When to expect Form 1095-A in the mail

Form 1095-A is a tax form that will be sent to consumers who were enrolled in health insurance through the Marketplace in the past year. You may have started hearing from consumers who have received their Forms 1095-A in the mail or in their online My Accounts. Consumers will use the information included on Form 1095-A to complete Form 8962, which they will file with their tax returns  to claim the premium tax credit or to declare premium assistance they received through advanced payments made to their insurance provider.  Form 1095-A is being sent out on a rolling basis, and not all forms have been sent out yet. All forms will be postmarked by February 2, 2015, so if a consumer has not received his or her form yet, it may be that the Form 1095-A has not yet been mailed.

As the 2015 tax season approaches, we are featuring materials in the newsletter to help assisters work with consumers as they prepare to file their taxes for the 2014 coverage year. The following three tools are designed to help you understand your role in assisting consumers during tax season, offer an introduction to new and existing IRS forms relevant to the ACA, and provide you with a consumer-oriented, step by step guide on how consumers will use these documents.

Medicaid Block Application Question

CMS has made updates to an application question, referred to as the “Medicaid Block” question. Updates were made such that consumers with denials from Medicaid or CHIP based on immigration status do not need to have received these denials since November 15, 2014 to answer the Medicaid Block question correctly.

The purpose of this question is to prevent “loopers” (applicants looping between the FFM and the state Medicaid/CHIP agencies regarding Medicaid/CHIP eligibility).  Since consumers who select their name under this question will not be evaluated for Medicaid or CHIP eligibility, the date parameter sought to ensure that the Medicaid/CHIP denial was recent, thereby decreasing the likelihood that the applicant’s income or household size had changed since the denial.  This question allows these consumers who attest to being denied Medicaid and CHIP recently to continue with their application and enroll in a Marketplace plan with APTC and CSRs, if they are otherwise eligible.

Answering the Medicaid Block question also helps HealthCare.gov properly determine eligibility for low-income, immigrant applicants, including those with income under 100% of the Federal Poverty Level (FPL) who are ineligible for Medicaid or CHIP due to immigration status, but who may be eligible for APTC and CSRs on the Marketplace.

Update to the text for the Medicaid Block question

The updated Medicaid Block question asks, “Were any of these people found not eligible for Medicaid or the Children’s Health Insurance Program (CHIP) in the past 90 days? Or, were any of them found not eligible for Medicaid or CHIP due to their immigration status since October 1, 2013? (Check the box only if a person was found not eligible for this coverage by their state, not by the Marketplace.).”  The two updates to the question include:

  1. Change to the date parameter for having received Medicaid and CHIP denials from “since November 15, 2014” to “in the past 90 days.” This change is designed to help ensure that consumers only attest to the question when they have had a recent Medicaid and CHIP denial, decreasing the likelihood that the applicant’s income or household size had changed since the denial.
  2. Clarification that consumers with denials from Medicaid or CHIP based on immigration status do not need to have received these denials since November 15, 2014. Instead, consumers will be able to indicate if they have been found not eligible for Medicaid or CHIP due to their immigration status since October 1, 2013.  For immigrant consumers, answering yes to this question will display a second question which asks whether the consumer was denied Medicaid and CHIP eligibility based on immigration status.

 

 

HHS Enrollment Report

According to an HHS report released January 29, 9.5 million consumers selected or were automatically reenrolled in Marketplace coverage through the second month of 2015 Open Enrollment. 87 percent who selected plans in states using HealthCare.gov are getting financial assistance to lower monthly premiums, and 2.5 million young people have selected a plan or been reenrolled. This report provides data for roughly the first two months of the 2015 Open Enrollment Period for all 50 states and the District of Columbia.

Rural Network Allied Health Training Program Grant T/TA webinar on Wed., Feb. 11 at 1pm CT (12noon MT)

In response to the White House Job-Driven Training initiative, the Federal Office of Rural Health Policy (FORHP) is pleased to announce the release of the Rural Network Allied Health Training Program (Allied Health Training), a new one-time funding opportunity.     

The Allied Health Training Program supports the President’s Rural Health Care Initiative by focusing on rural recruitment and retention activities and builds upon the accomplishments of the Rural Health Workforce Development (RHWD) pilot program, which ended in 2013.  As a result of the RHWD Program, approximately 4,000 program participants completed their rural training/rotation, and of these, almost half said they plan on returning to practice in a rural area and a number of them have.  Moreover, there was a significant economic impact of $19 million within rural America from FORHP’s $12 million investment via the RHWD Program.  

The Allied Health Training Program will support the development of formal, mature rural health networks that focus on activities that achieve efficiencies, expand access to, coordinate and improve the quality of essential health care services, and strengthen the rural health care system as a whole.  This purpose will be achieved through the recruitment, clinical training, and retention of allied health professionals.  

This program will further support integrated rural health networks that can partner with local community colleges and other accredited educational institutions (such as vocational and technical colleges) to develop formal clinical training programs.  These formal training programs will target enrolled rural allied health professional students, to include displaced workers and veterans, in completing a rural, community-based clinical training rotation and obtaining eventual employment with a rural health care provider. 

FORHP will hold a technical assistance webinar on Wednesday, February 11, 2015 at 2:00 PM Eastern Standard Time to assist applicants in preparing their applications.  The toll-free call-in number (for audio) is 800-857-9638, and the passcode is ALLIEDHEALTH.  The Adobe Connect webinar URL is https://hrsa.connectsolutions.com/ruralalliedhealth/ 

To learn more about applying for the FY15 Rural Network Allied Health Training Program (HRSA-15-068), please visit http://www.grants.gov/view-opportunity.html?oppId=272369 and look under the “application package” tab.  The deadline to apply is March 31, 2015.   

For further information, please contact: Marcia Colburn, at mgreen@hrsa.gov or (301) 443-3261.

 

Strategies for helping Nebraskans select QHPlans in the Marketplace webinar on Thurs., Jan. 29 at 12noon CT (11am MT)

Please reserve January 29th at 12pm CST for a special webinar. More information (registration and login) will be coming next week. Please share with your contacts that may find this information beneficial.

This webinar, presented by staff at the Center on Budget and Policy Priorities, will present strategies for helping Nebraska consumers compare and select qualified health plans in the Marketplace. The presentation will highlight key things that consumers should consider, including balancing monthly premium costs and deductible amounts, understanding cost-sharing differences, identifying if current providers are in-network or if specific medications are covered, and predicting consumers’ total out-of-pocket expenses for the year based on different plan structures. The webinar will feature a live-browsing demonstration in HealthCare.gov to review the specific aspects of qualified health plans offered in the state of Nebraska.

Outreach Materials of the Week: Youth Enrollment Day

Youth Enrollment Day is on January 29, 2015, and CMS encourages you to think about ways that you can help educate and enroll young adults. For more information on what some partner organizations are planning, visit Get Covered America, Enroll America, and Young Invincibles. Please also refer to the Online Resource Library for Assisters, an online community housed at CMSzONE, where new materials on this topic have been posted. The Online Library serves as a resource for members to share materials and to learn about events they are hosting to promote enrollment; instructions for signing up were featured in our November 25, 2014 assister newsletter.

There are also materials on the CMS Marketplace website on the technical assistance and outreach pages that you may find useful; (scroll down to “young adults” category); look for more information in future newsletters.

NEW Online Tools to Help Consumers During Tax Season

As the 2015 tax season approaches, CMS is featuring materials to help assisters work with consumers as they prepare to file their taxes for the 2014 coverage year.

Soon consumers will begin receiving the Form 1095-A.  Form 1095-A allows individuals to claim and/or reconcile their premium tax credit on their federal tax return.  The Federally-facilitated Marketplace (FFM) will upload Forms 1095-A to consumers’ HealthCare.gov accounts and mail the form to consumers; it will be postmarked no later than February 2, 2015. 

The 2015 tax season is the first time individuals and families will be asked for some basic information regarding their health insurance on their tax returns. Last week, CMS released new tools to help assisters and consumers understand how to fill out IRS Forms 8962 and 8965.   

One tool helps users to determine the amount of their 2014 Premium Tax Credit by calculating the premium of the Second Lowest Cost Silver Plan (SLCSP) available to them for 2014. Consumers would use this information to fill out Form 8962—Premium Tax Credit (PDF)(see instructions for completing this form here). Note that most consumers will find the information they need to fill out Form 8962 on Form 1095-A, which they will receive from the Marketplace. Thus, consumers should use this tool if the Form 1095-A they receive is incomplete or incorrect, which could happen, for example, when consumers have a change to their household in 2014 that they did not report to the Marketplace, such as having a baby, moving to a new home, or a family member getting job-based coverage; when consumers didn’t apply for savings when filling out their 2014 Marketplace application; or they applied for savings but didn’t take advance payments of the premium tax credit (APTC) to lower their monthly premium payments in 2014.

The second tool helps consumers to find the premium of the Lowest Cost Bronze Plan available to them for 2014, which they can use to determine whether or not they qualify for the exemption based on Marketplace coverage being considered unaffordable. Consumers would use this information to fill out Form 8965—Health Coverage Exemptions (see instructions for completing this form here).

Finally, CMS has posted a new fact sheet, Health Coverage and Federal Income Taxes, for consumers. The fact sheet offers basic information on what consumers need to know about health coverage and federal income taxes as well as specific information on different types of exemptions; it also includes links to other resources on these topics.

 

From Coverage to Care Roadmap Available in Chinese, Korean, and Vietnamese

From Coverage to Care (C2C) is a CMS initiative designed to help consumers understand their health care coverage and connect to primary care and the preventive services. The “Roadmap to Better Care and a Healthier You” is now available to download and print in Chinese, Korean, and Vietnamese. The C2C Roadmap includes 8 steps that explain what health coverage is and how to use it to get needed care. You can view links to the Roadmap in English, Spanish, Haitian Creole, Chinese, Korean, and Vietnamese on this website, along with other C2C materials and resources.

CMS acknowledges the following community partners for their assistance in reviewing these resources: Association of Asian Pacific Community Health Organizations, Asian Health Services, Korean Community Center of the East Bay, and North East Medical Services. C2C resources in additional languages are forthcoming.

Fast Facts on Assisting Consumers with Medicaid and CHIP

CMS has published a new fact sheet, “Medicaid and CHIP Fast Facts for Assisters,” aimed at helping assisters work with low-income individuals, families, and children who are seeking information about their health coverage options. This fact sheet can be accessed on the Marketplace website here, as well as at the link below.

Medicaid and CHIP Fast Facts for Assisters

Assister Q&A on Helping Consumers Prepare for Tax Season: 1095-A

The January 9, 2015 assister webinar featured a presentation on the Form 1095-A. Below are responses to some questions that assisters asked during the webinar; we will post the slides and answers to additional questions from assisters once they become available.

Who will receive the 1095-A Form?

Q: Will all consumers receive this form, including consumers who have Medicare, Medicaid, or employer sponsored coverage?
A: No. Only households who were enrolled in a Marketplace QHP will receive a Form 1095-A. Each member of a tax household who is on the same QHP will be listed on the same Form 1095-A.
Consumers who had health coverage in 2014 from another source, such as their employer, Medicare, Medicaid, or a plan they bought outside the Marketplace will not receive a Form 1095-A. These consumers will not have to fill out any additional tax forms related to having health insurance coverage. Instead, they will report their coverage simply by checking a box on their federal income tax forms to indicate that they had health insurance coverage during 2014.
Accessing and Using the 1095-A Form

Q: What should consumers do if they did not receive a 1095-A Form and do not have an online account? What if consumers do have a HealthCare.gov account but cannot view their 1095-A Form?
A: If consumers do not have online accounts, they can create an online account to view and print their Form 1095-A. If consumers do not have access to their Form 1095-A in their online account, the Marketplace can re-print the form and mail it to consumers.

Q: How will consumers in states that are transitioning from State Based Marketplaces to using the Federally-facilitated Marketplace, for example, Oregon, receive their 1095-A Form?
A: Consumers who enrolled in 2014 coverage through their state Marketplace instead of HealthCare.gov will receive a Form 1095-A directly from their state Marketplace. Consumers in these states should contact their state Marketplace directly for information and questions relating to their Form 1095-A.

Q: What do you do with the 1095-A form once you get it?
A: Form 1095-A is a tax form that will be sent to consumers that have been enrolled in health insurance through the Marketplace in the past year. Consumers use the information included on Form 1095-A to complete Form 8962, Premium Tax Credit (PTC). Consumers file Form 8962 with their tax returns if they want to claim the premium tax credit or if they received premium assistance through advance credit payments made to their insurance provider (whether or not they otherwise are required to file a tax return) (APTC).

Q: Can consumers claim a PTC if they bought a health insurance plan from a different source than the Marketplace?
A: No. Consumers can only qualify for APTCs or cost sharing reductions (CSRs) for health insurance plans they purchased through the Marketplace.
Contents of the 1095-A Form

Q: How do consumers notify CMS that they believe there is an error on the 1095-A Form?
A: Consumers can update demographic information that is incorrect on Form 1095-A themselves when they file their federal income tax returns. For enrollment-related information that consumers believe may be incorrect on Form 1095-A, such as the amount of APTC or the effective date of coverage, consumers should contact the Marketplace Call Center for research and resolution. In these cases, the FFM will:
• Research the consumer-reported inquiry;
• Update incorrect information when appropriate; and
• Mail and upload to a consumer’s online account a corrected Form 1095-A.

Assisting consumers with their 1095-A Forms

Q: How should individuals with a hardship waiver or exemption transmit this information to the IRS? Is this information communicated to the IRS by the Marketplace to avoid the penalty?
A: Consumers who were granted an exemption from the Marketplace should include their Exemption Certificate Numbers (ECN) on their tax returns. There is a field to report coverage exemptions on Form 8965, Health Coverage Exemptions. Consumers can refer to the letter they received from the Marketplace or they can call the Marketplace Call Center, which is able to look up their ECN(s) and give them to consumers over the phone so they can file their taxes. For more information on exemptions, please see the “Deep Dive” section below and see this section of HealthCare.gov.

Q: When is it best to refer consumers to other types of assistance, such as the IRS Volunteer Income Tax Assistance Program (VITA)?
A: Consumers can get free assistance with filling out their taxes. This may include free access to tax software programs, or free in-person assistance. For more information, visit IRS.gov/freefile or IRS.gov/VITA. If consumers have additional questions about taxes, need Form 8962, or want to learn more about the fee for not having health coverage, they can visit www.IRS.gov/aca. Assisters should refer consumers to the IRS for questions related to help filing taxes, help paying taxes owed to the IRS, questions related to tax filing such as how long it is possible to delay filing and what to do in cases when they have filed taxes prior to receiving the Form 1095-A, and questions related to completing other tax forms including the 8962 and the 8965 forms.

Q: How are tax preparers being educated on these new forms and the ACA?
A: Federal government officials are working closely with tax preparers to educate them on new IRS forms and the ACA. This is being done in various ways including the provision of official publications, fact sheets, Webinars, and other direct communications with tax preparers as new information and resources are developed. In particular, the IRS has a dedicated information center for tax preparers on ACA to ensure that tax preparers have all the information that they need when working with consumers for the 2014 tax filing season. For more information, please see the IRS website, “ACA Information for Tax Professionals.”

How to learn more about the 1095-A Form and the tax filing process?

Q: Can assisters see a copy of the 1095-A to become more familiar with it?
A: Yes. A sample Form 1095-A is located here, and instructions for completing the form are located here. These links are also included in the January 13, 2015 assister newsletter.

Q: What other information is available on the 1095-A form?
A: You can access a FAQ on the Form 1095-A here; this link was also included in the January 13, 2015 assister newsletter.

Q: When will information about taxes be added to Healthcare.gov?
A: To view information about how health coverage affects consumers’ 2014 federal income tax return, please visit www.healthcare.gov/taxes. You can also refer to the IRS website on ACA Tax Provisions, and look for more resources in the “TIPS on Filing Taxes” section of the weekly assister newsletter.