NEW INFORMATION Please forward to your distribution lists and colleagues:

Size: px
Start display at page:

Download "NEW INFORMATION Please forward to your distribution lists and colleagues:"

Transcription

1 From: Hillsberg, Bonnie S.(CMS/CMCS) Sent: Tuesday, January 27, :20 AM Subject: RE: New CMS Tribal Fact Sheets: Special Protections for AI ANs and AI AN Trust Income and MAGI NEW INFORMATION Please forward to your distribution lists and colleagues: CMS Tribal Affairs is pleased to announce the release of two new fact sheets. The first fact sheet explains the Protections for American Indians and Alaska Natives (AI ANs) in the Marketplace, Medicaid and CHIP. The second fact sheet describes Modified Adjusted Gross Income (MAGI) and what that means for AI AN Trust Income. These fact sheets support our outreach and education efforts to encourage AI AN enrollment in CMS programs. The fact sheets were developed with input from the CMS Tribal Technical Advisory Group and our federal partners at IHS and HHS IEA. Please feel free to distribute further. The fact sheets will be available for downloading on the CMS AI AN website at: and will be available to be ordered from the CMS warehouse in a few weeks.

2 Health Insurance Marketplace Protections for American Indians and Alaska Natives Marketplace Protections: The Marketplace provides special benefits for AI/ANs, but some are limited to members of federally recognized tribes and Alaska Native Claims Settlement Act (ANCSA) corporation shareholders. Special Enrollment Periods (SEP): Tribal members and ANCSA shareholders can enroll in the Health Insurance Marketplace throughout the year, not just during the yearly Open Enrollment period. In Federally Facilitated Marketplace (FFM) states, non-tribal members applying on the same application as a tribal member can take advantage of the SEP. Tribal members and ANCSA shareholders with income at or below 300% of FPL: May be able to enroll in a zero cost sharing plan, which means no copays, deductibles, or coinsurance when receiving care from Indian health care providers or when receiving Essential Health Benefits (EHBs) through a QHP. There is no need for a referral from an Indian health care provider when receiving EHBs through the QHP. Tribal members and ANCSA shareholders with incomes above 300% FPL: Can enroll in a limited cost sharing plan, which means no copays, deductibles, or coinsurance when receiving care from Indian health care providers. Will need a referral from an Indian health care provider to avoid cost sharing when receiving EHBs through a provider outside the Indian health system. Tribal members and ANCSA shareholders can enroll in a zero cost sharing or limited cost sharing plan at any metal level, including less expensive bronze plans. Tribal members and ANCSA shareholders who qualify for cost sharing reductions are not exempt from premiums. However, they may qualify for Advance Premium Tax Credits depending on income. All AI/ANs can apply for an exemption from the shared responsibility payment (tax penalty/fee) that others must pay when they file their taxes if they don t have health insurance. Did you know? The Health Insurance Marketplace benefits American Indians and Alaska Natives (AI/ANs) by providing increased opportunities for affordable health coverage through a Qualified Health Plan (QHP) bought in the Marketplace, through Medicaid, or the Children s Health Insurance Program (CHIP). Medicaid and CHIP Protections: All AI/ANs have the following Medicaid and CHIP protections: Do not have to pay premiums or enrollment fees. If they receive care from an Indian health care provider or through referral to a non-indian provider, they do not have to pay any cost sharing, such as deductibles or copayments.

3 Local Indian health care providers may be able to provide a letter to their beneficiaries to verify eligibility for these protections. Certain types of Indian income and resources are not counted when determining Medicaid or CHIP eligibility. For example: Per capita payments from a tribe that come from natural resources, usage rights, leases, or royalties Payments from natural resources, farming, ranching, fishing, leases, or profits from Indian trust land (including reservations and former reservations) Money from selling items that have tribal cultural significance, such as Indian jewelry or beadwork NOTE: Per capita income from Indian gaming is not excluded and should be reported. Indian Exemption: Due to a policy change, all AI/ANs, including individuals who are otherwise eligible for services through an Indian health care provider, can now apply for an exemption from the shared responsibility payment (tax penalty/fee) in two ways. 1. Apply when filing a federal income tax return through self-attestation or by providing an Exemption Certificate Number (ECN). Self-attestation Do not need to submit documentation because an individual can self-attest that they or a member of their tax household are eligible for an exemption Should retain the same documentation as if filing for an exemption through the Marketplace (see Step 5 of the exemption application) Must be able to produce this documentation if audited by IRS Provide an ECN (the number received from the Marketplace contractor) Keep this number, because it will need to be provided every year when filing taxes Because an individual has proven eligibility for an ECN, he or she will not need to produce tribal or eligibility documentation in case of an IRS audit 2. Apply through the Marketplace by completing an exemption application and mailing it with supporting documentation. Must submit documentation of membership in a federally recognized tribe/ancsa corporation, or eligibility for services through an Indian health care provider (see Step 5 of the exemption application) Will receive an ECN. The ECN is valid for a lifetime, but it must be reported if required to file an income tax return to avoid a shared responsibility payment (tax penalty/fee). If an individual does not have an ECN, he or she must file for the Indian exemption when completing his or her federal income tax return every year to avoid the shared responsibility payment (tax penalty/fee). Even if an individual applies for an exemption from the fee, he or she can also apply for QHPs on the Marketplace, or for Medicaid and CHIP programs, and still receive services from an Indian health care provider. Forms to apply for the Indian exemption on the Marketplace are available for downloading at: publications-and-articles/tribal-exemption.pdf For more information, visit: Contact Info:

4 American Indian and Alaska Native Trust Income and MAGI Q: What is Modified Adjusted Gross Income (MAGI)? A: MAGI is your adjusted gross income, as determined for federal income tax purposes, with certain types of income added in and subtracted out. Q: What is the purpose of MAGI? A: MAGI is used to determine an individual s eligibility for premium tax credits and cost sharing reductions for Qualified Health Plans purchased through the Health Insurance Marketplaces. MAGI is also used to determine eligibility for families and children coverage groups in Medicaid and the Children s Health Insurance Program (CHIP). Q: Are there special rules for calculating MAGI for American Indians and Alaska Natives (AI/ANs)? A: Yes. MAGI is based on taxable, adjusted gross income reported to the Internal Revenue Service (IRS). Because some types of income specific to AI/ANs are non-taxable, this income is excluded when determining eligibility for Marketplace tax credits, cost sharing reductions, Medicaid, and CHIP. Certain additional types of AI/AN income are excluded when determining eligibility for Medicaid and CHIP, even though they might be taxable. This means that your MAGI might be slightly higher for the purposes of Marketplace assistance than it is for Medicaid eligibility. Did you know? You may qualify for lower cost health insurance coverage on the Marketplace. When you provide your MAGI, you can find out if you re eligible for premium tax credits and other savings that can lower the cost of health insurance. Learn how MAGI works, the types of income counted and excluded, and the special rules for AI/ANs for the Marketplace, Medicaid, and CHIP. Use of any information from this document is for general information only and does not represent personal tax advice, either express or implied.

5 Q: What types of AI/AN income are generally exempt from MAGI? A: The following categories of income are generally excluded from an AI/AN s MAGI: Distributions from Alaska Native Claims Settlement Act (ANCSA) Corporations and Settlement Trusts Distributions from trust/reservation property Income from property and rights related to hunting, fishing, and natural resources Income from the sale and use of cultural/ subsistence property Student financial assistance provided by the Bureau of Indian Affairs and/or a Tribe Income that falls within the IRS General Welfare Doctrine Any other income that is non-taxable according to federal law or IRS guidance You should contact your Tribe if you are unsure whether a certain type of income is exempt from MAGI. Q: Income exempt under the General Welfare Doctrine is excluded from MAGI. What is the General Welfare Doctrine? A: Payments made under social benefit programs for the promotion of general welfare may be excluded from gross income under a concept known as the general welfare doctrine. This applies only to governmental payments out of a welfare fund based upon the recipient s need, and not as compensation for services. When distributions to tribal members are made equal (per capita) and not based on need, then they do not fall under the general welfare doctrine. Benefits payable regardless of the financial status, health, educational background, or employment status of the recipient may be included in gross income of recipient. Q: Is my tribal gaming per capita payment excluded from MAGI? A: No. Gaming per capita payments are taxable and must be included in your MAGI. Q: The list of AI/AN income includes distributions and payments from activities on trust property. Does that property have to be located on a reservation for the income to be excluded from MAGI? A: No. This income is exempt from MAGI so long as it is derived from property that is held in trust by the federal government, subject to federal restrictions, located on an Indian reservation or within the most recent boundaries of a prior federal reservation, or otherwise under the supervision of the Secretary of the Interior.

6 Q: How do I list AI/AN income on the application for Marketplace health insurance, Medicaid, and CHIP? A: When filling out an application for health insurance in the Marketplace, you will be asked to list your taxable income. You should provide the same income that you report to the IRS when you file your federal income tax. Do not include AI/AN income that the IRS exempts from taxation as part of your taxable income. In Appendix B of the Marketplace application, you will be asked to list certain types of AI/AN income that you previously included in Step 2 of your application. Even though this income is taxable, it still may be excluded from MAGI for the purposes of Medicaid and CHIP eligibility. You are asked to list this type of income on Appendix B to make sure that it is not counted toward your MAGI as part of the Medicaid and CHIP eligibility determination. If you don t have these types of income, just put a zero on the application after the questions in Appendix B. If you do have this type of income, list what kind you have and how much of it you receive. Do not list any per capita income from gaming in Appendix B, as it is taxable and included in MAGI. Q: Who should I contact for help when filling out the Marketplace application regarding my exempt AI/AN income? A: You should contact your Tribe or the enrollment assister at your local Indian Health Service, tribe or tribal organization, or urban Indian organization. You can also check with a Navigator or the Help Desk at your State s Marketplace or at Healthcare.gov. If someone helps you prepare your taxes, you can also ask them. Specific Types of AI/AN Exempt Income Below are some specific types of AI/AN income that may be excluded from your MAGI when determining eligibility for Medicaid, CHIP, and the tax credits and cost sharing reductions in the health insurance Marketplace. Please note that these are just examples and that this list is not exhaustive. Distributions from ANCSA Corporations and settlements trusts Cash distributions from an ANCSA corporation or settlement trust Stock or bonds issued by or acquired from an ANCSA Corporation A partnership interest distributed by an ANCSA Corporation, as well as subsequent partnership distributions Land or an interest in land (including land or an interest in land received from an ANCSA Corporation as a dividend or distribution on stock) Per capita payments or distributions from trust/ reservation property Rents from any such lands and any structures on the land (housing, retail facilities, etc.) Royalties or other compensation received from oil and gas production, mineral extraction, timber harvesting, and similar activities Profits or revenues derived from economic activity on the land, such as the operation of motels, retail stores, gas stations, farms and ranches, etc.

7 Grants from the Bureau of Indian Education s Higher Education program Payments from funds held in trust by the Secretary of Interior for an Indian tribe, including interest and investment income accrued while such funds are held in trust and initial purchases made with such funds Income derived from property and rights related to hunting, fishing, and natural resources Profits from the sale, lease, or harvest of mineral, timber, and other such resources Income derived from hunting, fishing, gathering, and harvesting fish, wildlife, and plant resources pursuant to federally protected rights, including off-reservation rights Income from the sale and use of cultural or subsistence property Earnings from ownership interests and usage rights to items that have unique religious, spiritual, traditional, or cultural significance that support subsistence or traditional lifestyle Materials such as the sale of sage or sweetgrass for use in a healing or spiritual ceremony The sale of artwork, pottery, or jewelry with cultural or religious significance Crafts made by AI/ANs from fish and wildlife resources taken for personal or family consumption Proceeds of subsistence fish and game Student financial assistance provided by the Bureau of Indian Affairs Student financial assistance provided under programs in Title IV of the Higher Education Act of 1965 Payments that are exempt from federal income taxation under federal statute Per capita shares distributed to Indians pursuant to the Indian Tribal Judgment Funds Use or Distribution Act (25 U.S.C et seq.), including interest and investment income earned on Judgment Funds while under administration Distributions from certain federal settlements, such as the Cobell v. Salazar class action settlement and some payments under the Keepseagle v. Vilsack settlement Income excluded under the General Welfare Doctrine Housing assistance Education assistance Programs serving elders and individuals with disabilities Cultural and religious programs Transportation programs Disaster relief Payments used to help establish AI/AN-owned businesses on or near a reservation Contact Info: Questions? Give us a call TTY:

Sam Ennis, J.D. Sonosky, Chambers, Sachse, Endreson & Perry, LLP Revised December 29, 2014 sennis@sonoskysd.com

Sam Ennis, J.D. Sonosky, Chambers, Sachse, Endreson & Perry, LLP Revised December 29, 2014 sennis@sonoskysd.com Determining Eligibility for Medicaid and Health Insurance Tax Credits: How to Calculate Your Modified Adjusted Gross Income (MAGI) Presentation for the Tribal Self-Governance Advisory Committee Sam Ennis,

More information

The Affordable Care Act and American Indian and Alaska Natives. Frequently Asked Questions

The Affordable Care Act and American Indian and Alaska Natives. Frequently Asked Questions The Affordable Care Act and American Indian and Alaska Natives Frequently Asked Questions 1. Is IHS coverage going away under the Affordable Care Act? No. The IHS, Tribal and urban Indian health programs

More information

Desk Aid 56: Income and Income Deductions

Desk Aid 56: Income and Income Deductions Employee compensation: (wages, salary, tips, bonuses, awards, and fringe benefits) Interest income: (taxable and non-taxable) Count 1040 line 7 Count 1040 line 7 Count 1040 line 7 Count 1040 line 8a and

More information

Rules of Department of Social Services Division 40 Family Support Division Chapter 7 Family Healthcare

Rules of Department of Social Services Division 40 Family Support Division Chapter 7 Family Healthcare Rules of Department of Social Services Division 40 Family Support Division Chapter 7 Family Healthcare Title Page 13 CSR 40-7.010 Scope and Definitions...3 13 CSR 40-7.015 Application Procedure for Family

More information

Understanding the Health Insurance Marketplace

Understanding the Health Insurance Marketplace Understanding the Health Insurance Marketplace GMR Symposium Brenda Delgado, MPH March, 2015 The Health Insurance Marketplace Part of the Affordable Care Act Where qualified individuals and families directly

More information

Native American Taxation Issues for California Taxpayers

Native American Taxation Issues for California Taxpayers (CILS) Community Legal Education Self-Help Series Bishop Escondido Eureka Sacramento Native American Taxation Issues for California Taxpayers What s in this guide and how can it help me? The focus of this

More information

Submitted via email to OIRA_submission@omb.eop.gov. May 12, 2014. CMS Desk Officer Fax Number (202) 395-5806 OIRA_submission@omb.eop.

Submitted via email to OIRA_submission@omb.eop.gov. May 12, 2014. CMS Desk Officer Fax Number (202) 395-5806 OIRA_submission@omb.eop. Submitted via email to OIRA_submission@omb.eop.gov May 12, 2014 CMS Desk Officer Fax Number (202) 395-5806 OIRA_submission@omb.eop.gov RE: Comments on CMS-10320 (OCN: 0938-1086) I write on behalf of the

More information

The information in this module was correct as of June 2015.

The information in this module was correct as of June 2015. This session will spotlight the section of applications on the Federally-facilitated Marketplace and State Partnership Marketplace application process that covers plan compare, choosing how much advance

More information

Update on Latest Affordable Care Act Implementation Issues

Update on Latest Affordable Care Act Implementation Issues Update on Latest Affordable Care Act Implementation Issues September 30, 2015 Doneg McDonough Technical Advisor, TSGAC DonegMcD@outlook.com Mim Dixon Technical Advisor, TSGAC TribalSelfGov.org http://tribalselfgov.org/health-reform/health-q-a/ask-a-question/

More information

MEDICAL ASSISTANCE FOR CHILDREN, PREGNANT WOMEN, & PARENT/CARETAKER RELATIVES INSERT

MEDICAL ASSISTANCE FOR CHILDREN, PREGNANT WOMEN, & PARENT/CARETAKER RELATIVES INSERT NH Department of Health and Human Services (DHHS) DFA Form 800 Insert Division of Family Assistance (DFA) 01/14 MEDICAL ASSISTANCE FOR CHILDREN, PREGNANT WOMEN, & PARENT/CARETAKER RELATIVES INSERT Complete

More information

HEALTH INSURANCE CHOICES FOR AMERICAN INDIANS

HEALTH INSURANCE CHOICES FOR AMERICAN INDIANS HEALTH INSURANCE CHOICES FOR AMERICAN INDIANS HEALTH INSURANCE IS AN IMPORTANT RESOURCE THAT CAN KEEP YOU AND YOUR FAMILY HEALTHY. If you have ongoing health issues, health insurance can help pay for treatment

More information

Use this application to apply for an exemption from the shared responsibility payment. Who can use this application?

Use this application to apply for an exemption from the shared responsibility payment. Who can use this application? Form Approved OMB No. 0938-1190 Application for Exemption for American Indians and Alaska Natives and Other Individuals who are Eligible to Receive Services from an Indian Health Care Provider Use this

More information

EMPLOYEE S GUIDE TO HEALTH CARE REFORM S TAX CREDITS

EMPLOYEE S GUIDE TO HEALTH CARE REFORM S TAX CREDITS The EMPLOYEE S GUIDE TO HEALTH CARE REFORM S TAX CREDITS Calculate Your Health Insurance Tax Credit 2 Introduction Beginning in 2014, massive tax credits will become available to help individuals buy health

More information

Federally-facilitated Marketplace Agent and Broker Training Outline and Summary

Federally-facilitated Marketplace Agent and Broker Training Outline and Summary DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, Maryland 21244-1850 Center for Consumer Information & Insurance Oversight Federally-facilitated

More information

Frequently Asked Questions about Form 1095-A for Assisters

Frequently Asked Questions about Form 1095-A for Assisters Frequently Asked Questions about Form 1095-A for Assisters This tax season, consumers enrolled in coverage through the Marketplace will receive a new Form 1095-A from the Marketplace. Just like a W-2,

More information

Overview of Health Insurance Exchanges in the USET Area. USET Impact Week February 4-7, 2013 Washington, DC

Overview of Health Insurance Exchanges in the USET Area. USET Impact Week February 4-7, 2013 Washington, DC Overview of Health Insurance Exchanges in the USET Area USET Impact Week February 4-7, 2013 Washington, DC 1 Affordable Care Act (ACA) Insurance Reforms No lifetime limits, annual limits Pre-existing conditions

More information

Group Health Core Flex Bronze AIAN (no cost share)

Group Health Core Flex Bronze AIAN (no cost share) Group Health Core Flex Bronze AIAN (no cost share) If you are American Indian or Alaska Native (AIAN), you may be eligible for this health plan. Covered services are provided at no charge, and you have

More information

Nebraska Health Insurance Exchange Update

Nebraska Health Insurance Exchange Update Nebraska Health Insurance Exchange Update Overview of the Affordable Care Act and the Federally Facilitated marketplace. September 2014 AFFORDABLE CARE ACT» The Affordable Care Act: Establishes a Health

More information

The Affordable Care Act: What Does It Mean for Self-Employed Individuals in Agriculture and Small Business?

The Affordable Care Act: What Does It Mean for Self-Employed Individuals in Agriculture and Small Business? FIRM Team Fact Sheet 13-03 Available at http://firm.msue.msu.edu David B. Schweikhardt Adam J. Kantrovich Brenda R. Long Michigan State University Extension October 2013 The Patient Protection and Affordable

More information

Questions (and Answers) to Questions Answered During Webinar #7 on Exemptions from the Tax Penalty for AI/ANs (Webinar Held on 10/22/14)

Questions (and Answers) to Questions Answered During Webinar #7 on Exemptions from the Tax Penalty for AI/ANs (Webinar Held on 10/22/14) Questions (and Answers) to Questions Answered During Webinar #7 on Exemptions from the Tax Penalty for AI/ANs (Webinar Held on 10/22/14) Disclaimer: The following Q&A is for informational purposes only

More information

Exchange Final Rule: Indian Provisions

Exchange Final Rule: Indian Provisions Exchange Final Rule: Indian Provisions DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS for MEDICARE & MEDICAID SERVICES Center for Consumer Information and Insurance Oversight Health Insurance Exchange

More information

Affordable Care Act: Impact on People with Disabilities

Affordable Care Act: Impact on People with Disabilities Affordable Care Act: Impact on People with Disabilities Stephanie Altman, Assistant Director of Healthcare Justice stephaniealtman@povertylaw.org October 2014 About Us: The Shriver Center The Sargent Shriver

More information

The Affordable Care Act: What it Means for Seniors

The Affordable Care Act: What it Means for Seniors December 12, 2013 The Affordable Care Act: What it Means for Seniors Amber Cutler, Staff Attorney National Senior Citizens Law Center www.nsclc.org 1 The National Senior Citizens Law Center is a non-profit

More information

July 24, 2015 HCFA 1

July 24, 2015 HCFA 1 COUNTABLE AND EXCLUDED INCOME Legal Authority: 26 USC 36B(d)(2)(B); 42 CFR 435.601; 42 CFR 435.949; 42 CFR 435.952 1. Policy Statement Income eligibility for certain TennCare Medicaid categories and CoverKids

More information

Presented by South Dakota Community Action Partnership

Presented by South Dakota Community Action Partnership Presented by South Dakota Community Action Partnership The project described was supported by Funding Opportunity Number CA-NAV-13-001 from the U.S Department of Health and Human Services, Centers for

More information

American Indian Health Commission for Washington State Improving Indian Health through Tribal-State Collaboration

American Indian Health Commission for Washington State Improving Indian Health through Tribal-State Collaboration American Indian Health Commission for Washington State Improving Indian Health through Tribal-State Collaboration Washington Insurance Issuer Requirements for American Indian/Alaska Native Enrollees and

More information

GLOSSARY OF KEY HEALTH INSURANCE CONCEPTS

GLOSSARY OF KEY HEALTH INSURANCE CONCEPTS The Affordable Care Act: A Working Guide for MCH Professionals Module 2 GLOSSARY OF KEY HEALTH INSURANCE CONCEPTS Overview A fundamental first step in accessing health care in the United States is having

More information

Family-Related Medical Assistance Application

Family-Related Medical Assistance Application Family-Related Medical Assistance Application Form Approved DCF. CF-ES 2370, Dec 2013 THINGS TO KNOW Use this application to see what coverage choices you qualify for Free or low-cost insurance from Medicaid

More information

Part II Exemptions & the Individual Shared Responsibility Payment

Part II Exemptions & the Individual Shared Responsibility Payment Part II Exemptions & the Individual Shared Responsibility Payment Tara Straw November 4, 2014 Steps in the Tax Return Related to the ACA 2 There is a requirement to have health insurance coverage starting

More information

Understanding the ObamaCare Health Insurance Plans in North Carolina Understanding Insurance and Affordable Care Act Terminology: ACA- Marketplace

Understanding the ObamaCare Health Insurance Plans in North Carolina Understanding Insurance and Affordable Care Act Terminology: ACA- Marketplace Understanding the ObamaCare Health Insurance Plans in North Carolina As a result of the Affordable Care Act (a.k.a. ObamaCare) the following provisions are now in place for health insurance policies with

More information

DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, OREGON HEALTH INSURANCE MARKETPLACE

DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, OREGON HEALTH INSURANCE MARKETPLACE DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, OREGON HEALTH INSURANCE MARKETPLACE 945-001-0002 Definitions DIVISION 1 PROCEDURAL RULES The following definitions govern the meaning of terms used in administrative

More information

Medicaid and CHIP in 2014: A Seamless Path to Affordable Coverage. The New World of Modified Adjusted Gross Income (MAGI)

Medicaid and CHIP in 2014: A Seamless Path to Affordable Coverage. The New World of Modified Adjusted Gross Income (MAGI) Medicaid and CHIP in 2014: A Seamless Path to Affordable Coverage The New World of Modified Adjusted Gross Income (MAGI) Final Rule: Seamless and Affordable Coverage Expands access to affordable coverage

More information

Washington Healthplanfinder: American Indian/Alaska Native Verification Process for QHP/Tax Credit Eligible AI/AN Enrolled Members

Washington Healthplanfinder: American Indian/Alaska Native Verification Process for QHP/Tax Credit Eligible AI/AN Enrolled Members Washington Healthplanfinder: American Indian/Alaska Native Verification Process for QHP/Tax Credit Eligible AI/AN Enrolled Members The Patient Protection and Affordable Care Act (ACA) requires verification

More information

Affordable Care Act Exemptions and Affordability Information. Exemptions. Exemption from What? 10/2/2014

Affordable Care Act Exemptions and Affordability Information. Exemptions. Exemption from What? 10/2/2014 Affordable Care Act Exemptions and Affordability Information Kristy Maitre Tax Specialist Center for Agricultural Law and Taxation October 14, 2014 Exemptions What qualifies for an exemption? How is the

More information

Application for Health Coverage & Help Paying Costs

Application for Health Coverage & Help Paying Costs CMS Product No. 11708 October 2013 Instructions to Help You Complete the Application for Health Coverage & Help Paying Costs Starting October 1, 2013, you can apply for health coverage through the new

More information

Answering Questions about Your Family s Income When Applying for Health Insurance

Answering Questions about Your Family s Income When Applying for Health Insurance What You Need to Know about Health Insurance Applying for Health Insurance Answering Questions about Your Family s Income When Applying for Health Insurance About this fact sheet You may be able to get

More information

The Affordable Care Act: What Does it Mean for Individuals and Families?

The Affordable Care Act: What Does it Mean for Individuals and Families? The Affordable Care Act: What Does it Mean for Individuals and Families? FIRM Team Fact Sheet 13-04 Available at http://www.firm.msue.msu.edu David B. Schweikhardt Adam J. Kantrovich Brenda R. Long Michigan

More information

Application for Health Coverage & Help Paying Costs

Application for Health Coverage & Help Paying Costs Application for Health Coverage & Help Paying Costs Use this application to see what coverage choices you qualify for Who can use this application? Affordable private health insurance plans that offer

More information

2015 Special Enrollment Period (SEP) Reference Guide

2015 Special Enrollment Period (SEP) Reference Guide A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association 2015 Special Enrollment Period (SEP) Reference Guide

More information

Find health care options that meet your needs and fit your budget. ctober 2014

Find health care options that meet your needs and fit your budget. ctober 2014 O Health Insurance Find health care options that meet your needs and fit your budget. ctober 2014 The Health Care Law In March 2010, President Obama signed the Affordable Care Act into law generally requiring

More information

AFFORDABLE CARE ACT FAQ

AFFORDABLE CARE ACT FAQ AFFORDABLE CARE ACT FAQ What is the Healthcare Insurance Marketplace? The Marketplace is a new way to find quality health coverage. It can help if you don t have coverage now or if you have it but want

More information

Application for Health Coverage & Help Paying Costs

Application for Health Coverage & Help Paying Costs Application for Health Coverage & Help Paying Costs Use this application to see what coverage choices you qualify for Affordable private health insurance plans that offer comprehensive coverage to help

More information

Health Care Reform: Health Insurance Marketplace FAQs

Health Care Reform: Health Insurance Marketplace FAQs From Filice Insurance Health Care Reform: Health Insurance Marketplace FAQs What is a Health Insurance Marketplace? The Health Insurance Marketplace (Marketplace) is a way to find health coverage that

More information

NOT ALL OF THE COLORADO MARKETPLACE S INTERNAL CONTROLS WERE EFFECTIVE IN ENSURING THAT INDIVIDUALS WERE ENROLLED IN QUALIFIED HEALTH PLANS ACCORDING

NOT ALL OF THE COLORADO MARKETPLACE S INTERNAL CONTROLS WERE EFFECTIVE IN ENSURING THAT INDIVIDUALS WERE ENROLLED IN QUALIFIED HEALTH PLANS ACCORDING Department of Health and Human Services OFFICE OF INSPECTOR GENERAL NOT ALL OF THE COLORADO MARKETPLACE S INTERNAL CONTROLS WERE EFFECTIVE IN ENSURING THAT INDIVIDUALS WERE ENROLLED IN QUALIFIED HEALTH

More information

Health Insurance Marketplace 101. Find health care options that meet your needs and fit your budget.

Health Insurance Marketplace 101. Find health care options that meet your needs and fit your budget. Health Insurance Marketplace 101 Find health care options that meet your needs and fit your budget. March 2014 The Health Care Law In March 2010, President Obama signed the Affordable Care Act into law

More information

What Happens at Tax Time? Tax Penalties and Premium Tax Credit Reconciliation. JoAnn Volk Tricia Brooks Michigan Assister Training October 23, 2014

What Happens at Tax Time? Tax Penalties and Premium Tax Credit Reconciliation. JoAnn Volk Tricia Brooks Michigan Assister Training October 23, 2014 What Happens at Tax Time? Tax Penalties and Premium Tax Credit Reconciliation JoAnn Volk Tricia Brooks Michigan Assister Training October 23, 2014 Warning! This training is intended to remind assisters

More information

Find health care options that meet your needs and fit your budget.

Find health care options that meet your needs and fit your budget. Health Insurance Marketplace 101 Find health care options that meet your needs and fit your budget. October 2015 Objectives This session will help you Explain the Health Insurance Marketplace Define who

More information

The Affordable Care Act: The Health Insurance Marketplace -- What Does It Mean for Individuals, Families, and Employers?

The Affordable Care Act: The Health Insurance Marketplace -- What Does It Mean for Individuals, Families, and Employers? The Patient Protection and Affordable Care Act (ACA) includes provisions that will have significant implications for individuals, families and employers in 2014. These provisions include: The creation

More information

Understanding the Health Insurance Marketplace. August 2013

Understanding the Health Insurance Marketplace. August 2013 Understanding the Health Insurance Marketplace August 2013 Objectives This session will help you Explain the Health Insurance Marketplace Identify who will benefit Define who is eligible Explain the enrollment

More information

Currently, for the very low-income, Medicaid is available for children, parents, and individuals who are disabled, elderly, or pregnant.

Currently, for the very low-income, Medicaid is available for children, parents, and individuals who are disabled, elderly, or pregnant. 0 Currently, for the very low-income, Medicaid is available for children, parents, and individuals who are disabled, elderly, or pregnant. Parents are typically covered at very low income levels, and most

More information

INDIVIDUAL HEALTH INSURANCE GUIDE. Introduction. What is the Health Insurance Marketplace?

INDIVIDUAL HEALTH INSURANCE GUIDE. Introduction. What is the Health Insurance Marketplace? INDIVIDUAL HEALTH INSURANCE GUIDE Introduction On November 15th, 2014, the second annual Open Enrollment Period for Individual Health Insurance begins. The Affordable Care Act (ACA) requires all US citizens

More information

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE Scott Walker, Governor Theodore K. Nickel, Commissioner Wisconsin.gov 125 South Webster Street P.O. Box 7873 Madison, Wisconsin 53707-7873 Phone:

More information

National Training Program

National Training Program National Training Program Module 12 Medicaid and the Children s Health Insurance Program Session Objectives This session will help you Describe eligibility, benefits, and administration of Medicaid Define

More information

Application for Health Coverage & Help Paying Costs

Application for Health Coverage & Help Paying Costs CMS Product No. 11708 October 2014 Instructions to Help You Complete the Application for Health Coverage & Help Paying Costs Starting November 15, 2014, you can apply for health coverage through the new

More information

B. Justification. 1. Need and Legal Basis

B. Justification. 1. Need and Legal Basis Supporting Statement for Data Collection to Support Eligibility Determinations for and Enrollment through Affordable Exchanges, Medicaid and Children s Health Program Agencies A. Background On March 23,

More information

IRS Virtual Town Hall Series: Tax Impacts of Health Insurance Coverage for Individuals & Families in 2014

IRS Virtual Town Hall Series: Tax Impacts of Health Insurance Coverage for Individuals & Families in 2014 IRS Series: Tax Impacts of Health Insurance Coverage for Individuals & Families in 2014 The information contained in this presentation is current as of 10/23/2013. For the latest information about tax

More information

Health Insurance Exchange: MAGI Eligibility Flow Charts

Health Insurance Exchange: MAGI Eligibility Flow Charts Health Insurance Exchange: MAGI Eligibility Flow Charts October 18, 011 Comments and questions may be submitted to info@svcinc.org. 1 Flow Chart LEG Prior Enrollment State Specific Comment Household Size

More information

FAQ: Frequently Asked Questions about Health Insurance in Wisconsin

FAQ: Frequently Asked Questions about Health Insurance in Wisconsin FAQ: Frequently Asked Questions about Health Insurance in Wisconsin Relating to Changes in the Affordable Care Act (ACA) & BadgerCare/Medicaid Employer Sponsored Insurance Am I obligated to enroll in my

More information

2015 TAX UPDATES. TaxSmarter.com

2015 TAX UPDATES. TaxSmarter.com 2015 TAX UPDATES TaxSmarter.com NEW TAX LAWS FOR 2015 Standard Deduction: $12,600 MFJ or QW (increase of $200) $9,250 - Head of Household (increase of $150) $6,300 - Single or MFS (increase of $100) Additional

More information

Tribal Planning for Health Insurance Exchanges Begins Now

Tribal Planning for Health Insurance Exchanges Begins Now Tribal Planning for Health Insurance Exchanges Begins Now Kris Locke and Mim Dixon 1 Prepared for the Tribal Self-Governance Advisory Committee March 14, 2011 Health Insurance Exchanges are a centerpiece

More information

Application for Medical Assistance for Families with Children

Application for Medical Assistance for Families with Children Application for Medical Assistance for Families with Children Who can use this application? Use this application to see what choices you have Apply faster online This application is for families, children,

More information

Out of Town Business Registration Fee $35.00 per year

Out of Town Business Registration Fee $35.00 per year Out of Town Business Registration Fee $35.00 per year City Ordinance #1172-81 requires that all businesses apply for and obtain a business registration prior to engaging in business. Please fill out the

More information

Application for Health Coverage & Help Paying Costs

Application for Health Coverage & Help Paying Costs Application for Health Coverage & Help Paying Costs Form Approved OMB. 0938-1191 Use this application to see what coverage you qualify for Affordable private health insurance plans that offer comprehensive

More information

Medicaid and CHIP FAQs: The Basic Health Program May 8, 2014

Medicaid and CHIP FAQs: The Basic Health Program May 8, 2014 DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850 General Medicaid and CHIP FAQs: The Basic Health

More information

The Health Insurance Marketplace 101 provides a high level overview of the Affordable Care Act, and the new Health Insurance Marketplace. The Centers for Medicare & Medicaid Services (CMS) developed and

More information

State Health Reform Assistance Network

State Health Reform Assistance Network State Health Reform Assistance Network Charting the Road to Coverage ISSUE BRIEF February 2014 Consumer Assistance Resource Guide: MAGI Household Income Eligibility Rules Prepared by Manatt Health Solutions

More information

Individual Shared Responsibility Provision What You Need to Know

Individual Shared Responsibility Provision What You Need to Know Individual Shared Responsibility Provision What You Need to Know Virtual Town Hall The information contained in this presentation is current as of 5/28/2014. For the latest information about tax provisions

More information

Consumer Guide for Annual Household Income Data Matching Issues

Consumer Guide for Annual Household Income Data Matching Issues Consumer Guide for Annual Household Income Data Matching Issues This is a guide to help you understand how the Marketplace uses annual household income to decide whether you qualify for help paying for

More information

6.0 SMALL BUSINESS HEALTH OPTIONS PROGRAM (SHOP)

6.0 SMALL BUSINESS HEALTH OPTIONS PROGRAM (SHOP) 6.0 SMALL BUSINESS HEALTH OPTIONS PROGRAM (SHOP) Summary Minnesota intends to implement and operate a State-Based Exchange per the requirements of the Affordable Care Act (ACA). This Exchange will meet

More information

Instructions for Form 8965

Instructions for Form 8965 Department of the Treasury Internal Revenue Service Instructions for Form 8965 Health Coverage Exemptions (and instructions for figuring your shared responsibility payment) For each month you must either:

More information

Application for Health Coverage & Help Paying Costs

Application for Health Coverage & Help Paying Costs Application for Health Coverage & Help Paying Costs Use this application to see what coverage choices you qualify for Affordable private health insurance plans that offer comprehensive coverage to help

More information

Application for for Health Coverage & Help Paying Costs

Application for for Health Coverage & Help Paying Costs Application for for Health Coverage & Help Paying Costs Use Use this this application to to see see what coverage choices qualify for e e coverage to to help stay well. A new tax credit that can immediately

More information

One of the more visible changes soon to be brought MONTANA S HEALTH INSURANCE A PREVIEW OF MARKETPLACE

One of the more visible changes soon to be brought MONTANA S HEALTH INSURANCE A PREVIEW OF MARKETPLACE A PREVIEW OF MONTANA S HEALTH INSURANCE MARKETPLACE by Gregg Davis and Christina Goe One of the more visible changes soon to be brought to the forefront by passage of the Affordable Care Act (ACA) is the

More information

Advance Premium Tax Credits and Cost-Sharing Reductions: A Primer for Assistors

Advance Premium Tax Credits and Cost-Sharing Reductions: A Primer for Assistors Advance Premium Tax Credits and Cost-Sharing Reductions: A Primer for Assistors Support for this resource provided through a grant from the Robert Wood Johnson Foundation s State Health Reform Assistance

More information

Tax Implications of the Affordable Care Act

Tax Implications of the Affordable Care Act Year-by-Year Guide Tax Implications of the Affordable Care Act 1 Year-by-Year Guide: Tax Implications of the Affordable Care Act Introduction The Patient Protection and Affordable Care Act, commonly referred

More information

Medicaid 101 & Affordable Care Act (ACA) June 2015

Medicaid 101 & Affordable Care Act (ACA) June 2015 Medicaid 101 & Affordable Care Act (ACA) June 2015 1 Eligibility To be eligible for Medicaid, an individual must be a member of a coverage group. What is a group? Individuals who share specific common

More information

Affordable Care Act HEALTHCARE.GOV. Marketplace Implementation Briefing Virginia Organizing Marketplace Public Forum August 20, 2013

Affordable Care Act HEALTHCARE.GOV. Marketplace Implementation Briefing Virginia Organizing Marketplace Public Forum August 20, 2013 HEALTHCARE.GOV Affordable Care Act Marketplace Implementation Briefing Virginia Organizing Marketplace Public Forum August 20, 2013 Joanne Corte Grossi, MIPP Regional Director U.S. Department of Health

More information

Department of Health and Human Services. No. 137 July 17, 2013. Part II

Department of Health and Human Services. No. 137 July 17, 2013. Part II Vol. 78 Wednesday, No. 137 July 17, 2013 Part II Department of Health and Human Services 45 CFR Part 155 Patient Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non-Navigator

More information

Exemption Application at the Health Insurance Marketplace

Exemption Application at the Health Insurance Marketplace CMS Product No. 11746 February 2015 Instructions to Help You Complete an Exemption Application at the Health Insurance Marketplace Every person needs to have health coverage or make a payment on their

More information

Application for Health Coverage and Help Paying Costs

Application for Health Coverage and Help Paying Costs Iowa Department of Human Services Application for Health Coverage and Help Paying Costs Use this application to see what coverage choices you qualify for Affordable private health insurance plans that

More information

HEALTH CARE REFORM: FREQUENTLY ASKED QUESTIONS (Group, Individual, Seasonal)

HEALTH CARE REFORM: FREQUENTLY ASKED QUESTIONS (Group, Individual, Seasonal) Group Health Insurance Q & A HEALTH CARE REFORM: FREQUENTLY ASKED QUESTIONS (Group, Individual, Seasonal) 1. Will small employers continue to have 12 month rates as they exist today? a. Yes. Employer groups

More information

Federal and State Subsidies Questions

Federal and State Subsidies Questions Federal and State Subsidies Questions 1. Qualified Health Plans (QHP) vs. Minimum Creditable Coverage (MCC) on all covered benefits. How do these two things relate? All QHPs offered through the Health

More information

The Health Insurance Premium Tax Credit. Topics. What is the Premium Tax Credit? 10/1/2014

The Health Insurance Premium Tax Credit. Topics. What is the Premium Tax Credit? 10/1/2014 The Health Insurance Premium Tax Credit Kristy Maitre Tax Specialist Center for Agricultural Law and Taxation October 8, 2014 Topics Definitions Premium Tax Credit Basics Determining the amount of the

More information

Getting Ready. December 2014

Getting Ready. December 2014 Marketplace Coverage & Taxes Getting Ready for Tax Season December 2014 Intr troduction This presentation provides an overview of the connections between Health Insurance Marketplace coverage and Federal

More information

Gary Cohen, CMS Deputy Administrator and Director Center for Consumer Information and Insurance Oversight (CCIIO)

Gary Cohen, CMS Deputy Administrator and Director Center for Consumer Information and Insurance Oversight (CCIIO) DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Room 352-G 200 Independence Avenue, SW Washington, DC 20201 Date: July 12, 2013 From: Subject: Gary Cohen, CMS Deputy Administrator

More information

LCB File No. R205-03 PROPOSED REGULATION OF THE NEVADA TAX COMMISSION

LCB File No. R205-03 PROPOSED REGULATION OF THE NEVADA TAX COMMISSION LCB File No. R205-03 PROPOSED REGULATION OF THE NEVADA TAX COMMISSION Section 1. Title 32 of NAC is hereby amended by adding thereto a new chapter to consist of the provisions set forth as sections 2 to

More information

Tax SEP. March 27, 2015

Tax SEP. March 27, 2015 Tax SEP March 27, 2015 Tax SEP Overview On February 20, 2015, CMS announced that individuals and families without minimum essential coverage ( MEC ) who owe the individual shared responsibility payment

More information

COMMON QUESTIONS AND ANSWERS ON DESIGNATION OF CERTIFIED APPLICATION COUNSELOR (CAC) ORGANIZATIONS IN FEDERALLY-FACILITATED MARKETPLACES

COMMON QUESTIONS AND ANSWERS ON DESIGNATION OF CERTIFIED APPLICATION COUNSELOR (CAC) ORGANIZATIONS IN FEDERALLY-FACILITATED MARKETPLACES COMMON QUESTIONS AND ANSWERS ON DESIGNATION OF CERTIFIED APPLICATION COUNSELOR (CAC) ORGANIZATIONS IN FEDERALLY-FACILITATED MARKETPLACES 1. The preamble to the final rule and CMS guidance says that the

More information

Medicaid and Long-Term Care Application for Medicaid and Insurance Affordability Programs (Financial Assistance)

Medicaid and Long-Term Care Application for Medicaid and Insurance Affordability Programs (Financial Assistance) Use this application to see what Medicaid and/or Children s Health Insurance Program (CHIP). coverage choices you qualify for. New tax credits that can immediately help pay your premiums for health coverage.

More information

Commonwealth of Pennsylvania chipcoverspakids.com. Application for Health Care Coverage

Commonwealth of Pennsylvania chipcoverspakids.com. Application for Health Care Coverage Commonwealth of Pennsylvania chipcoverspakids.com Application for Health Care Coverage This page has been left intentionally blank. Information about health care coverage Who can use this application?

More information

Health Care Reform PPACA. General Assembly Greensboro, NC 2013

Health Care Reform PPACA. General Assembly Greensboro, NC 2013 Health Care Reform PPACA General Assembly Greensboro, NC 2013 Near-term Provisions 1 These fees apply to both insured and self-insured plans. Additional Coming Changes PPACA Patient Protection and Affordable

More information

TITLE 8 SOCIAL SERVICES CHAPTER 230 MEDICAID ELIGIBILITY - FULL COVERAGE FOR PREGNANT WOMEN PART 500 INCOME AND RESOURCE STANDARDS

TITLE 8 SOCIAL SERVICES CHAPTER 230 MEDICAID ELIGIBILITY - FULL COVERAGE FOR PREGNANT WOMEN PART 500 INCOME AND RESOURCE STANDARDS TITLE 8 SOCIAL SERVICES CHAPTER 230 MEDICAID ELIGIBILITY - FULL COVERAGE FOR PREGNANT WOMEN PART 500 INCOME AND RESOURCE STANDARDS 8.230.500.1 ISSUING AGENCY: New Mexico Human Services Department (HSD).

More information

WASHINGTON QUALIFIED HEALTH PLAN SELECTION: CONSIDERATIONS FOR CONSUMERS

WASHINGTON QUALIFIED HEALTH PLAN SELECTION: CONSIDERATIONS FOR CONSUMERS WASHINGTON QUALIFIED HEALTH PLAN SELECTION: CONSIDERATIONS FOR CONSUMERS December 2013 Support for this resource provided through a grant from the Robert Wood Johnson Foundation s State Health Reform Assistance

More information

SHO# 14-002. November 7, 2014. Minimum Essential Coverage. Dear State Health Official: Dear State Medicaid Director:

SHO# 14-002. November 7, 2014. Minimum Essential Coverage. Dear State Health Official: Dear State Medicaid Director: DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850 SHO# 14-002 November 7, 2014 Re: Minimum Essential

More information

The Affordable Care Act. President Obama signed the Affordable Care Act (ACA) into law on March 23, 2010.

The Affordable Care Act. President Obama signed the Affordable Care Act (ACA) into law on March 23, 2010. The Affordable Care Act President Obama signed the Affordable Care Act (ACA) into law on March 23, 2010. The ACA was enacted to: v Increase quality and affordability of health insurance v Lower the uninsured

More information

What Counts as Income for Premium Tax Credits and Medicaid: Beyond the Basics

What Counts as Income for Premium Tax Credits and Medicaid: Beyond the Basics What Counts as Income for Premium Tax Credits and Medicaid: Beyond the Basics Center on Budget and Policy Priorities August 28, 2013 Topics What Counts As Income Whose Income Counts (Including a Review

More information

Counting Income for MAGI What Counts as Income

Counting Income for MAGI What Counts as Income Counting Income for MAGI What Counts as Income Wages, salaries, tips, gratuities, bonuses, commissions (before taxes are taken out). Form(s) W 2. Alimony received Annuities Awards and Prizes (In addition

More information

Department of Health and Human Services. No. 186 September 25, 2013. Part III

Department of Health and Human Services. No. 186 September 25, 2013. Part III Vol. 78 Wednesday, No. 186 September 25, 2013 Part III Department of Health and Human Services Centers for Medicare & Medicaid Services 42 CFR Part 600 Office of the Secretary 45 CFR Part 144 Basic Health

More information

SPECIAL MEDICAL ASSISTANCE PROGRAMS

SPECIAL MEDICAL ASSISTANCE PROGRAMS SPECIAL MEDICAL ASSISTANCE PROGRAMS Use this brochure for information on Qualified Medicare Beneficiaries (QMB), Specified Low Income Medicare Beneficiaries (SLMB), and Qualified Disabled and Working Individuals

More information

Inaugural Tribal Accounting Conference November 16th & 17th, 2015 The Linq Las Vegas, NV

Inaugural Tribal Accounting Conference November 16th & 17th, 2015 The Linq Las Vegas, NV Inaugural Tribal Accounting Conference November 16th & 17th, 2015 The Linq Las Vegas, NV 1 7:30 8:30am Registration/ Breakfast / Exhibit Hall Opens 8:30 8:40am Opening Prayer 8:40 8:45am Opening Remarks

More information