1 Starting Strong for Community Health! Webinar Tax Season: What Enrollment Assisters Should Know February 11, 2015
2 Updates: helphub.illinoishealthmatters.org/ Open enrollment closes February 15, 2015 Check Help Hub announcements for latest enrollment and policy information, particularly related to Special Enrollment Periods Mark your calendar for March 5 th Upcoming Starting Strong Webinar in partnership with HFS on upcoming enhancements to ABE and updates on IES phase 2.
3 Questions? Ask questions using the chat box feature We will answer as many questions as possible at the end of the presentation. A recorded copy of today s webinar will be available in the coming days at Contact us about Starting Strong Webinars:
4 What is the Assister s role related to taxes? Understand Form 1095-A Help consumer understand how to apply for exemptions Explain the Shared Responsibility Provision to consumers Know where to refer clients for more tax information/help Help consumers update their Marketplace Accounts to reflect accurate income/coverage situation Continue Enrolling! (4 days until February 15 th Deadline)
5 Today s Presenters: Alicia Siani, Coordinator, Health Reform Initiative, EverThrive IL April Friend, Senior Director of Tax Services, Center for Economic Progress Stephani Becker, Senior Policy Specialist, Sargent Shriver National Center on Poverty and Law
6 Guest Presenter April Friend Senior Director of Tax Services, Center for Economic Progress The Center for Economic Progress (CEP) helps lowincome, working families as a trusted provider of tax and financial services.
7 Tax Basics: Who files a tax return? Many rules and guidelines around who must and who should file a tax return. Anyone who earned income (as an employee or self-employed) should file a tax return, particularly if they have children. Even if someone only worked for a month they may get a refund of the taxes that were taken out of their check, and they might qualify for additional tax credits. Those who must file a return include anyone who received an advanced premium payment through the Marketplace.
8 Tax Basics: What goes on a tax return? Almost all sources of income employment, selfemployment, unemployment, interest from bank accounts, dividends. Many types of expenses are potentially deductible business expenses if self-employed, student loan interest paid. Tax credits many different tax credits available, including the Child Tax Credit, if someone has children under 17, education credits for those who attended post-secondary education, child care credit for those who paid for kids under 13 to go to day care while they worked, and more. For the first time, information about health care coverage for everyone listed on the tax return.
9 Important Terms Minimum Essential Coverage (MEC) Insurance coverage that meets minimum qualifications as set forth under the ACA. Most insurance, including employer-sponsored, Marketplace coverage, student insurance plans, Medicaid, Medicare, and CHIP qualify as MEC.
10 Important Terms Premium Tax Credit (PTC) The Premium Tax Credit is the tax credit designed under the ACA to help make insurance more affordable by giving taxpayers a tax credit for monies paid for health insurance premiums. Advanced Premium Tax Credit (APTC) Consumers who purchased insurance through the Marketplace may be eligible to receive advanced payments of the Premium Tax Credit in order to pay for the insurance in real-time. This may also be called a subsidy, advance payments, etc.
11 Important Terms Second Lowest Cost Silver Plan (SLCSP): This is the second cheapest health plan in the Silver Category that was available to a consumer. Why is this important to know? The amount of the tax credit is calculated using the premium of the second lowest cost plan in the Silver category that was available to you in It is also used to determine if you qualify for an exemption because insurance was considered unaffordable. Good resource: Use this tool to look up the premium amounts for the second lowest cost Silver plan that was available to each member of your family for each month of When you get your results, we ll tell you how to use the information to complete your tax forms.
13 Important Terms Premium Tax Credit Reconciliation Remember that advanced premium tax credits are based on expected 2014 income while the premium tax credit you receive will be based on actual 2014 income. On the tax return, consumers must reconcile their Premium Tax Credit by reporting all of their income and expenses, as well as any Advanced Premium Tax Credit received during the year. Depending on what the consumers reported to the Marketplace during enrollment, this reconciliation process may result in the consumer: - Being eligible for additional tax credit or - Being required to repay some of the advanced credit received.
14 Important Terms Exemption For ACA purposes, exemption refers to an exception granted to a consumer from the provisions of the ACA. The most common exemptions will be for those who are not technically required to file a tax return because their income is below the filing requirement level, but exemptions also exist for consumers who are undocumented immigrants, experienced a short gap of less than three months in their insurance coverage during 2014, and many other more complicated reasons.
15 What does this look like at tax time? Those who had employer-sponsored coverage, Medicaid, Medicare, VA, or other insurance other than the Marketplace for all 12 months of 2014 for everyone in their household will probably not receive any documentation of their insurance coverage for There is a small box to check on the tax return to indicate fullyear coverage (1040, page 2, Line 61). Most commercial tax preparation software has an interview process that will ask questions and check this box for the preparer.
16 Marketplace Statement (Form 1095-A) For those who had coverage through the Marketplace: The consumer will receive Form A, which reports all the information necessary to reconcile the Premium Tax Credit. Consumers will use this form to complete Form 8962 (described next). Form 1095-A lists covered household members, dates of coverage & the total monthly premium amount, the monthly premium for the Second Lowest Cost Silver Plan (SLCSP), and the amount of monthly advanced payment of the Premium Tax Credit.
17 Form 1095-A should be postmarked by February 2nd. Consumers can access also access the form through their account online. If a consumer thinks their Form 1095-A is incorrect, they should contact HealthCare.gov: Good Resource: Frequently Asked Questions about Form A for Assisters:
18 Premium Tax Credit Reconciliation Form 8962 Consumers who received advanced payments of the PTC are required to file Form 8962 Premium Tax Credit - with their tax return in order to complete the reconciliation process.
19 Form 8962, Part 1 asks for a substantial amount of information, and compares income and premium amounts of national averages, federal poverty line, and other amounts. Consumers choosing not to use commercial software or a tax preparation service should be very careful to complete this section accurately using the instructions.
20 Form 8962, Part 2 asks for information related to amounts paid for insurance, including monthly premium amount, monthly premium for the SLCSP, and the Monthly Advance Payment of PTC amounts from Form 1095-A. It also calculates a number of other fields based on information from Part 1.
21 At the bottom of Form 8962 is the full reconciliation process. If, based on the taxpayer s situation, he qualifies for more tax credit than was received throughout the year, the additional credit will be applied against the tax liability and/or added to the taxpayer s refund. If they must repay some of the advanced payment, that amount will be added to the tax liability.
22 Repayment Limits on Advanced Premium Tax Credits
23 Relief From Late Payment Penalty IRS will waive late payment penalties for eligible taxpayers if they resulted from repayment of excess advance payments of the premium tax credit for Marketplace coverage. In order to qualify for this late payment penalty relief, taxpayers should wait for the letter from IRS that indicates they are subject to a failure to pay penalty. Respond to that letter with a signed statement that states, I am eligible for the relief granted under Notice because I received excess advance payment of the premium tax credit. The notice number must be included in the signed statement. Taxpayers who receive a penalty for not paying enough in estimated taxes also qualify for relief from the penalty by checking Box A on Form 2210, part II. They should complete Page 1, and attach a signed statement that states, Received excess advance payment of the premium tax credit. Note: Relief from the penalty does not change or extend the April 15 th deadline to pay, nor does it exempt taxpayers from a failure to file penalty.
24 Health Coverage Exemptions Form 8965 Consumers may not have had insurance coverage for part or all of Some of them may qualify for an exemption from ACA provisions. Exemptions can be granted either through the Marketplace or through the tax return, depending on the type of exemption. In either case, exemptions are reported on Form 8965, Exemptions.
25 -Some exemptions can only be granted through an application to the Marketplace. These exemptions include more than 14 exemptions due to various types of financial hardship or domestic circumstances (such as bankruptcy or domestic violence) and members of certain religious sects. -Other exemptions could be granted through either the Marketplace or the tax return, including for those who were incarcerated, or members of a federally recognized Native American tribe. Good resource: For a comprehensive chart explaining the different types of exemptions and if they may be granted by the Marketplace or claimed on tax return, go to the Instructions for Form 8965 (page 2):
26 Marketplace-Granted Exemptions If a consumer applied for and was granted a Marketplace exemption, they will receive an Exemption certificate number (ECN) that must be entered in Part 1 of Form If the Marketplace is still processing the filer s application for an exemption, the filer can write pending on line 1c
27 Tax Filing Threshold Exemptions Some consumers may be exempt from ACA provisions because they are not required to file a tax return. This is also calculated on Form 8965, in Part 2. Most tax prep software will calculate these amounts, but may not automatically grant the exemption.
28 Exemptions Claimed on Tax Return Exemptions claimed directly on the tax return, through Part 3 of Form 8965 include those listed below. Insurance is unaffordable (>8% of income) Certain noncitizens Short coverage gap (< 3 months) Months prior to effective date of MEC that is effective on or before May 1, 2014 Incarceration Membership in a Federally -recognized Indian tribe or eligibility for services of Indian Health Service Transition relief for 2014 for certain limited benefit and non - calendar year plans
29 Exemptions, con t Exemptions claimed in Part 3 of Form 8965 may apply for only certain months, or for the full year. This is also indicated in Part 3. The instructions for Form 8965 show what exemption code to use in the box below, Exemption Type.
30 No coverage, No exemption Consumers who did not have Minimum Essential Coverage and do not qualify for an exemption will be required to pay a Shared Responsibility Payment with their 2014 income tax return. The Shared Responsibility Payment (SRP) is sometimes referred to as the individual mandate or penalty. For 2014, the amount of the SRP is the greater of 1% of income above the filing threshold (up to $12,240), or $95 per adult and $47.50 per child, up to a total of $285 per household. There is no separate form to compute the SRP. Worksheets are available in the instructions for Form 1040, and tax preparation software will compute automatically.
31 No coverage, no exemption 2015 SRP Amounts 2016 SRP amounts 2% of income above filing threshold OR $325 per adult, $ per child, up to $975 per household 2.5% of income above filing threshold OR $695 per adult, $ per child, up to $2,085 per household
32 Partial Year Coverage Consumers who were covered for only part of the year may qualify for an exemption for the other part of the year, or may need to pay the Shared Responsibility Payment. Exemptions will be listed on Form The Shared Responsibility Payment is pro-rated to apply only to those months that a consumer was without MEC.
33 What happens if I can t pay the penalty? The IRS routinely works with taxpayers who owe amounts they cannot afford to pay. The law prohibits the IRS from using liens or levies to collect any individual shared responsibility payment. However, if you owe a shared responsibility payment, the IRS may offset that liability against any tax refund that may be due to you in future years. Good resource: IRS FAQ on the Shared Responsibility Provision Families/Questions-and-Answers-on-the-Individual-Shared- Responsibility-Provision
34 For More Information Clients who have questions or concerns can contact their tax preparer for additional assistance. Clients who are low-income may qualify for free tax preparation assistance through the IRS Volunteer Income Tax Assistance (VITA) program. Most ACA-related issues can be addressed at VITA sites, if clients meet other qualification guidelines (i.e. income under $55,000, not too complex). The Internal Revenue Service (IRS) is also available on a limited basis to address questions ( ). Get Covered Illinois has a good Q&A section on Marketplace Coverage and Tax Filing:
35 Center for Economic Progress The Center for Economic Progress offers free tax filing assistance through the VITA program for qualifying taxpayers throughout Chicago, the metro area, and Springfield. For more information, please visit CEP also operates a Low Income Taxpayer Clinic (LITC) that can help clients resolve problems or concerns with the IRS or the Illinois Department of Revenue. To speak with an intake specialist or ask questions, please contact the Clinic by calling
36 Some Tips/Warnings Consumers should never pay a tax preparer directly for any penalty that they owe. Penalties will be paid directly to the Internal Revenue Services (IRS) or deducted from their tax refund. People who are ineligible to buy insurance through the ACA marketplace because they are not classified as lawfully present for ACA purposes are not subject to the individual and do NOT have to pay the penalty. If you learn of instances where consumers are being inappropriately penalized or tax preparers are requesting consumers pay them the penalty directly please Gather the name and company of the tax preparer The address of their office Any additional contact information like a phone number or Please send to
37 Health Insurance and Your 2014 Federal Taxes Flowchart Tool Available now:
38 Health Insurance and Your 2014 Federal Taxes Flowchart Tool Available now:
39 Questions? Ask questions using the chat box feature Contact information: Alicia Siani Stephani Becker April Friend A recorded copy of today s webinar will be available in the coming days at Next Starting Strong Webinar: March 5- Registration information will be sent out soon!
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