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Affordability


ILLMAS

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I have a client that says they could not afford health insurance but never attempted to go through the ACA process, their income is fairly low, however they are still being hint with a small penalty.  My question is, can a TP still claim un-affordable under Part III individual exemptions?  I figure someone would know here.

Thanks

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47 minutes ago, ILLMAS said:

I have a client that says they could not afford health insurance but never attempted to go through the ACA process, their income is fairly low, however they are still being hint with a small penalty.  My question is, can a TP still claim un-affordable under Part III individual exemptions?  I figure someone would know here.

Thanks

"Unaffordable" is determined using the Affordability Worksheet that is part of the form 8965. If your client meets that test, code A would apply to this situation, and that code does not require any sort of exemption request from any Marketplace.  I'm assuming that ATX has the worksheet and generates the "A" code if applicable information is entered.

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  • 3 weeks later...

The way I understand it, first you start with the SRQ questions, and when you get to step 4, you will see the income threshold amounts.  If your client's income is under this then you look at # 5 and #6.  If #6 is yes then you don't have a shared responsibility and it checks box 7 on form 8965.  As I understand it from the instructions that is all you do and no need to fill out Part III.  If the income is more than the threshold then you will need to do other tabs.  Just read the notes in blue at the top of each page.  After much reading I finally think I got it.  Good luck

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