Ferris passed out at 31 Flavors. :P 4 Quote Link to comment Share on other sites More sharing options...
Lolly Posted November 17, 2015 Share Posted November 17, 2015 We used an agent this summer when dh had to drop his business coverage. We found him through a friend. However, I believe the Marketplace has a place where you can find agents to assist you. It was helpful to have his expertise to start out. This last few weeks, I have navigated the system on my own and feel very confident in my decisions. I did have to call the help line a couple of times, but unlike the other poster I have actually found the people on the phones to be extremely helpful and capable. No long wait to reach a human either. For the first time user, I think an agent is the way to go. Because things are weird for us (the market will not cover but 5 out of our 6 people), we have a family plan on the Marketplace and an individual private plan for one dc. The agent was able to make both purchases. It was very strange to not have to pay anything to him, but his fees are covered by the insurance company. I do think that I actually did a better job with finding plans for us than he did. Running the numbers myself just made things much more clear to me. It took a tremendous amount of time (which is why I did a better job!) and a whole lot of nervous stomach. You have to figure out how much it will cost if you do not use any medical services and how much it will cost if you expend the entire amount possible for the year. 2 Quote Link to comment Share on other sites More sharing options...
Scarlett Posted November 17, 2015 Share Posted November 17, 2015 We used an agent this summer when dh had to drop his business coverage. We found him through a friend. However, I believe the Marketplace has a place where you can find agents to assist you. It was helpful to have his expertise to start out. This last few weeks, I have navigated the system on my own and feel very confident in my decisions. I did have to call the help line a couple of times, but unlike the other poster I have actually found the people on the phones to be extremely helpful and capable. No long wait to reach a human either. For the first time user, I think an agent is the way to go. Because things are weird for us (the market will not cover but 5 out of our 6 people), we have a family plan on the Marketplace and an individual private plan for one dc. The agent was able to make both purchases. It was very strange to not have to pay anything to him, but his fees are covered by the insurance company. I do think that I actually did a better job with finding plans for us than he did. Running the numbers myself just made things much more clear to me. It took a tremendous amount of time (which is why I did a better job!) and a whole lot of nervous stomach. You have to figure out how much it will cost if you do not use any medical services and how much it will cost if you expend the entire amount possible for the year. I too felt confident about the decision I made about which plan. But I spent hours doing it. I did have a few good encounters with the marketplace people....but a couple of horrible ones (rude and no basic knowledge of their job). Usually the problems were not so much with the people but with the process. Like telling me sometimes that my step son's ss number was invalid. Or asking me for proof of income when we dropped coverage and weren't receiving subsidies anyway. 1 Quote Link to comment Share on other sites More sharing options...
Carol in Cal. Posted November 17, 2015 Share Posted November 17, 2015 I know a very good agent who is licensed only in California. If you're in CA, let me know and I'll PM you her contact info. I seem to remember her saying that if you accept even a month of COBRA you can't get subsidies, so be careful. I'm not sure if that is just for that calendar year or for the entire 18 month COBRA period of availability. The agent gets paid by whatever insurer you end up with, and you don't pay anymore if you go through an agent than if you don't. If you're not in CA, say what state you're in and probably someone here will know a good agent. This is a well-connected place. 1 Quote Link to comment Share on other sites More sharing options...
zimom Posted November 17, 2015 Share Posted November 17, 2015 I was able to purchase a BCBS of Georgia plan that was a little bit better fit for my family then what I could find on the exchange. I did not go through an agent but rather directly from the BCBS of Georgia website. I was specifically looking for an HSA plan among other things. I compared those plans to the exchange plans to find the best plan at the best price. 1 Quote Link to comment Share on other sites More sharing options...
Scarlett Posted November 17, 2015 Share Posted November 17, 2015 I was able to purchase a BCBS of Georgia plan that was a little bit better fit for my family then what I could find on the exchange. I did not go through an agent but rather directly from the BCBS of Georgia website. I was specifically looking for an HSA plan among other things. I compared those plans to the exchange plans to find the best plan at the best price. Were you eligible for a subsidy? I too went straight to BCBS because I like them and they have great coverage of my doctors back home. 1 Quote Link to comment Share on other sites More sharing options...
Lolly Posted November 17, 2015 Share Posted November 17, 2015 Btw, the best advice we were given was to 1. go with BCBS (they are really the only ones doctors take, at least here!) and 2. never chose an E plan (very few d0ctors take/none here). So make sure to check what providers are covered 1 Quote Link to comment Share on other sites More sharing options...
zimom Posted November 17, 2015 Share Posted November 17, 2015 Were you eligible for a subsidy? I too went straight to BCBS because I like them and they have great coverage of my doctors back home. No. And if I remember correctly, you can only use/claim subsidies through the exchange. Of course, since this did not apply to me, I could be wrong. 1 Quote Link to comment Share on other sites More sharing options...
Scarlett Posted November 17, 2015 Share Posted November 17, 2015 No. And if I remember correctly, you can only use/claim subsidies through the exchange. Of course, since this did not apply to me, I could be wrong. Yes you have to go through the exchange to get a subsidy. 1 Quote Link to comment Share on other sites More sharing options...
Serenade Posted November 18, 2015 Author Share Posted November 18, 2015 I seem to remember her saying that if you accept even a month of COBRA you can't get subsidies, so be careful. I'm not sure if that is just for that calendar year or for the entire 18 month COBRA period of availability. This is very good to know. I'm not in CA, but will check the rules on this just the same. That right there would be a major reason not to go with COBRA for the remainder of this year. Quote Link to comment Share on other sites More sharing options...
Ellesmere Posted November 18, 2015 Share Posted November 18, 2015 I'm not sure how our state differs from other states, so I know this may not apply to everyone. For us, we were eligible for COBRA towards the end of 2014. Even though the premium was something like 17% of our gross income, we needed coverage because of the time gap between leaving the old job and open enrollment on the marketplace. We were eligible for a special enrollment, but we couldn't do a market place plan in 2014. (We had a particular issue unique to our state marketplace that prevented us from using it.) For 2015, when the open enrollment began, we ended our COBRA and applied on the market place. One major issue was scarcity of doctors in our region accepting any of the plans, but it was good enough to sign up. We also thought, because we had only done the initial estimator (where you put in your ages, zip code, etc), that we would have to put the kids on Medicaid but it turns out we weren't eligible for it in our state. (I have found that this calculator almost exactly predicts our subsidies using both last year's and this year's incomes, and gives an accurate pricing of a plan available to us and a closer estimate regarding the subsidy within $40, whereas the govt site estimated we wouldn't get one at all. For us, it slightly underestimates the cost of the bronze level):http://kff.org/wp-content/themes/vip/kff/static/subsidy-calculator-widget.html Anyway, we qualified for a subsidy even after we gave the full application all the information regarding the previous employer, our COBRA coverage, and when we'd ended COBRA. From what I understand, being on COBRA for a short time, among other problems, made us ineligible only for a special enrollment period. As far as I know, it didn't affect our eligibility for a subsidy as long as our COBRA was terminated, which we were happy to get rid of since it was draining our account. (Although so is our current plan but that's another story.) The problem would have been if we had used COBRA from, say, April to June and decided it was too expensive. If I understand correctly, at that point, you can no longer enroll under special enrollment because accepting COBRA for even a month makes you ineligible for special enrollment, but again I could be wrong on that too. This isn't very helpful, but this was all I found so far:https://www.healthcare.gov/unemployed/cobra-coverage/http://ww2.kqed.org/stateofhealth/2014/01/14/covered-california-a-personal-obamacare-review/http://www.forbes.com/sites/deborahljacobs/2014/05/06/obamacare-gap-gets-a-band-aid/http://www.insure.com/health-insurance/job-change-and-obamacare.html ETA:http://kff.org/health-reform/faq/health-reform-frequently-asked-questions/#question-im-enrolled-in-cobra-now-but-i-want-to-drop-it-does-that-affect-my-eligibility-for-marketplace-subsidies That link gives more information about what happens if you elect COBRA and then want a marketplace plan and subsidy eligibilty. Quote Link to comment Share on other sites More sharing options...
Ellesmere Posted November 18, 2015 Share Posted November 18, 2015 Regarding income uncertainty -- we didn't have to use the full subsidy offered. We could have set it to zero and just paid the full premium if we had thought we might make a lot more.We had just a little uncertainty last year about dh's income and so I didn't use the full subsidy. Still, when I realized he'd made about 2% more than expected, I logged into my account to update the income. Unfortunately, when reporting a life change you have to go through a lot of steps. Somewhere, I must have clicked something incorrectly (although the rep couldn't find what it was during our ninety minute phone call) and the result of the report kicked on of our children off our plan. Finally the rep asked if I wanted her to redo the application with the original income I had reported on our original application and to just lower the subsidy amount again.For this year, I took 85% of the subsidy, and was told we'd probably be fine. I could have done zero but we can't afford that and I am reasonably sure we won't be making far above the income that I reported on the application.I don't know if that would help since it sounds like there's a lot more uncertainty with your income but we weren't warned about any issues unless it appeared we had grossly misstated our income in order to get a bigger subsidy They can compare records and ask for documentation to support things but I didn't see that you could be fined. But again, I don't know for sure. If I had had more than one insurer option for my state, I would have probably looked to an agent for advice because it can be complicated.http://kff.org/health-reform/faq/health-reform-frequently-asked-questions/#question-what-if-i-dont-know-what-my-income-will-be-next-yearhttp://kff.org/health-reform/faq/health-reform-frequently-asked-questions/#question-whats-the-most-i-would-have-to-repay-the-irshttp://kff.org/health-reform/faq/health-reform-frequently-asked-questions/#question-what-if-i-dont-know-what-my-income-will-be-next-year Here is a link to questions about uneven incomes:http://kff.org/health-reform/faq/health-reform-frequently-asked-questions/#question-my-income-is-uneven-and-hard-to-predict-because-i-am-self-employed-most-years-i-make-between-20000-and-30000-though-two-years-ago-i-did-especially-well-and-earned-35000-how-will-this-affect-m Quote Link to comment Share on other sites More sharing options...
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