492 comments on “Search results for: type in your search terms here

  1. Question:

    I received a Form 1099-MISC with an amount in box 7 for nonemployee compensation. What forms and schedules should I use to report income earned as an independent contractor?

    Answer:

    • Independent contractors report their income on Schedule C (Form 1040), Profit or Loss from Business (Sole Proprietorship). However, you may qualify to use Schedule C-EZ (Form 1040), Net Profit from Business (Sole Proprietorship).
    • Also file Schedule SE (Form 1040), Self-Employment Tax, if net earnings from self-employment are $400 or more. This form allows you to figure social security and Medicare tax due on your net self-employment income.
    • You may need to make estimated tax payments. Refer to Form 1040-ES, Estimated Tax for Individuals, for more details on who must pay estimated tax. If you need to make estimated tax payments and do not pay them timely, you may also need to file Form 2210, Underpayment of Estimated Tax by Individuals, Estates & Trusts.

    Additional Information:

     

  2. Question:

    I received a Form 1099-MISC instead of a Form W-2.   I’m not self-employed and do not have a business.

    How do I report this income?

    Answer:

    If payment for services you provided is listed in box 7 of Form 1099-MISC, Miscellaneous Income, the payer is treating you as a self-employed worker, also referred to as an independent contractor.

    • You do not necessarily have to have a business for payments for your services to be reported on Form 1099-MISC. You may simply perform services as a non-employee.
    • The payer has determined that an employer-employee relationship does not exist in your case.

    If you were not an employee of the payer, where you report the income depends on whether your activity is a trade or business. You are in a self-employed trade or business if your primary purpose is to make a profit and your activity is regular and continuous.

    • If you are in a self-employed trade or business, you must include payments for your services on Schedule C (Form 1040), Profit or Loss From Business (Sole Proprietorship), or Schedule C-EZ (Form 1040), Net Profit From Business (Sole Proprietorship).
    • If you are self-employed, you will also need to complete Schedule SE (Form 1040), Self-Employment Tax, and pay self-employment tax on your net earnings from self-employment of $400 or more.
    • There is no withholding of tax from self-employment income. As a self-employed individual, you may need to make estimated tax payments during the year to cover your tax liabilities.

    If you believe you may be an employee of the payer,

    see Publication 1779, Independent Contractor or Employee, for an explanation of the difference between an independent contractor and an employee.

    For more information on employer-employee relationships, refer to Chapter 2 of Publication 15, (Circular E), Employer’s Tax Guide, Chapter 2 of Publication 15-A,

    Employer’s Supplemental Tax Guide, and Tax Topic 762, Independent Contractor vs. Employee.

    Additional Information:

  3. My husband is turning 65 in November and going on Medicare.

    • how do we deal with the income reporting for Covered CA since Bob (primary tax payer) will no longer be on CC or alternatively –
    • how does estimating income change when only one person is applying for CC (not the primary tax payer)??

  4. I am applying for covered california and I have reduced income from the Korna and I am not sure how to apply

    my last year’s tax return and stuff is going to be way off and I haven’t filed yet anyway –

    is this something you can help me with?

    What would be the cost to me?

    I am sure I qualify for a subsidy but not sure how to do it…

  5. How do I keep my separated spouse from hiding all our assets?

    Reply
    Steve Shorr says:
    Fri 08 Nov 2019 at 21:33 PST

    a Los Angeles family court judge ruled that a woman had violated state asset disclosure laws because she neglected to reveal she had won $1.3 million in the California state lottery . . . just 11 days before she filed for divorce!

    According to the Los Angeles Times, the judge in this case determined that the wife had acted out of fraud or malice, and as a result, he awarded all of the winnings to the ex-husband. Forbes.com *

    hiding assets, income and debt is not only unethical; it’s also illegal and subject to severe penalties IF discovered. forbes.com *

    contempt of court or criminal charges for fraud or perjury.

    An investigator or forensic accountant can thoroughly examine income tax returns, public records and bill statements. Your attorney can submit questions to your spouse, through written interrogatories and oral depositions, in an attempt to find hidden assets. However, as a “The New York Times” article notes, although your suspicions might be justified, it’s “what you can prove that counts.”

    a husband who repeatedly failed to produce current financial statements so angered the judge that he allocated 90 percent of the marital assets to the wife.

    Depending on the laws of your state, if you refuse to disclose assets or information requested by the court, you might be held in contempt of court, a misdemeanor which can result in fines or even jail time. If you lie about your assets in court, you might be charged with perjury for testifying falsely under oath. In California, for example, you can serve up to four years in jail for perjury. You might be charged with fraud, a criminal act, if a prosecutor decides to charge you with deceiving the other party by hiding assets. Penalties include restitution and jail time. legal zoom *

    https://www.divorcemag.com/articles/financial-fraud-and-divorce

    17 Ways to Really Piss Your Spouse Off During Your Divorce

    Allowing your attorney to needlessly slander your spouse: Some lawyers can get out of control and it’s your job to stop them.

    Forcing your children to accept your lover (or any new partner) before they’ve had time to emotionally process the divorce: This one is especially self-serving. Psychology Today *

  6. I changed employers, can I switch from Bronze to Silver?

    **********

    Only if there is a change in income, that changes subsidies or silver level. See explanation above and the main special enrollment page.

  7. I have read conflicting info on internet.

    Some places it says that under medi-cal you can’t have more than $3,000 for a couple and in other places, including your site, it says that bank accounts are not counted.

    We are under 65 but a low income family.

    Can you please clarify this?

  8. What happens to your medi-cal program if you didn’t know that you had to report that you started a business.

    It hasn’t made much money though. 2019 had 0 profit.

    Does receiving a stipend to host international students count as income?

    Money received was for food, shelter and transportation.
    That was also not reported.
    We didn’t think it was income because it was for care of the student.

    • Here’s the worst that I’ve researched that could happen!

      IMHO and I’m not an attorney and can’t give legal advise nor a CPA – having a business with zero profit doesn’t affect eligibility

      E. Reporting Changes

      Medi-Cal beneficiaries must report changes that affect their eligibility, such as income or household size, within 10 days.

      Covered California enrollees must report changes that affect their eligibility for enrollment or financial assistance within 30 days.

      For information on reporting changes, see Chapter 6, Section A.1 Source

    • Hosting?

      Will you be getting a 1099?

      Did you account for specific expenses?

      Learn more on Intuit.com

      The IRS and state and local authorities will tax you net income, which means you take your gross stipend, deduct the expenses directly associated with hosting and then declare the balance as taxable income. homestaynetwork

      We don’t get compensated to help with Medi-Cal. How about considering us for your other Insurance needs, like life insurance.

  9. I have several questions before submitting our Medi-Cal renewal redetermination application:

    1. Will my 19 year old who is a full time college student living at home and is claimed as a dependent on my husband and my tax returns be still eligible under our medi-cal account?

    2. What is the income threshold for a family of 5 or if he counts as part of our family, then what is the income threshold for a family of 6?

    3. Do assets and bank savings count in the eligibility determination?

    If so, what is the max we can have?
    If so, Will money in kids custodial savings accounts count as an asset?

    4. We have a small business that hasn’t made money. It is an S Corp.

    Will a paystub from our own company count as income verification?

  10. Hi Steve,
    .
    I have a question related to MAGI for clergy.
    .
    I left a normal church position to start a new church and my salary was significantly reduced. We qualify for Medicaid assistance in Pennsylvania but only if our housing allowance is not part of our MAGI as you mentioned in your article. Our application in the marketplace was sent over to our county assistance office and that’s where the problem comes in.

    The county claims that they have a policy that indicates that if the housing allowance is paid directly to me, then it counts as salary.

    ***The minister’s employing organization must officially designate the allowance as a housing allowance before paying it to the minister. (IRS.Gov/Topic 417)

    I’m waiting for a call from a supervisor and I would like to have definitive information to show him that the MAGI for clergy does not include the housing allowance.

    Do you know where to find that in the healthcare law?

    ***Here’s what I have. I’m concerned about if you are an employee or not. Here’s what I found. I suggest you contact competent tax counsel.

    A licensed, commissioned, or ordained minister is generally the common law employee of the church, denomination, sect, or organization that employs him or her to provide ministerial services. However, there are some exceptions, such as traveling evangelists who are independent contractors (self-employed) under the common law.

    A licensed, commissioned, or ordained minister may be able to exclude from income the fair rental value of a home (a parsonage) or a housing allowance provided as compensation for ministerial services performed as an employee. (IRS Publication 517 Page 9)

    If you are a minister performing ministerial services, all of your earnings, including wages, offerings, and fees you receive for performing marriages, baptisms, funerals, etc., are subject to income tax, whether you earn the amount as an employee or self-employed person. However, how you treat expenses related to those earnings differs if you earn the income as an employee or as a self-employed person.

    Facts and circumstances determine whether you are considered an employee or a self-employed person under common-law rules. Generally, you are an employee if the church or organization you perform services for has the legal right to control both what you do and how you do it, even if you have considerable discretion and freedom of action. See Common Law Rules in Publication 15 A.

    The minister’s employing organization must officially designate the allowance as a housing allowance before paying it to the minister. (IRS.Gov/Topic 417)

    Thank you for your help!
    Pastor Jason

  11. This FAQ was before we had commenting on our site. Please bear with us as not all the links work and the formatting might not be as nice as we would like.

    My wife and I filed joint return, and the same for 2017. No dependent. If only one of the spouses has income, and we try to apply for Family Coverage on Covered California, are we going to be split into two different insurances?

    ***No it’s all one qualification for subsidies your mandated to file jointly and two people at 28,000 would probably give you Silver 87.

    Get a complementary calculation and benefits report or view the income chart, metal level page and enhanced Silver page. http://www.quotit.net/eproIFP/webPages/infoEntry/InfoEntryZip.asp?license_no=0596610

    I only get paid for helping you if you appoint me as you’re covered California agent. They don’t pay me a monthly salary just to put up this website.

    2 One spouse with income qualifies to buy subsidized metal plan and the other spouse without income only qualifies for Medi-cal? Our line 37 will be approximately $28,000

    ***You qualify together your mandated to file jointly

    3 ACA says you can keep your child under the family plan until he/she turns 26, but Covered California says a child cannot be included in the family plan unless he/she is claimed as a dependent on your tax. which one is correct?

    ***I guess you could put the child on the plan. But there won’t be any subsidies for the child unless the child is on your tax return. Since you are asking me to explain the Jiggery Pokery that Covered CA tells you, don’t you think it fair that I get paid?

    Appoint us as your agent. No extra charge. Section 1301 a 1 c (iii) PPACA 42 U.S. Code § 18021 10 more reasons to appoint us.

    There’s really no point in putting the child on your plan just get the child their own coverage. Click here for quotes for your adult child.

  12. Hello sir,

    can you please advise me with this question and what I have to do.

    I am applying for medical and I am a married man ,but my wife and kids are not here at this time

    do I have to fill as married filling jointly or separately for my household and is there any difference between both?

    Thank you so much.

  13. I lost my job due to COVID 19, I reported that to Covered CA and I was transferred to Medi-Cal.

    I don’t really want to be on Medi-Cal.

    I have a new job starting in June.

    What about the $600/week from the Feds? Does that count as Income for Covered CA? Medi-Cal? I reported the $600 but I heard from Covered CA that that income doesn’t count toward MAGI.

    How much $$$ does one need to earn, to qualify for Covered CA rather than Medi-Cal?

    • Here’s the income chart for Medi-Cal vs Covered CA and Enhanced Silver Levels

      So, for a single, as of March 2020 it would be around $18k. Please use an accurate estimate and be sure to update any changes within 30 days. 10 days for Medi Cal.

    • We have a VERY confusing situation here on the $600/week PUC Pandemic Unemployment Compensation!

      4. Will the extra $600 per week Pandemic Unemployment Compensation (PUC) payments be considered countable income for purposes of determining eligibility for financial help and premium assistance available through Covered California?

      Yes, all unemployment benefits (including the extra $600 per week PUC payment) are included in the recipient’s income for purposes of eligibility for financial help available through Covered California (APTC, CSR, and state subsidy).

      5. Will the extra $600 per week Pandemic Unemployment Compensation (PUC) payments be considered countable income for purposes of determining Medi-Cal and CHIP eligibility?

      No, the extra weekly $600 PUC payments are not included in the recipient’s income for purposes of eligibility determination for Medi-Cal and CHIP (C-CHIP and MCAP). However, traditional ununemployment benefits are still considered income for Medi-Cal and CHIP purposes. source

    • So, what do you expect your Annual MAGI income to be for 2020?

      PUC counts for Covered CA.

      How much will you be making at your new job?

      How much PUC will you get?

      How much did you earn on your old job?

      Please let us enter the numbers for you, AFTER you provide them in WRITING!

      Covered CA’s income, expense & deduction questions are very confusing!

  14. If I sell off some stock and realize about $15,000 in gain from it, and

    I am in the 0% long term capital gains bracket because of my total income and family size,

    do I still count this $15,000 toward my MAGI for Covered CA even though I will not be taxed on this by the IRS?

    • I think the bottom line is, what # will you be putting on line 6 of your tax return?

      Note also that Form 8962 Premium Tax Credit Reconciliation asks for AGI Adjusted Gross Income and doesn’t say anything about line 6 capital gains not counting if you have low income.

      If your income is lower than $39,375 (or $78,750 for married couples), you’ll pay zero in capital gains taxes.

      If your income is between $39,376 to $434,550, you’ll pay 15 percent in capital gains taxes. And if your income is $434,551 or more, your capital gains tax rate is 20 percent. https://www.acorns.com/money-basics/taxes/how-are-stocks-taxed/

      While Covered CA’s list of countable income above says to only count taxable portion I’m not sure if that includes what you are talking about as your saying your income is low enough to pay zero in taxes.

      Taxable Capital Gains probably means, after you subtract your costs – basis.

      MAGI income is line 8b – Adjusted Gross Income + other things, see above. It says nothing about an exclusion for taxable gains if you have low income. Will the capital gain take your income above the zero amount?

      42 CFR 435.603(e) calculates income as defined by 26 U.S.C. § 36B. Any taxable capital gain on the
      sale of a home is included in AGI and must be entered on IRS Form 1040, line 13, capital gains (IRS Form 8949 and schedule D).

      I checked with my own CPA and he didn’t know the answer, but he did point out that just because income is not subject to tax, doesn’t mean it’s not MAGI Income for APTC subsidies.

      Covered CA nor their agents are allowed to give tax advice. See VITA above.

      • What my CPA said 5 years ago about the calculation and reporting for subsidies.

        The cost of preparing the paperwork to get them properly qualified to receive the benefit would exceed anything I could reasonably charge them. The instructor, a fine fellow from Iowa, stated he unfortunately had to agree with me. So now tax preparers will have to decide whether to accept clients based on our health care system — just like doctors. Town Hall

      • Long-term capital gains tax rates for the 2020 tax year
        FILING STATUS 0% RATE 15% RATE 20% RATE
        Single Up to $40,000 $40,001 – $441,450 Over $441,450
        Married filing jointly Up to $80,000 $80,001 – $496,600 Over $496,600
        Married filing separately Up to $40,000 $40,001 – $248,300 Over $248,300
        Head of household Up to $53,600 $53,601 – $469,050 Over $469,050 See better formatting click on the following link https://www.bankrate.com/investing/long-term-capital-gains-tax/

      • Here’s the reply I got from Covered CA

        Household will need to speak to a tax professional to confirm what will be their taxable portion. Once they confirm the amount then that is what would need to be reported. If they have no taxable portion then they do not need to report any capital gains.

        • A little more clarification from Covered CA

          The Covered CA application needs to match the tax filling information.

          Member will need to speak to a tax professional to confirm what income he will be reporting and that is the income that would go on the application.

  15. My divorce agreement provides that my X Spouse must provide lifetime housing in one of their rental units or bedroom. More specifically – My ex-wife is providing me one room for my living space which values around $450 per month. She also allows me to use her car. Does that count as alimony even though it’s non cash? Does that count as income for Covered CA subsidies?

    *****************
    Our Reply

    In the example on page 14 of IRS Publication 504 https://www.irs.gov/pub/irs-pdf/p504.pdf it says that it wouldn’t be alimony as it’s a home you own and the debts are yours. If you owned the home jointly with your spouse see page 15 table 4

    ****************

    More clarification
    Publication 504 is a 30 page document and refers one to other documents, including your actual separation agreement. Be sure to seek competent tax and legal counsel. Covered CA basically just goes by the definition of MAGI line 37 of your 1040 and not how your AGI is calculated.

  16. I am trying to calculate my income to see if I am eligible for Medi-cal or what I can buy through Covered California [with a certified agent, at no additional charge]. Would you please answer these questions for me:

    1) Does spousal support count as income?

    2) Do gifts count as income?

    3) What time period is taken into account when calculating one’s income?

  17. For the last one month I have been calling covered Ca to resolve the problem of getting form 1095 to submlt my tax return. Almost every time I had to waste almost half an hour but no luck. Yesterday I spent between two to three hours continuously in talking to one or the other person from covered ca.

    They helped me in getting fresh password. Later the computer gets jammed. The the message comes site is down etc.

    On Feb 20 I talked to one of their rep and I was promised that form will come in my mail in two weeks. I called on March 5 and was told to wait for one more day i.e till March 6. Still no luck

    Today my son made a few attempts to log in to my account without any success. Then he tried to log in to his account. He too had the same kind of frustation.

    Will you please get me form 1095 ASAP.

    Also please submit this complaint to the highest authorities of covered Ca.

    Needless to say covered ca is giving me this frustration. I would like to take up this complaint with head of covered Ca.

  18. How is this rule enforced? I don’t see any place on my tax return 1040 or #8962 Premium Tax Credit asking about if coverage was offered to my whole family, at a ridicules’ price?

    • Here’s the reply we got from Covered CA on 1.27.2020

      Covered CA does not enforce any of the penalties, so if there is a household that received premium assistance and should not have been eligible for it, they would need to work that out with the IRS. It would be the same if they did not receive premium assistance they should have been eligible for.

      Maybe the IRS would know if they match up the 1095’s A Individual **** B Employer?

      Here’s a bulletin we just got today on a proposed CMS rule:

      end automatic enrollment for low-income exchange enrollees who receive $0 premium plans with tax credits.

      automatic re-enrollment may lead to incorrect expenditures of (advanced premium tax credit), some of which cannot be recovered through the reconciliation process due to statutory caps.

      health insurers to implement copay accumulator programs to prevent drug manufacturer coupons from going toward a patient’s annual limit on out-of-pocket costs when a generic drug is available. https://www.modernhealthcare.com/politics-policy/cms-proposes-rules-rein-aca-subsidies

  19. Hello – I am looking for medical insurance alternatives for my 78 year old aunt. She currently has Covered CA but I am interested to learn more. Thank you!

  20. I’m applying for insurance on the Covered California website.

    While registering it asks how much I anticipate my income to be in 2020.

    I’m currently unemployed but looking for a job.

    Should I put the number I anticipate to make or $0.00 since I’m unemployed?

    If I put a number in, the next question it asks is who employs me.

    Should I type “unemployed” even though I typed in a dollar amount for “Anticipated Income”?

    • If you put zero, you’ll qualify for no premium Medi-Cal.

      If your MAGI Income estimate changes, you’re mandated to report to Covered CA within 30 days. If you’re on Medi-Cal 10 days.

      How about appointing us as your agent, no extra charge, so that we get paid for helping you?

      Advocacy Tip: Enrollees who are uncertain about their income estimate may be well served by taking a smaller amount of premium tax credits each month in advance so they are not at risk of owing money come tax time. The Covered California website includes a sliding bar that allows enrollees to choose how much of the tax credit to take ahead of time.

      individuals who enroll in a plan through Covered California without premium tax credits and realize later that they were eligible can claim those premium tax credits when they file at tax time.

      Western Poverty Law *

      So, if you just pay “full price,” (get quote) then you shouldn’t have to put in an employer. When you do get employed, you can change your estimate. This way you don’t have to have Medi Cal.

  21. Is my 10,920 in Social Security added in as MAGI?

    I have 62,368 of Adjusted Gross Income.

    I read your article on it and there was a footnote 4. I couldn’t read it.

  22. Could you please help us to determine what option would be available at this point for health insurance for one person household with salary of $27,949 in 2018 and less than $10,000 in 2019 living in 92604

  23. I just got this letter from Covered CA. Is my coverage all messed up? Am I OK?

    Covered California Eligibility

    You qualify for health and dental insurance with premium assistance (a federal tax credit) through Covered California. This was based on your household income of $31,753.00 for the year ($2,646.08 a month). This is the income you said you expected to get for the year you want coverage. You qualify for up to $1525.36 per month in premium assistance to help pay for your health insurance coverage. If you choose a silver plan, you will get lower out-of- pocket expenses, such as lower copays and deductibles. Premium assistance cannot be used to help pay for dental insurance coverage.

    You also qualify for cost-sharing reductions. [Enhanced Silver] Cost-sharing reductions are lower out-of-pocket expenses through smaller co-payments and deductibles. If you choose a Silver plan, you will get lower out-of pocket expenses through lower co-payments and deductibles.

    You do not qualify for the California Premium Subsidy because you do not meet the income requirements for the program.

    • Thank you so much for sending me the actual letter so that I can review it. The main thing I learned in my one year of law school was that you have to read something 3 times and then when you think you understand it read it AGAIN. See our page on how to read statutes & contracts.

      What the letter is saying, is that at your income level, you get the Federal Tax Credits, but not the NEW California ones, that go up to 600% of Federal Poverty Level, not just 400%. You also get Enhanced Silver – Cost Sharing Reductions – Silver 87. The letter doesn’t say 87, that’s shown in your quotes and confirmation of coverage.

      California 600% subsidy

  24. I haven’t used my health insurance at all this past year, and I’m planning to move abroad January 2020.

    Not sure this is the best use of funds.

    • There is now a tax penalty if you don’t have coverage! Will you be gone the entire tax year to avoid penalties? See our exemptions page.

      If you knew when your were going to have a claim and should buy coverage, would the Insurance Companies sell it to you?

      You should be thankful you didn’t have a claim last year. While you might not have made a claim, that doesn’t mean the Insurance Company kept the $$$. Insurance Companies are mandated to pay out 80% of the premiums in claims. Someone else got your $$$. Same as if you had a claim. Insurance just spreads out the loss, so that you can pay a small premium and if you have a serious claim, don’t have to go without treatment or face bankruptcy. https://en.wikipedia.org/wiki/Insurance

      How will you get coverage in a foreign country?

      Is this a permanent move?

      Do you want to keep the option to come back to USA for treatment?

      There are only certain times you can buy insurance, considering no medical or health questions are asked. No Pre X clause!

      Click here for quotes
      foreign travel

  25. I do not have a line 37 on my 1040 – however I do have a Schedule A (Agriculture business) amount on my line 8 that is subtracted from my line 7 (gross income) to get My line 10 taxable income – from which 12% is calculated and became the amount I paid in taxes.

    Do I use my taxable income for 2018?

  26. My x husband went back to his country of origin. Does a California order apply overseas? What if he won’t pay?

    • Here’s an excerpt from the CA Child Support Handbook:

      Cooperating with other states, countries, and tribunals

      A parent owing support sometimes moves out of California. However, every state and many foreign countries or tribunals have an agency to enforce child support orders. Although laws differ from state to state, all child support agencies work with each other to locate parents and their assets, and to collect current and past-due child support. Federal law requires every state to enact the Uniform Interstate Family Support Act (UIFSA) so states can work together to establish and enforce child support orders. Some foreign countries do not have agreements to establish and enforce child support orders from the United States.

      Here’s some links I googled on collecting out of country:

      Israel and the U.S. entered into a federal-level Memorandum of Understanding (MOU) under the terms of which Israel and the United States each express its intent to process child support requests for the other. acf.hhs.gov

      43 percent of divorced fathers in Israel don’t pay child support haaretz.com

      US State Department on International Child Support

      Hague Convention

      Practical Handbook for Caseworkers under Hague Convention

      Prohibition on Leaving the Country
      For parents who fear that the other parent will leave the country, some safeguards are already in place. If the obligated parent owes $4,000 or more in child support arrears, his or her passport application will be denied and any existing passports can be revoked.HG.org

  27. Does CA’s new law increasing subsidies do anything to fix the family glitch. That is, where an employer only pays for the employee’s health insurance thus making coverage “affordable” even though the dependents have to pay full pop?

  28. I have a Mexican Passport and USA Permanent Residency Green Card. Do I need a visa to visit Peru and return to USA?

  29. Do you know anything about applying for Covered California and using the salary only portion of clergy compensation (excluding housing allowance) to qualify for financial assistance for health care?

  30. I have a Health Sharing Ministry plan. It was accepted as compliant coverage under Obamacare. Will it be under the CA law?

  31. I was direct off exchange with Kaiser, not Covered CA. I called Kaiser and they say they don’t have my 1095 B form. What do I do?

  32. I want to get an Individual plan that UCLA accepts. I went to their webpage https://www.uclahealth.org/health-plans and they accept WAY MORE plans than just Blue Shield PPO and Oscar EPO!!! They also told me this over the phone.

    What’s the problem? Are you trying to sell me just the plans you make the most commission on?

    • First off, we have to accept that Covered CA controls the CA marketplace, even if you get a plan directly from an insurance company. Check my website for the citation.

      Here’s the companies that write Individual Coverage in CA for 2020

      1. Anthem Blue Cross of California.
      2. Blue Shield of California.
      3. Chinese Community Health Plan.
      4. Health Net.
      5. Kaiser Permanente.
      6. L.A. Care Health Plan.
      7. Molina Healthcare.
      8. Oscar Health Plan of California.
      9. Sharp Health Plan.
      10. Valley Health Plan.
      11. Western Health Advantage.
      Covered CA.com

      Go to this link https://individuals.healthreformquotes.com/companies/ and then scroll down for information on each company. You can get quotes here for 2020 on 11.1.2019 Sure you can get quotes from Covered CA or on each companies affliate link – no extra charge for our services, they pay us. It’s just that if you want us to help you compare, our tools won’t be ready till 11.1.2019.

      So, sure UCLA lists a lot of plans they accept, but how are you as an Individual going to buy them?

      Preferred Provider Organizations (PPOs)
      Aetna – Left CA!
      Anthem Blue Cross Left CA in 2018 but came back for 2020
      Blue Shield of California
      CIGNA – Left CA
      First Health
      Health Net of California OK, but not on the list for Individual Plans
      Interplan (a HealthSmart product)
      MultiPlan
      UFCM Health System, Inc. dba California Foundation Medical Care (CFMC)
      Prime Health Services
      Private Healthcare Systems (PHCS)
      TriCare Are you Military?
      UnitedHealthcare – Left CA for Individual Plans
      https://www.uclahealth.org/health-plans

      If you have Medicare we can help you on this website.

      If you have a business with at least one non-spousal employee, we can help you here. Group Employer Quotes

    • We do not care or want to comment about what anyone said over the phone. It’s just too unreliable. The courts won’t even accept hearsay evidence.

      Here’s where we spent an hour with our crystal ball, coming up with reasons why someone over the phone said something…

      It might often depend on the question you ask. You might not be asking the right question. Sure, UCLA accepts a lot of Insurance Companies. The question is, what companies can you buy as an individual that they accept?

  33. I had 56k in w 2 g gambling winnings gains with equal in losses..

    however my tax person says for covered ca, it does not count the losses and pg 1 is reported.

    She say I owe back 10k to covered ca.

    I cannot understand when I actually have zero gains.

  34. You said that my friend does not make enough for her and the baby to be on blue Shield so we are going by what you said. That is why we did not list the baby on the Covered CA application. We do not want the baby on Medi-Cal.

    • We do not allow clients, web visitors or prospects to quote what we said, or worse yet, what you think we said. What we said or what you think we said doesn’t count. It’s what the law, regulation, case law or actual brochure says. You may only cite those going forward.

      Medi-Cal offers a Blue Shield option. Talk to your Social Worker about it. We don’t get paid to help you with Medi Cal.

      Please take another look at the income chart above. Please note that the subsidies, qualification, etc. go by household size. So, if the baby isn’t listed, then we only have a household of one.

      We do not need any hassles with household members going uninsured. It’s not Open Enrollment and Covered CA’s interpretation says that going into Medi-Cal is NOT a loss of coverage. Thus, the baby can’t get individual coverage till January. We are not willing to be party to this lawsuit waiting to happen.

      We are not willing to engage in any possible tax fraud or allegation.

      Also, we do not deal with 3rd parties when the person who wants coverage is a competent adult.

      So, please, would stop getting in the middle and have the client, fill out the application properly, including all family members, so that we can upload all the information to your Covered CA account and make sure the information in the online portal is correct.

      Even if the baby gets enrolled in Medi Cal, you can have a private plan, that you will not get subsidies on and Medi Cal.

  35. I’m making more than 600% of Federal Poverty Level, per chart above.

    Does that me I can’t have no longer eligible Covered CA anymore?

    Does that mean I have to get new coverage?

    Can your Certified Agency help me either stay with Covered CA or get coverage direct with an insurance company?

    • There is no maximum income for Covered CA.

      They might ask for income documents though. Our webpage on proof of income.

      If you are already with Covered CA, I suggest you just stay there, no hassle in filling out a new application. Automatic renewal, etc.

      Note, if your income goes down unexpectedly during the year, you can’t get back into Covered CA unless you’re already there….

      Covered CA and Direct are pretty much mandated to be the exact same coverage, guaranteed issue and premium. One caveat, due to a court case… The subsidies for enhanced silver… didn’t work out. So, if you want a Silver Plan and are not getting subsidies, the premium is less if you go direct to an Insurance Company.

      See link above to get quotes. Covered CA and the Insurance Companies pay us, so there is no charge to you for our expertise.

  36. Hi,

    My mom has been told that she is no longer eligible for Medi-Cal because of her Alimony. She’s been on Medi-Cal for close to 3 years with this alimony and is just now being told that she doesn’t qualify.

    My mom is self employed and reported a loss of $6000 on her federal taxes as part of her schedule C. Her alimony is $20,0000 annually. Her AGI based on line 37 is around $14,000. She has been repeatedly told that her loss of $6000 and the fact that her AGI based on line 37 of her 1040 is under the income limit for Medi-Cal do not matter, and that her alimony is higher than the income limit and that is all that matters.

    Based on everything that I’ve found online, including what is on your website, it seems like she should be eligible for Medi-Cal. She has been told on the phone and in person at the Medi-Cal office that she is not eligible and will not have Medi-Cal as of the end of August.

    Is there any advice you can give us?

    Thank you!

    • Here’s our page on Alimony.

      Near as I can tell and I’m not allowed to give tax advice, if the divorce settlement was done before 12.31.2018, alimony counts as income.

      But you are right, Medi Cal is based on MAGI income as defined above. Line 37 – now 7 + …

      $14k qualifies one for Medi Cal see chart.

      Here’s our page on MAGI income qualification for Medi Cal.

      Here’s our contact page for Medi Cal Try emailing your question and my research to this address [email protected]

      B. Counting Income

      MAGI Medi-Cal and MCAP use largely the same MAGI methodology that is used by Covered California for counting income. Taxable income, Social Security benefits, tax-exempt interest and foreign earned income are all included.

      2. Income Threshold for Financial Assistance

      Most adults with household incomes up to 138% FPL in California are eligible for Medi-Cal (for children, the income standard is set at 266% FPL), and as described above, eligibility for Medi-Cal precludes eligibility for Covered California. In the vast majority of cases, an individual must have household income above 138% FPL to qualify for premium tax credits – and most children must be in families with incomes above 266% FPL in order to obtain premium tax credits. Western Poverty Law *

      What is your Mother’s expected income for 2019? 2020? When income gets too high, then you can get subsidized coverage with Covered CA. Get quotes here. No charge to have us as your broker.

      the IRS does often rely on what is known as the “3-of-5 test.” This means that a successful small business should typically earn a profit three of every five years. If you have attempted to turn your hobby into a profitable business for seven years with no success, it may become difficult to claim profit as your true motivation. biz fluent.com

      Our webpage on hobby or business

    • Reference Materials:

      Settlements – Taxability
      https://www.irs.gov/pub/irs-pdf/p4345.pdf

      Award Settlement Guide
      https://www.irs.gov/pub/irs-utl/lawsuitesawardssettlements.pdf

      I’ve won a lawsuit and will soon receive a large award of money damages.
      Do I have to pay taxes on this money?

      The glow of victory may begin to dim after you get your attorney’s bill. As if that disappointment isn’t enough, we have more sobering news — the IRS may try to claim its share of the total. So postpone that trip to Cabo, and read on.

      According to the tax code, the only damages you can enjoy tax-free are those that compensate you for physical injury or physical sickness. (26 U.S.C. § 104(a).) So if this describes your case, you will probably keep the cash safely away from the grip of the IRS. Nolo.com

  37. I’m getting the tax subsidy, but now I’m thinking that I’m paying too much.

    How do I apply for Medicare and what are the cost and coverage differences?

  38. The 2020 FPL’s are forecasted FPLs. Until the Feds actually release the FPL numbers, sometime in January 2020, these are just estimates. I assume they were used to forecast the potential subsidy amount. Also forecast are the numbers of people who would

    a. Qualify for the subsidy., and

    b. Those who will actually take advantage of it.

    I am very skeptical they can actually deploy the subsidy for 2020. That would be asking FTB to develop a whole new system and software for the accounting, from scratch, to have it in place for Jan 2020.

  39. It’s not a done deal.

    There is still massive work to be done between FTB and CC to integrate the system.

    There are still questions as to where the money will come from if the penalties fall short of the expectation.

    Plus who will help consumer navigate the scenario of a family receiving the state subsidy, but when they do their taxes, they are under 400% and don’t qualify for the state subsidy but the federal subsidy?

    Who claws back the state subsidy money because the household didn’t qualify for it, but the family receives a large federal subsidy on their taxes?

    What if the federal subsidy is lower than what the household received from the state subsidy?

    This is going to get nasty complicated.

    We know CC refuses to work on tax related issues.

    That means the work falls to agents.

  40. I didn’t make changes to my subsidy amounts, income, family filing status, dependents, etc. due to illness.

    What is the criteria to get an exemption and fix the issues now?

    • ACCEPTED:

      Fear of IRS.
      Taxpayer who had been laid off was overwhelmed by Schedule C instructions. As a result he just shut down and stopped filing for several years as the fear and anxiety mounted. He hired a CPA (Weston) to get his books in order. Once all returns were filed and taxes assessed, the IRS abated all penalties, because they agreed that the taxpayer had no malicious intent.

      Health issues.
      Prolonged illness made it difficult to concentrate, and short-term memory suffered.

      Mourning.
      Grief due to death of a close family member.

      Burglary.
      House was robbed and family computer with all records was stolen

      ONE FREE PASS:

      But before taxpayers go groveling with excuses, they have another, guilt-free option: the first-time penalty abatement waiver. Apparently the IRS has a warm and fuzzy side, because it believes that everyone is entitled to one mistake. So if you’ve got a clean record — you’ve filed (or filed a valid extension for) all required returns and are all paid up — you can qualify for the FTA waiver.
      USA Today

      *****************

      Reasonable Cause

      The key word here is “reasonable,” and it doesn’t include, “I forgot.” If you ask for a waiver for reasonable cause, you need to establish the facts for the issue you are having that keeps you from taking care of your taxes, and you need to produce documentation to back it up.

      Fire, natural disaster, casualty, or other serious disturbances count as reasonable cause. Plenty of people in the U.S. have been hit with extreme weather, devastating forest fires, and other issues over the past year or so. If your home or business is in a riot zone, you may receive a waiver since having your structure blocked off by police tape is probably considered a pretty serious disturbance.
      If you are unable to obtain your records, the IRS may grant a waiver.

      Death, serious illness, incapacitation, or unavoidable absence of you, the taxpayer, or a member of your immediate family is considered reasonable cause. It’s pretty cool of the government to acknowledge that dead people would have a tough time taking care of their taxes.
      Other reasons establishing you used all “ordinary business care and prudence” to meet your Federal tax obligations but just couldn’t do it. “I forgot” does not, unfortunately, count as reasonable care and prudence. Neither does lack of funds unless the reason for the lack meets reasonable cause criteria.

      Top Tax Defenders.com

      IRS Website on Penalty Relief due to Reasonable Cause

    • One of the problems was that our child moved out, got a good job and filed his own taxes. Is there a way we can fix that on our tax return?

  41. One of the issues with Obamacare APTC Advance Premium Tax Subsidy is it does not look at income in arrears, because that would be too simple.

    Instead it relies on enrollee’s to guess what they will make in same – future year and oh by the way how much they will have in deductions or if an adult son who’s listed on the plan will find a job or not. Who knows?

    The premium assistance relies on MAGI Modified Adjusted Gross Income, do you have a complete list of acceptable deductions allowed for 2018 and for 2019?

  42. I have just begun to receive retirement income that will make me ineligible to continue to receive Medi-cal benefits.

    I have questions about the Kaiser Program…

  43. I am 65, with Medicare, self employed not retired.

    My husband is 53. with Covered California, self employed.

    We file jointly. what income should we declare for my husband?

  44. I am working on my taxes and need to know how I calculate what I will need to pay if my salary is slightly less that what was estimated for my blue shield policy under covered california.

    I believe $17,000 was the number we used to calculate and I’m currently a little over $14,000 with my income.

    As I’m a self employer instructor and am verifying all sources income including cash, cc and the charge cards I accept to confirm my numbers are Correct.

    Is there a website I can also use for these calculations ?

    I’m assuming this number is to be taken from line 12 on the tax return or is it the adjusted number line 17.

    I have a lot of deductions that could bring my number even lower that 14k If it’s the adjusted number I should be looking at.

  45. I don’t understand the chart above where it lists number of people in the household going down and FPL Federal Poverty Level percentage across with amounts in the middle.

    What does the amount represent?

    Max Min ?

    • The dollar amount on the chart represents what one expects to earn as MAGI Income for the upcoming year. Namely, adjusted gross income + Social Security, Foreign Income and Tax Exempt interest.

      If one is less than 138% of federal poverty level and a family of one, or $16,754 MAGI income, you would go Medi Cal. If your income is over 138% or $16,754 up to 250% or $30,350, not only do you get subsidies, but they give the the Silver Plan lower co pays, deductibles, etc. Click here for more details on enhanced silver aka CSR Cost Sharing Reductions.

      If you are over 250% of FPL you get subsidies, but not the lower deductible, co pay, etc. The easiest way to figure all this out is just to play with our quote engine.

      Please note, the screen shot is only an EXAMPLE. Please use our quote engine and get your own individual – private quote.

      Estimate Income

  46. I’m just confused because it seems you are looking primarily insurance that falls under covered California which is means tested.

    I don’t qualify for that this year.

    When I emailed you, why do you ask so many questions about my income?

    • We want to make sure that you have a plan and payments that best suit your needs. We didn’t do all the education just to have you order any old policy. We consult with you and make sure it fits your needs with what is available in the marketplace. We do grant, that our time is limited and those wishing to use our services, must be internet savvy enough to fill out the affiliate enrollment application on their own. We didn’t get all the education and build this extensive website to do clerical work.

      The average person might not know if they qualify for subsidies. The term MAGI income can be quite complex. The new tax forms don’t have a line 37 AGI Adjusted Gross Income anymore. AGI is NOT MAGI!

      Don’t forget, President Trump said insurance was very complicated! Scroll down to see video.

    • Means tested is a big word for us… I’m not sure it’s the correct one…

      A means test is a determination of whether an individual or family is eligible for government assistance, based upon whether the individual or family possesses the means to do without that help. https://en.wikipedia.org/wiki/Means_test

      This just goes to show how complex it all is and why we assist people even if they think they know more than us or even if they actually do.

  47. Should I file an appeal regarding lack of premium assistance for part of last year?

    Covered CA probably thought we were only a family of 2, which would make our income greater than the 400% line. They just needed to correct it to family of 3.

    • Enrollee’s Duty to Report Changes in Circumstances

      An enrollee, or application filer on behalf of an enrollee, must report any change of circumstances with respect to the eligibility standards within 30 days of such change. An enrollee, however, who has a change in income that does not impact the amount of the enrollee’s Advance Payments of Premium Tax Credit (APTC) or the level of Cost-Sharing Reduction (CSR) is not required to report such a change. Source *

      (45 C.F.R. § 155.330(b);

      10 CCR California Code of Regulations § 6496
      § 6496. Eligibility Redetermination During a Benefit Year.

      (a) The Exchange shall redetermine the eligibility of an enrollee in a QHP through the Exchange during the benefit year if it receives and verifies new information reported by an enrollee or identifies updated information through the data matching described in subdivision (g) of this section.

      (b) Except as specified in subdivisions (c) and (d) of this section, an enrollee, or an application filer on behalf of the enrollee, shall report any change of circumstances with respect to the eligibility standards specified in Sections 6472 and 6474 within 30 days of such change. Changes shall be reported through any of the channels available for the submission of an application, as described in Section 6470(j).

      (c) An enrollee who has not requested an eligibility determination for IAPs shall not be required to report changes that affect eligibility for IAPs.

      (d) An enrollee who experiences a change in income that does not impact the amount of the enrollee’s APTC or the level of CSR for which he or she is eligible shall not be required to report such a change.

      (e) The Exchange shall verify any reported changes in accordance with the process specified in Sections 6478 through 6492 before using such information in an eligibility determination.

      Cal. Code Regs., tit. 10, § 6496, subds. (b), (d).)

    • https://www.merriam-webster.com/dictionary/change

      Definition of change (Entry 1 of 2)
      transitive verb

      1a : to make different in some particular : ALTER
      never bothered to change the will
      b : to make radically different : TRANSFORM
      can’t change human nature
      c : to give a different position, course, or direction to
      changed his residence from Ohio to California
      2a : to replace with another
      let’s change the subject
      b : to make a shift from one to another : SWITCH
      always changes sides in an argument
      c : to exchange for an equivalent sum of money (as in smaller denominations or in a foreign currency)
      change a 20-dollar bill
      d : to undergo a modification of foliage changing color
      e : to put fresh clothes or covering on change a bed
      intransitive verb

      1 : to become different some things never change
      2 : to undergo transformation, transition, or substitution winter changed to spring
      3 : EXCHANGE, SWITCH
      neither liked his seat so they changed with each other
      4 : to put on different clothes need a few minutes to change for dinner
      5 : to shift one’s means of conveyance : TRANSFER
      on the bus trip he had to change twice
      6 of the voice : to shift to lower register : BREAK
      His voice started to change when he turned 13.
      7 of the moon : to pass from one phase (see PHASE entry 1 sense 1) to another change hands
      : to pass from the possession of one owner to that of another money changes hands many times
      change noun
      Definition of change (Entry 2 of 2)
      1 : the act, process, or result of changing: such as
      a : ALTERATION
      a change in the weather
      b : TRANSFORMATION
      a time of vast social change going through changes
      c : SUBSTITUTION
      a change of scenery
      d : the passage of the moon from one monthly revolution (see REVOLUTION sense 1a) to another also : the passage of the moon from one phase (see PHASE entry 1 sense 1) to another
      e : MENOPAUSE
      2a : money in small denominations received in exchange for an equivalent sum in larger denominations
      b : money returned when a payment exceeds the amount due
      a cashier quick at making change
      c : coins especially of low denominations
      a pocketful of change
      d : a negligible additional amount only six minutes and change left in the game
      e : MONEY sense 1
      cost a large chunk of change
      3 : a fresh set of clothes
      4 British : EXCHANGE sense 5a
      5 : CHANGEUP
      6 : an order in which a set of bells is struck in change ringing

  48. Am I eligible for a subsidy if I elect and am on COBRA coverage?

    Even if I have a poverty-level income for the year?

  49. We are selling our home.

    Does the income from the sale get reported to Covered CA?

    If it does, we would not qualify for subsidies, what happens?

  50. My wife, son (age 11) and I have marketplace – Covered CA Oscar insurance this year. The premium is $175/month after ACA subsidy based on projected 2018 income of $75k for 3-person household.

    My employer just offered us medical insurance, which means family glitch. However, there is no employer contribution to the premium for my dependents.

    Can I get a hardship exemption and get catastrophic minimum coverage for my dependents?

    • What you are asking is way more complicated than it sounds.

      Here’s what sounds like the relevant exemptions:

      Coverage considered unaffordable—The required contribution is more than 8.16% of your household income.

      .0816 unaffordable

      Please enter your information, so that we can see what you have to pay for coverage.

      Aggregate self-only coverage considered unaffordable—Two or more family members’ aggregate cost of self-only employer-sponsored coverage was more than 8.16% of household income, as was the cost of any available employer-sponsored coverage for the entire family.

      Coverage considered unaffordable based on projected income—The Marketplace determined that you didn’t have access to coverage that is considered affordable based on your projected household income.

      How is affordable coverage defined?

      Coverage is considered unaffordable for individuals if their cost of coverage exceeds 8 percent of annual household income.

      If an individual is eligible for employer coverage, affordability is determined by comparing the “employee share” of the premium cost of self-only coverage for the employer’s cheapest coverage option that achieves minimum value (i.e., 60% actuarial value) to the taxpayer’s household income.
      If the individual is not eligible for employer coverage, affordability is determined by comparing to household income the lowest cost bronze plan (taking into consideration any applicable federal premium subsidies) offered in the Exchange where the individual would purchase coverage. BCBCM.com

      Even considering all that, does the premium difference between bronze and catastrophic make sense to do all the paperwork and hassle?

    • You might ask your employer to change his rules and not allow any dependents on the plan, as he’s not making any contribution anyway. Then you wouldn’t have the “family glitch.” Read above carefully for the citation.

      Affordability “Glitch”: This is only applicable to individuals that have an offer of coverage from their spouse’s employer. copied from Covered CA memo 1.31.2014

      What if the employer doesn’t offer family coverage?

      Some employers offer coverage for employees only, or for employees and their children, and do not offer spousal coverage. Large employers will face a penalty for failing to offer coverage to full-time employees and their children under the age of 26 if at least one employee receives a premium tax credit for marketplace coverage. There is no penalty for failure to offer coverage to the employee’s spouse. If no plan offered by the employer covers the spouse or children, the spouse or children may purchase insurance in the Marketplace and qualify for premium tax credits, assuming all other eligibility rules are met.

      Example
      It’s a new plan year and Jose’s employer has changed its coverage options. Now, Jose’s employer offers employee-only and employee-plus-children coverage. They’ve dropped the family coverage option so Alma no longer has an offer of coverage. Employee-only insurance costs $2,500 per year (7.1 percent of income) and coverage for the employee plus children costs $4,500 per year (12.8 percent of income). The “employee plus children” option is considered affordable, even though it costs more than 9.56 percent of income, because Jose’s employee-only insurance is affordable. This means that Jose and his children are not eligible for premium tax credits, whether or not they accept this coverage option. Alma doesn’t have an offer of coverage through her own or Jose’s employer so she may be eligible for premium tax credits to purchase coverage in the marketplace. Health Reform Beyond the Basics

      Here’s how Kaiser asks the question on their Employer Application…

      kaiser.application

      See also https://insuremekevin.com/helping-small-group-dependents-get-covered-california-tax-subsidy/

  51. I’m currently on a Covered California Silver Enhanced Plan. I’m now caring for my elderly parents, who are not on Medi-Cal.

    They are providing me with room and board paying me $1,000 a month. I also receive $994 a month in Social Security.

    Is there a way to keep my current insurance plan and avoid Medi-cal?

  52. Last month I left my job and now I am freelancing.

    Not sure what to do about reporting my income since I really don’t know what it will be – I am transitioning to 1099 project work.

    I can continue to cover my premium if best option is to leave as is and settle up at tax time.

  53. I’m not clear as to when and how to update/verify my income for this year based upon my last year’s tax return.

    Can you please advise?

    • 1040 Income – Line 37 + Foreign Income + Tax Exempt Interest + Social Security

      The question is NOT what you earned last year. It’s what do you expect to earn in 2018. That’s what form 8962 is, to reconcile your taxes and what was advanced to you as a subsidy.

      In a private email, we sent you your 2016 tax return. Please advise how you think your numbers will look for 2018.

      If your estimate changes, see above, on our webpage about reporting that within 30 days.

  54. What counts as projected income for this year 2018?

    How to project income for 2018?

    Attestation of anticipated income for the 2018 year.

  55. I don’t believe I received my 1095-A form from Covered CA for the 2017 year.

    I tried to track it down online but it appears the only way I can get it is by filling out a dispute form.

    How can I get it?

  56. Is there a risk of my being in legal trouble if the income information to Covered CA for APTC Advanced Premium Tax Credit – Subsidy that we reported was incorrect earlier in the year?

  57. If I qualify for subsidies, when do I receive that money? Is it deducted from my monthly premium or do they reimburse me later?

  58. I expect to make a lot more than the 26K I made last year.

    Are the subsidies based on last year or on this year’s earnings?

  59. We are having technical difficulties with replies being indented.

    Here’s the question, I’m answering:

    Anonymous Asks:

    I called Covered CA and told them my income was the following:

    To date Jan thru Feb 25, 2018 for Bxx Hxxx I have received 4 paychecks. YTD gross for them is $3838.00.

    Txxx On Rxxx less than $500.00 this year.

    Just started with CxxC on Feb 26, 2018 and so far received a check for approximately $274.02 from them.

    My premium just took a drastic jump, Why?

    *************************************************************
    Our Reply

    First of all, while Covered CA did add all the entry pages for ones income and deductions, IMHO (In my Humble Opinion) it’s best to just figure out what you are going to have as MAGI income at the end of the year on your tax return. It’s basically line 37. Scroll to the top of this page for more detail.

    If you are going to fill out the entire form, then again IMHO it’s best to log into your Covered CA account and complete the form yourself. Here’s our webpage on how to update, change your income.

    I do not recommend just calling and having someone else enter information for you. This is also why, we prefer that you email us rather than call. This is how someone whose income went from $15/hour to $15.20/hour gets hit with $40k in income, when it should be closer to $25k, being as she’s a teacher and doesn’t work summers.

    Here’s our free quote engine to figure your subsidy based on the income you project for the current year. The PAST is not relevant, unless your projected income is in question and Covered CA wants some kind of proof.

    Excerpt of Covered CA Income Entry Page

  60. I will qualify for Health Insurance through my employer and don’t need my Covered CA coverage anymore.

    How do I cancel coverage?

    Do I need proof of new coverage?

    What is the deadline so that I don’t have to pay for two policies?

  61. I wanted to to ask you if all is ok with my CoveredCa account because there was a notification about eligibility on my account.

    When I went to check the enrollment Status it stared that I was late in applying for the Covered Ca services.

    I had applied for the healthcare coverage long before the expiration time of 1/31/18.

    Can you please let me know if everything is ok with my account or was it some sort of error on their part.

  62. I am currently on Medi-Cal.

    I may have the opportunity to increase my income to $1.980/mo. (Not sure if this matters – my current income includes early social security $720/mo. in which case, they will take back 50% of every dollar I make over $1,600/mo.)

    Need quote in case my income increases.

  63. 1. I went through you to get assistance with the subsidies. Which you told me I was unable to qualify for due to projected income in 2018.

    2. I have since spoke with other agents that have assured me that I could have qualified.

    • 1. As I recollect, you said you were disabled and would not have any income for 2018 or if you did it would be below the amount the IRS needs to get subsidies. See our Covered CA income chart or use our instant calculator and proposal quote engine.

      While past income might be accepted as an indicator of future income, it’s what you file on your taxes at the end of the year for 2018 that counts. See forms 8962 Premium Tax Credit and 1040.

      Even if you were to get on board with Covered CA and got advance subsidies, you are mandated to report any change in income within 30 days. See above for details. The application is under penalty of perjury. If you get subsidies you are not entitled to, you have to pay them back, when you file your taxes.

      Our agent contract, CA Law and Federal Law – Tax Code prohibits us from helping people obtain tax benefits they are not legally entitled to.

      If you want to submit and application to Covered CA, you are welcome to do so. The main problem I told you was that they would put you into Medi-Cal and you said you didn’t want that.

      2. It’s nice that you spoke to someone, but I don’t see any citations for why they think you can get subsidies with zero income. We do not pay attention to hearsay.

      Don’t forget – President Trump said health care is very complicated and President Obama didn’t even know ACA changed employer plans too.

      One advantage to applying for Medi-Cal either direct or through Covered CA would be that if you do get a job that qualifies for subsidies, you could use a special enrollment event at that time, as you would be losing coverage.

      If I recollect, you said if you did get a job, you would have Health Coverage there, thus no point.

      Open Enrollment lasts till 1.31.2018

  64. me and my wife are only visitors with tourist visa,

    she is currently pregnant in last months,

    my income in another country is about 70 thousand US dollar per year.

    she is not working, family size 4.

    so can we apply for any option for maternity services,

    because it is very expensive in California,

  65. My wife and I are here on a Visitor Visa. She’s pregnant and due soon. We are a family of 4 with foreign income of $70k from my job. What coverage can we get for her.

  66. I receive a tax-free gift of $14,000 every year and I earn about $2,400/year in interest income.

    I am trying to have at least $16,644 income in 2018 to avoid having to pay back the Covered CA subsidy (Because I would qualify for Medi-Cal with income but not qualify with assets).

    Do you know whether the tax-free gift I receive counts as income in the eyes of CoveredCA?

  67. I have a wife and 13 year old daughter. Our household income is under $40,000.00 BUT, thanks to a hefty loss carryforward, my MAGI is -$150,000.00.

    Is there any way to get covered California, at least for my wife and daughter (I have Medicare)?

      • 1 This year I am earning $20,000.00. I have Medicare Advantage. My wife and daughter currently have Medi-Cal.

        2 I’ve just started receiving Social Security which will be $22,000.00 next year. If I continue earning $20,000.00 from working, our total income of $42,000.00 will knock my wife out of Medi-Cal, at least as I understand it.

        3 My daughter, however, can continue with her Medi-Cal.

        4 This is why I’m looking at insurance for my wife and not necessarily for my daughter.

        5 If we have to pay $12,000 to $15,000 for health insurance, maybe I should stop working and leave my wife (and daughter) on Medi-Cal.

        • 2 Here’s the income chart for Covered CA While $42k would put you in Silver 73, the chart goes by MAGI Modified Adjusted Gross income that is Line 37 Adjusted Gross Income of your tax return, plus Social Security (It might not count in full), Foreign Income and Exempt Interest.

          Your tax loss would show on line 13 or 14, right? Thus as a negative number it would make your $42k below zero, right? Thus, since your income is below $34k for a family of four, that would put you in Medi-Cal and not subsidies.

          I’m not a CPA or tax attorney. Please review the Government Documents cited, this website and our Medi-Cal website, Western Poverty Law and go over them with appropriate counsel.

          4. If you put your mouse over the premium on my quote engine, it will show the premiums for each person.

          5. There are some who say that Obamacare will die on it’s own. The Middle Class can barely afford their own premiums, let alone the subsidies and Medi-Cal.

            • Letters from Covered California / MediCal said that with our household sized our household earnings could be up $2,2014.08 per month for my wife to stay on Medi-Cal and $4,527.00 for my daughter to stay on Medi-Cal.

              The renewal forms ask about our monthly earnings (wages) and income (I assume this includes Social Security) and nowhere mentions MAGI so it’s quite a surprise to me to find that our qualification is MAGI-based.

              I need to thank you for letting me know this.

  68. we are a family of 4 our in come ranges between 4,500-5,000 per month . what health plan best suits us and will it be expensive?

  69. Are we correct that we can purchase health insurance off of the exchange without premium assistance even though we fall into the Medi-Cal category?

  70. My wife and I have had some serious work challenges over the last year and our income has plummeted down ridiculously low but we’re still on a private-pay Kaiser plan.

    We just had our fourth child and the monthly premiums at Kaiser are getting a bit out of hand for us.

    Do we qualify for Covered California and at what level.

    We’re both self-employed at the moment so I’m not sure what kind of proof of income you need

  71. My employer will be providing a MEC – Minimum Essential Coverage plan through https://theamericanworker.com/ or Ben E Lect

    Does that keep me from the individual mandate penalty?

    If I don’t feel the coverage meets my needs, can I still get subsidies from Covered CA?

    • See the information above on “minimum value.”

      The American Worker website at https://theamericanworker.com/solutions/mecplans.html states that MEC is not minimum value, thus one would still be eligible for Covered CA subsidies.

      MEC [Minimum Essential Coverage] plans help employers meet one of the Employer Mandate penalties. By offering this level of qualifying coverage, employers will meet the requirement of offering “qualifying” coverage but not the requirement of “affordable” coverage. Employers must offer a Minimum Value Plan that meets the 60% Actuarial Value rule [Bronze] and affordability rules in order to avoid a $3,390 tax penalty for each employee who enrolls in a plan from the Exchange and receives a tax subsidy.

      See our webpage on budget plans for employers over 50 lives to avoid the tax penalties.
      https://employers.healthreformquotes.com/employer-mandate-over-50-lives/penalties/

    • Do you mean on Medi-Cal or with Covered CA subsidies? Click here and get a complementary proposal, benefits and subsidiy calculation. Note that Medi-Cal is 138% of FPL for the whole family. If you are above that, the parents can get Covered CA with enhanced silver and subsidies, while the children stay on till 266% of FPL. In certain northern counties till 322% of fpl. Again, the best way to see is getting the free quote. Even if you don’t qualify for Medi-Cal, with subsidies, the premiums are VERY low!

  72. With a income of 22,818.00 a year what does cover ca pay on a health net silver 87 plan, and what do I pay out of pocket.

  73. My question is about my mom, who is both a senior and disabled.

    She is currently receiving Medi-Cal aid since she requires a significant amount of home care during the day and early evenings.

    What is the income level for her to receive 100% Medi-Cal benefits for home care.

    Rather than the rate based on a “cost-sharing reduction”.

  74. i am head of household (IRS and CA FTB – CA Taxes) for my daughter and grandson who are both adults and grandaughter who is 2 yo.

    The three live full time with me, they have no income, and are all on medi-cal (no special circumstances).

    my AGI in 2016 will be approximately $78,000.

    can i claim them as dependents for tax purposes and still keep them on medi-cal?

  75. I am an independent contractor. I have 2015 1040 Profit and Losses [Schedule C?] and adjusted income proof.

    It should be the same for 2016. However, since taxes aren’t due until April and we already filed for an extension with the IRS, how can I prove my adjusted gross income? I won’t have until we file. I have 1099 forms from 3 employers but the losses are not included–it’s gross which is not what I clear.

    What to do?

  76. i am having a hard time trying to see if i can get medi-cal. i dont understand most of those charts. i am 60 years old drawing ssi – Supplemental Security Income from my deceased husband. i make 18,588.00 a year, i cant work and i am trying to get on disabilty. but not went through yet. can you send me to the right web site, or tell me if i can get it?

  77. What happens if I overstated my income.

    I’m self employed and my month to month income is not consistent.

    I’ve been covered with a PPO using APTC Advance Premium Tax Credit – subsidy for 2014-16.

    The first two years I made less than $5K and in 2016 I had no income at all. I’ve been borrowing to pay premiums.

    Each year I’ve “projected” approx $18K income partially to prevent falling into the Medi-Cal zone and I also naturally expected to do much better financially.

    CoveredCA has extended my coverage but they need to see evidence by March when checking with the IRS that all years have been filed. I’m just now filing my returns.

    Will I be able to keep my PPO the APTC for this year (2017) and how will the IRS and CoveredCA interpret all this?

  78. The number Blue Cross Help Line 1-844-301-5617 you provided for help is a SCAM and they will take your personal data and SSN. Please remove it from your article immediately so people are not affected by this scam.

    People should only call the number in the customer service numbers back their BCBS cards.

    • Thank you very much for pointing this out. We have removed the number. According to agent-link.net the phone # was set up on a temporary basis to handle the influx of calls the first year that 1095 B’s came out.

      I’ve received several bulletins about this year’s 2016 1095 B where the deadline has been extended. I’ll see if I can forward them to you. This page does not get much traffic, so I haven’t put this at the top of my priorities.

  79. Dear Sir: you probably have answered these before somewhere but I hope you don’t mind I ask again.

    1. My wife and I filed joint return, and the same for 2017. No dependent. If only one of the spouses has income, and we try to apply for Family Coverage on Covered California, are we going to be split into two different insurances? One spouse with income qualifies to buy subsidized metal plan and the other spouse without income only qualifies for Medical? Our line 37 will be approximately $28,000

    2. Regarding child eligibility. If I understand it correctly, ACA says you can keep your child under the family plan until he/she turns 26, but Covered California says a child cannot be included in the family plan unless he/she is claimed as a dependent on your tax. which one is correct?

    Thanks for your help.

    • Married people are mandated to file a joint return. Please get a quote from our complementary quote engine so that we can better help you. The subsidies are by tax return. See our income chart. You probably both qualify for Silver 87.

      Both answers are correct about age 26 and getting subsidies. Since your adult child won’t get subsidies as they are doing their own taxes, they should just get their own policy. There is really no family discount.

      Sorry, I had a computer SNAFU and didn’t see your question before. I hope you got coverage, as Open Enrollment is over. Do you have a Special Enrollment reason?

  80. Please help me. I am 75 yrs old retired newly immigrant. I just got my GC this year and I have never worked in US. I have income from my investments and from my pension in India.

    I applied for Obamacare coverage. On one side they want my income proof and on other side they are not able to direct me what documents I can show to them to verify my income in India.
    I submitted my annual statements from my banks in India which clearly show what my pension is and what my returns on investments are but still they do not agree to the documents.

    They need income proof documents like people have in US but in India there is no such such documents .

    Please suggest me what to do.

  81. I am so lost in all these health care programs. I am not from USA, but I am a citizen. When it came this thing of everyone having to have health insurance (2011/2012) [Obama Care] I was getting a divorce after being a stay home mother for 20 years. I never dealt with health insurance, I didn’t work, I just didn’t understand any of it. I was unemployed and qualified for Medi-cal, now my situation changed; one son still leaves with me, but he is 21 so I don’t think he counts as dependent anymore,

    ***Is he on your tax return? Click here for household definition.

    I got a job and I sold my house. Can you let me know what changes I should expect and what i should do.?

    My household is 3 ( me, my 13 years old daughter and my 21 one years old son), my income is $24,096.

    ***Click here and enter your information to our complementary Quote engine, it will let you know if you qualify for Covered CA Subsdies, Enhanced Silver or MAGI Medi-Cal.

    I sold my house that I had with my ex, but have been unable to buy a house to live as I don’t qualify for a mortgage (finally employed, but making minimum wage). Now I have all this money in the bank and I have been using it to pay rent. Will I lose my eligibility due to now having money that should go towards a house, but I can’t afford one?

    ***Under Health Care Reform, assets are not relevant for MAGI Medi-Cal. It’s if you household income is under 138% of Federal Poverty Level, chart.

  82. I agree that the consumer should be able to reconcile the PTC on their taxes with Form 8962 regardless of whether they opted in for a subsidy or not. I think Covered California is pointing to condition 1b above that the person was not eligible for minimum essential coverage from the government. The only way to know that is to do an income test and see if the individual or family is deemed Medi-Cal.

    However, we all know some family’s may have low monthly incomes, but still have a MAGI that is over 138% of the FPL at tax time. So technically, they weren’t eligible for Medi-Cal from the IRS standpoint. But because Medi-Cal is based on monthly income, CC deems them eligible, and indirectly ineligible for PTC.

    It has not gone unnoticed by people at Covered California that a family that truly won’t have a final MAGI below 138% of the FPL is being forced to be creative on the income section of the application. Some people say they are being forced to lie about their income to avoid Medi-Cal. But in reality, they are not eligible for Medi-Cal.

  83. I was told by covered California that they only count the AGI when you are self employed we have a pension and are on Social Security disability is only part of that taxable covered California considers it all taxable amount because they say they are considering the whole thing. I thought they only went by your adjusted gross income no matter whether your self employed disabled or working

    • I’m on vacation, so I can’t give you all the details and links. Please use the menu above and find the definition of MAGI income. It’s not the same as AGI line 37, there are things like Social Security that get added back in. See the menu here:

      http://taxcredits.healthreformquotes.com/quotes-subsidy-tax-credits/magi-modified-adjusted-gross-income-line-37/magi-faqs/

      And see what the treatment is for Social Security payments and pensions.

      If you send me a private email with all your tax documents, I can review them on the 30th when I’m back in town.

      You can also go into your Covered CA account and appoint us as your agent, no extra charge, so that we get paid to help you. Along with authoritative answers and citations to the law or actual insurance company rules.

  84. If my line 37 on my return is $40,103.. 3 people in house, i am only insured, 92656 is zip…

    I want blue shield Platinum, 90/10…can I get tax credits and if so how much?

  85. I am in the process of applying, [for Covered CA] I do long form taxes, [1040] can I deduct car registrations, home property taxes, amortization from rental and expenses on rental to lower my income.

    • MAGI income is defined at the top of this page. MAGI is line 37 of your 1040 plus foreign income, tax exempt interest and some Social Security benefits. For details of what goes on line 17 Rental Income, please see our rental income page. We are happy to be your agent for Covered CA and there is no additional charge. Click here for instructions to appoint us if you already have an account with them.

    • Know how adjusted gross income affects taxes
      • A taxpayer’s AGI and tax rate are important factors in figuring their taxes. AGI is their income from all sources minus any adjustments or deductions to their income.

      Generally, the higher the AGI, the higher their tax rate, and the more tax they pay.
      • Tax planning can include making changes during the year that can lower a taxpayer’s AGI. The taxpayer could:
      o Contribute to a Health Savings Account
      o Claim educator expenses if they’re a qualifying educator
      o Pay student loan interest

      A full list is on Schedule 1 of Form 1040.https://www.irs.gov/pub/irs-pdf/f1040s1.pdf

      Save for retirement
      • Retirement savings can also lower AGI. https://www.irs.gov/retirement-plans
      o Contributing money to a retirement plan at work like a 401(k) plan can reduce a taxpayer’s AGI.
      o Investing in a traditional IRA plan is another way to save for retirement and lower AGI.
      o Self-employed SEP, SIMPLE, and qualified plans are also retirement options that can lower AGI.

  86. Hi Steve,

    The county claims that they have a policy that indicates that if the housing allowance is paid directly to me, then it counts as salary.

    Pastor Jason

    ….****We will look into this matter on a new webpage.

  87. I have a Anthem PPO 70 Silver plan. I have one dependent, therefore a household size of 3. I currently am receiving a subsidy of approximately 900-1000 per month based on a $60,000 income. If I were to make more money, where does the subsidy stop.

    Thanks

  88. Hi,

    I have a couple of questions for you:

    I am currently receiving Medi-Cal and have had an increase in wages which has brought me to $16,938 in annual income. I desperately want to be enrolled in the Kaiser silver 94 HMO benefits through covered California.

    Will the increase in wages be considered a qualifying event?

    If I were to have you assist me would that remove the DHCS caseworker from determining approval or speed up the process?

    Thank you

  89. I recently was divorced as of January 6. I have lost my health insurance. I’m on Social Security disability and I get half of my husbands retirement. I did not file income tax last year,and did not want my x to use me as a dependpendt. If I take photos of these documents how do I send them in.

    • This question is more complex then it appears. The first thing is to get a complementary quote. We are building a new pages please use our search feature above to explain how to see if you qualify, get complementary quotes, calculate subsidy level, when you can enroll outside of Open Enrollment, sign up for complementary experienced agent support, etc.

      Here’s instructions on how to upload documents to your Covered CA account. If you appoint us as your agent, no extra charge, we can do that for you.

      You do need to file taxes. You also need to come up with a number for what you expect 2017 MAGI income to be. Line 37, plus Social Security, tax exempt interest and foreign income.

      Check with competent tax counsel on how you should file your 2016 taxes, being as you were still married. Going forward, married couples are mandated to file a joint return, (publication 974 page 4 section 2 c) if they want subsidies aptc.

  90. Hi Steve,

    I am trying to calculate my income to see if I am eligible for Medi-cal or what I can buy through Covered California [with a certified agent, at no additional charge]. Would you please answer these questions for me:

    1) Does spousal support count as income?

    2) Do gifts count as income?

    3) What time period is taken into account when calculating one’s income?

    Thanks,

    Linda

  91. Hello,
    I’m 66 years old My question is; if my income goes to about 16,000 do I qualify for Medi cal with no out of pocket expense including premium?
    Thank you for your response
    Best,
    Nora

  92. Hi,

    I was wondering if you could possibly help me with some questions I have about medical and covered California income requirements…

    Mary F

  93. I am moving and am using special enrollment to change my healthcare coverage. According to the rules, if I apply before the 15th of a month, coverage begins on the 1st of the following month. If I apply after the 15th, then coverage begins on the 1st of the second month after I apply. Thus coverage can start up to a maximum of 45 days or so after I apply.

    In applying, I was declared as “conditionally eligible” due to them requiring that I “verify income” by 90 days after my application date.

    My question is:

    Will I be uninsured for the period after my coverage is suppose to start up until the day the approve my attempt to verify income? This could be a 45 day period in which I need medical care. Or will I be covered for those 45 days and if they reject my verification of income – then will they drop me from my new plan?

    Thanks for all the help on your website!

  94. Hi Steve,

    1. I am on disability retirement and my wife is still working, self-employed psychotherapist.

    2. I get disability payments from Liberty Mutual (LM) which are not considered taxable income.

    3. Our cobra ends at the end of April.

    4. So I’m trying to continue with Kaiser but get the federal tax credit on the monthly premiums.

    5. Both Kaiser and Covered California told me that without including the LM payments we would qualify for Medi-Cal, but I know we would be disapproved because we have investment savings that would disqualify us.

    6. So, back to Covered California, they tell me go ahead and include the LM income so then I would qualify for the federal tax credits….was told that our total was just under the limit for 2 people of $63,720 so we qualify.

    7. I go through the application online with them on the phone and we get to the point of choosing a plan, and nothing shows up for the federal credit amount…..it just shows the full monthly price for the plan I chose.

    8. They went through the whole application again to make sure I didn’t make any errors, and they say its a glitch, that it should be showing a credit.

    9. They send a report to their Resolution Team. Tonight I get an online notification saying that our total income is over the limit!!

    10. Did the income limit get lowered, they don’t say.

    11. Do you agree that the $63,720 is the correct income limit to be under to be able to get federal tax credit?

    12. I know that Medi-cal disqualifies you for having too much assets, but does Covered California do that as well?

    13. Thank you for your help.

    • 2. The big issue here is whether your non-social security disability – retirement income counts as MAGI IncomeLine 37 of your 1040 + 3 other things – Foreign Income, Tax Exempt interest and Social Security Benefits. Click on the link for the EXACT definition.

      Do the Liberty Mutual Disability Payments show up on line 16 of your 1040? Anywhere on your 1040?

      For more information on whether Disability Payments are taxable check these links:

      Disability vs SDI State Disability

      Taxable vs Non Taxable Income

      IRS Publication 525 Taxable vs Non Taxable Income See page 17 the section on Disability Pensions.

      My interpretation, which I’m not allowed to give you, as I’m not a CPA or Tax Attorney is that your LM payments are showing up on line 7 of your 1040. Is that correct? Please check with competent tax counsel and respond below or email me privately as to what your line 37 Adjusted Gross Income will be for 2016.

      3. Cobra ending will give you a special enrollment period.

      5. I do not care what anyone says over the phone. Medi-Cal no longer has an asset test for Health Insurance Coverage under Health Care Reform. It’s all MAGI Income. Here’s a chart showing the income levels, Medi-Cal, Enhanced Silver and max amount for subsidies.

      6. While you might be under the limit of $63,720 – 400% of Federal Poverty Level – there is a complex formula CFR 1.36 B that tells you exactly what the credit will be. It’s not a yes or no credit – it’s how much. Click here to use our FREE Quote Engine to calculate your credit.

      11. Yes I agree, that’s what’s on the income chart. But it’s not a yes or no question. Use our Quote Engine to calculate.

      12. Covered CA is basically just a sales agent for Medi-Cal. It’s the same rules. Assets are no longer relevant for Medi-Cal.

      If you don’t qualify for subsidies and even if you do, the premium would be deductible from your wife’s self employment on line 29 of your 1040.

      How about going direct to an Insurance Company using the quotes from our quote engine above so that we can get paid for helping you and being honest about referring you to tax counsel and official IRS publications as to whether your LM income counts as MAGI income. IMHO it does, thus Medi-Cal is off the Table anyway. Did your phone calls get you any actual reference materials or citations. If you have a complex claim, who will be there to actually help you? Here’s 15 reasons how we can be of help. How long were you on the phone with Covered CA & Kaiser? Here’s instructions to appoint us as your Covered CA agent, if by chance our quote engine and your CORRECT MAGI income estimate gets you subsidies. There is NO EXTRA charge for our help. Covered CA and Kaiser will pay us, so that they don’t have to hire as many telephone people.

      Please note also that if your income goes over 400% of Federal Poverty Level for 2016 you have to pay back all the subsidies! Learn more ===> Premium Tax Credit Form # 8962

      Publication 974 Premium Tax Credit

      Here’s where a guy had to pay back $13k as Covered CA said Social Security Income didn’t count.

      Ways to keep your income under 400% of poverty level. But do not even think of asking me to get involved in any shenanigans with you!

      • Hi Steve,
        Been meaning to respond and give you updates. First off, thank you so much for your response back then with great information! You were right on many points.
        We ended up qualifying for Medi-cal because they don’t look at assets just “taxable” income. Since the LM disability income isn’t taxable we only had some dividend income and my wife’s small income (on our 1040) so we were under the limit to qualify us. We started 6/1 the day after cobra ended. It took a month, til 7/1, to get back on Kaiser again…Medi-cal through Kaiser. Had a health emergency on 6/9 and had to go to our neighborhood health clinic, but that lasted only a week fortunately.
        I’m awaiting an appeal on SS disability (initial SSDI claim was denied in March). That, I believe, will be considered taxable income, right? If so that could then kick us off Medi-cal, but will have to cross that bridge if/when that happens. LM required me to apply for SSDI and then appeal too because if it is approved they won’t have to pay me as much (about 90% of what they’re paying me now).

        Thank you again
        Sara

          • Hi Steve,
            My main question, that I can’t seem to find an answer to anywhere, is whether SS Disability income is considered taxable in the same way as SS retirement income is calculated. Everything I see is talking about SS retirement income, not disability income. Is there any difference when it comes to taxes?
            Thanks,
            Sara

              • Thanks Steve!

                I kind of hope they don’t approve the SSDI appeal. Not only will there likely be some of it taxed, but the non-taxable LM [Liberty Mutual] disability funds will be reduced, and we will be kicked off Medi-cal so will have to start paying something toward a covered california policy.

                A benefit, I guess, to getting SSDI, however, is that Medicare starts 2 years later and won’t have to wait til I’m 65 (so it’ll be about a year early for me).

                • Check out our complementary quote engine, above right, to see what your subsidies and enhanced silver levels are, depending on your MAGI income. You should be able to get a much wider provider list, which is also in our quote engine.

  95. 1. I have Covered Ca plan since 2014, I am self-employed.

    2. In 2015, my gross revenue was just short of $25,000.

    3. I had to lend my business lots of money.

    4. I have a 94 [Enhanced] Silver Plan and used to have a Silver 87 through Anthem.

    5. I have to send in a Profit & Loss Statement [Schedule C] for 2015 and am worried I may not be able to keep my insurance.

    6. What are your thoughts?

    • 2 The question is, what number will you be putting on line 12 of your 1040 Business Income or Loss.

      3. I don’t know where lending money to a business shows on Schedule C. See our Schedule C page for Official IRS Instructions or contact competent tax counsel. Here’s VITA which is run by volunteers and its free.

      5. What will you have for line 37 MAGI Income?

      6. If your income is too low, then you get FREE Medi-Cal. If you want private coverage, you can opt out of subsidies and pay the full price. Here’s our FREE Quote Engine. The quote engine will calculate subsidy and Medi-Cal qualification based on MAGI Income.

  96. Hi Steve—

    1. I’ve CCed [redacted] (my wife), and [redacted] (my Mom, who has strong opinions re my healthcare)

    2. For the last 2 years I’ve been on an [redacted] PPO through the [redacted] union.

    3. On March 31 my coverage ended.

    4. I’m trying to figure out how to best proceed. I would like a PPO (my Mom feels strongly that it’s a plan where I could be treated at a hospital of my choice out of state if I’d like).

    5. Also, this year (for the first time) I’m filing my taxes jointly with my wife.

    6. She has been on Medi-Cal due to her tax bracket, but we’re presuming that since we’re filing jointly now, she may be ineligible for Medi-Cal some point soon.

    7. How does that work? How/when would we be notified?

    8. Finally, I’m curious how your services work re payment. Will using your services cost me more money than going through the Covered CA marketplace?

    Thanks so much!

    Best,

    Jerry

    • 3. That gives you 60 days to get new coverage – Learn More

      4. Click here to get quotes from ALL companies, with and without subsidies, in and out of Covered CA.

      7. The quote engine will give you a calculation of what plans your qualify for based on MAGI Income. Line 37 of your expected 2016 tax return. But that is simplistic – click on the click for exact definition of MAGI income. See also the income chart.

      You are supposed to notify Medi-Cal within 30 days of income or family status changes. You will hear from them if your wife no longer qualifies. I don’t get paid to do Medi-Cal. Here’s everything I have on Medi-Cal. When your wife gets notified that she’s losing Medi-Cal that gives her a special enrollment period. Also, there is a special enrollment period when one gets married.

      8. I get paid from whatever insurance company you choose. The 10 minutes I spent answering your questions today – save them time and money. I would also hope that with my education, background and experience, you are getting better and more helpful answers here.

  97. Hi Steve:
    I got a letter from Covered CA asking more proof of income or risk of losing coverage or subsidies by April 10th. I had a full time job in 2015 so my income is much higher than what I will have in 2016 since I’m now retired due to health. I submitted an affidavit explaining my situation as well as an letter from my former employer stating this fact. Also, I’ve submitted the final paycheck stub and my investment account statement.

    As of today, I’ve also submitted the 2015 Federal Tax return along with Schedule D. I don’t know what else will they need since they are not very specific on what kind of form they want to see and if my last year income will affect the subsidy amount.

    Thank you in advance for your response.

    Ryan Le

  98. Is the income limit for premium assistance based on the persons AGI (adjusted gross income) as I was told by the agent at Covered California ?

    • That is very close and I would still give that phone representative the cigar, however it’s not fully accurate.

      First, the term is MAGI, Modified Adjusted Gross Income, which is AGI plus a few extra things for some people. Learn more on our MAGI page. Be sure to read carefully and never trust anything over the phone and without documentation. Here’s where Covered CA’s advise caused at $13k refund of all the subsides as they didn’t tell the client that he needed to add back in Social Security Income.

      Second, what you did last year is only a guide. The issue is what do you expect your CURRENT year MAGI income to be? Thus, if you earned say 20K last year as a single, sure you get premium assistance and enhanced silver benefits but if you earn over $47k you have to pay back all* the subsidies at tax time. That is why there is a rule to report income changes within 30 days.

      • my income did not change from the number I used when I signed up; and it isn’t going to change this year either. They approved me for premium at that income but when I do my taxes- Im told I owe it all back…!

        • Please when stating income, give more details.

          What was your MAGI Income, line 37 of your 1040 + a few extras for 2014 and 2015?

          What is your line 22 total income?

          How are you defining income?

          What was the reason your tax person said that you owe all the Advance Premium Tax Credit back?

          Do you get Alimony, line 11?

          Schedule C Business Income Line 12?

          Were you offered affordable coverage 9.5% at work?

          Are you claimed as a dependent on your parents tax return?

          Student Loans?

          Eligible for coverage on parents coverage? Spouses Coverage?

          Lawfully Present in the USA?

          Please co-operate, since we are not your agent and not getting paid to help you, by getting a FREE quote and subsidy calculation on our website, so that we have an idea of what your MAGI income is and what the subsidy should be.

          Click here for instructions to appoint us as your agent, so that we can get compensated to help you, no extra charge.

          Covered CA states all over their website that they don’t give tax advise. One must read the OFFICIAL IRS Rules Publication 974 – 71 pages to get authoritative answers. Here’s where the wrong answer from Covered CA caused someone to pay back $13k as Social Security counts as MAGI Income.

          It’s a real shame that our government is so much like the emperor wears no clothes. I went to a seminar where our local congress person had a speaker give us WRONG information about how things were Pre Obama Care. When I raised my hand to correct her, the Congress Woman’s Aid and the other speaker told me that I must NEVER correct or interrupt a well respected Congresswoman’s Dog & Pony show!

          You are welcome to email me the relevant documents privately.

  99. Hi, i am currently on Medi-cal. i am about to turn 65 and will be required to register for medicare.

    How do the two work together?

    What will my choices for coverage be? What about the supplements?

    Thanks so much

  100. 1. In 2015 I only had international insurance for 4 months before

    2. my medicare started in may.

    3. I lived in Mexico more the 330 day exemption for living abroad.

    4. The health insurance form 8965 asks for exemption certificate # in part II, and asks for exemption type in part III.

    5. What do I put in those columns.

    • The instruction for Form #8965 https://www.irs.gov/forms-pubs/about-form-8965 page 3 say the Code for Exemption is “C” and it’s claimed on your return. It doesn’t require Covered CA to grant the exemption.

      Thanks for pointing out that I had linked to the 2014 Form 8965.

      I think you are confusing the parts…

      …..Part 1 is for market place granted exemptions
      …..Part 2 Household Exemptions
      …..Part 3 Line 8 Column C is where you would put “C” for your exemption as living out of country.

      I’m not a CPA… Free Tax Advise is available at VITA.

  101. Good morning Steve,

    So do I need to make F 1040 EZ as my income equal to $12000 per year, or do I need to count $18000 to IRS? Please let me know which income should I report for 1040 EZ.

    Thank you very much.

    Mark O

    • Sorry, I’m not licensed, educated or trained on filing taxes. I do have a webpage though with links to the 1040, instructions, more forms and information including FREE tax assistance from VITA. So, check that out.

  102. If a person owns property and is on Covered California will all the medical expenses have to be payed paid back after the death of the person on Covered California?

  103. Hi, Steve. I qualified for Enhanced Silver 94 in 2015 using my 2014 income. Now I am doing my 2015 taxes and I need to know how much to put into my IRA to maintain this coverage (since I need some operations).

    I need to know the exact range of MAGI for 2015 and 2016 that will let me keep this coverage.

    Household= 2 people (one 66 year old on Medicare, so not eligible), me, 63 years old.

    Are you accepting new clients? Do you do taxes too? Thanks, Brian Alexander

    • Telling you an exact range is likely to get me in Federal Prison… Here’s a chart that shows the numbers. See the FAQ’s there is some question about the multiplication of the Federal Poverty Level X 138%… I also suggest you play with the numbers on our FREE quote engine.

      The “exact” range is VERY narrow. I dislike selling the Silver 94 as so many people wind up in Medi-Cal.

      Yes, we are accepting new clients. No we don’t do taxes. I’m only this involved, as I took a 2 S deferment from Vietnam to get a Bachelors Degree in Insurance. President Obama as Supreme Commander of US Forces, called me to duty.

      Click here for instructions to appoint us as your agent.

      • Thanks Steve. So I need between 138%-150% FPL (2014) to calculate my IRA contribution for 2015.

        I always put money into our IRAs, I just needed to know how much to put in there now to keep my 94 silver. Thanks, It’s pretty simple. Brian

  104. Stive

    Earlier of the 2016 we spoke of income for 2016 . Which income are we spiking of please advise .

    Regards

    Diane P

    Sent from my iPhone

  105. Good morning Steve,

    After starting this year, I tried to get money for my target of $1,500/month – $18k/year MAGI Income to be on enhanced Silver and I made a ledger sheet from Jan. to March. (some are in estimate).

    However, I could not find where to apply the ledger sheet and receipts at the Website of coveredca,com.

    Do you know where can I find to send those documents (for my quarterly income proof)?

    Thank you very much.

    Mark O

  106. i am self employed and won’t get all the docs i need to file 2015 taxes until much closer to 4/15/16. However, Covered CA wants proof of income or threatens dis-enrollment by tomorrow, 3/10. How can they do that and what do i do?

    • That’s a really good question. Let’s take a look at the letters and information they sent.

      Given a little more time, I’m sure I could find a reason that they can’t. Everything I’ve seen before said one had 90 days to prove income, lawful presence, Insure Me Kevin.com. We could look up those citations. In the meantime, I suggest you appoint us as your agent. No charge. Send us everything you have to show 2016 and 2015 income and we will contact them and ask for more time. It doesn’t make sense they would want your 2015 tax return as it’s not due till 4.15.2015.

      What is your expected MAGI income for 2016? What was it for 2015 and 2014? What income proofs have you sent so far? When did you first get coverage with Covered CA?

  107. A side observation- it seems to be a really weird system to navigate for someone who is self-employed and has unstable income.

    Actually, it’s weird for everyone, in the sense that no one really knows if their income will change suddenly for better or worse, and then they’ll have to resolve things retroactively with IRS.

    • That’s why they want you to report deviations of more than 10% of your estimated annual income within 30 days. See link for publication 5152 and job aid for reporting income above.

      • Haha thanks for your responses, I didn’t know about the monthly thing! Wow you are SO knowledgeable, it’s incredible. As a knowledgeable insurance agent, you’re basically a rocket scientist.

        Okay I’ll get the documents together and send them to you.

        Thank you so much,

        Mindy

  108. Kirk . . .

    Who is responsible for CoveredCA’s newly released (“March 3, 2016”) MAGI numbers for household sizes 1-6?

    All of the “138%” amounts stated for these 6 households are higher than 138%, by up to as much as 1.28% for a household of 1 to just 0.04% for a household of 6. The numbers for 7, 8, and each additional person over 8 are correct.

    The effect of this error will be to force some persons into Medi-Cal, unjustly denying them access to CSR-enhanced commercial health insurance.

    Attached is a print of the Excel spreadsheet I have used and shared with other agents for three enrollment periods now, and its numbers are accurate to within $1.00.

    MAX

    MAX H. HERR, MA
    Life & Disability Insurance Analyst
    California Insurance License #0596197

    MAX HERR INSURANCE SERVICES
    Pomona, CA 91766
    http://www.maxherrinsuranceservices.com

    • Well, I guess we’re both right and both wrong. I found a document from HHS issued in the Federal Register on January 25 (no wonder no one heard about the changes) that was an update to the previously released 2016 FPL guidelines. https://www.federalregister.gov/articles/2016/01/25/2016-01450/annual-update-of-the-hhs-poverty-guidelines#t-1

      according to the January 25 update for the 100% FPL guidelines, your 138% column values are correct, but your chart did not update the 100% column with those values. As a result, all of your subsequent column values other than 138% are also incorrect. Attached is my revised worksheet with unlocked formulas so you can see for yourself how the numbers should be calculated. You might want to revise your document accordingly.

      MAX
      On 09-Mar-16 09:45, Duran, Gil (CoveredCA) wrote:
      Hi Max,

      The FPLs introduced into the application on 3/7 are set by the federal government, and the chart we released to agents was reviewed by our Legal and Policy divisions. I am confident they are accurate figures. The issue may be that the way Medi-Cal eligibility and APTC eligibility are determined uses two different years for determinations. Below is a summary of the issue which can also be found in our release notes here. I found this chart is also helpful to explain what happens when Medi-Cal changes to start using 2016 FPLs.

      Let me know if you have any questions,
      Gil

       Covered California and Medi-Cal use the FPL to determine financial eligibility for Insurance Affordability Programs (Medi-Cal, Advanced Premium Tax Credit, Cost-Sharing Reductions, etc.)
       FPL is a function of household size and income
       The FPL guidelines adjust every year for inflation
       The FPL guidelines are issued at the beginning of each year by the U.S. Department of Health and Human Services (DHHS)
       DHHS issued the 2016 FPL guidelines per Bianca’s email below; DHCS has chosen to implement in the release this weekend
       Modified Adjusted Gross Income (MAGI) Medi-Cal eligibility determinations in the online application will use 2016 FPLs as of March 7, 2016
       Per regulation, Covered California (APTC/CSR) will continue to use 2015 FPLs through the 2016 coverage year.
       How will this affect consumers?
       New consumers will first be evaluated for Medi-Cal eligibility, using 2016 FPLs. If not eligible for Medi-Cal, they will be evaluated for Covered California (APTC/CSR) using 2015 FPLs.
       Covered California consumers who report changes may be reevaluated for eligibility and find that they now qualify for Medi-Cal.

  109. Hello Steve.

    Thanks for your time. Bob P here.

    I would like to know the income levels to stay above medi-cal becoming involved in my insurance for 2014 and 2015. Thank you so very much.

    Bob P

  110. Hi Steve,

    I appreciate your responses.

    1. However, I’m confused from the link to the income chart.

    2. I’m also confused how I was able to get off Medi-Cal for January but something got booted off now and you need new documentation that you did not need before.

    3. At this point, all of a sudden, I’m not even sure if I’m still on Anthem Blue Cross or on Medi-Cal or nothing?

    4. And it’s on auto-bill pay so I’m not sure if March was even paid or will be automatically billed. What a mess.

    Thanks,

    Mindy

  111. Will a letter from someone saying they will gift me $X amount by Y [December 31st] if I don’t make [enough] equivalent money [MAGI Income *** Line 37 1040] from my own business to qualify for Covered CA subsidies, rather than MAGI Medi-Cal be sufficient for proof of income?

    If so, what are the minimum requirements for X and Y?

  112. Hi Steve,

    I just got my my taxes done this past week and found out that i had to do a repayment and ended up losing $357.00 on my federal tax return. I was wondering if you could make an adjustment on income so i don’t have to take as large of a discount so this doesnt happen in the future, thank you

    ~Tom

  113. I’m trying to help my son in CA renew a medi-cal eligibility based solely on income. He’s self employed (sch C), and I believe based on his past business expenses that his AGI (line 37 on the 1040) for the 2015 return will fall below $16200. However, from what I’ve read so far

    1. certain sch C deductions are not allowed.

    His 2015 return is not yet completed. Is this true? Any thoughts or recommendations for his renewal application?

  114. Hi Steve,

    I’m enrolled in anthem blue cross viA California Covered Care.

    I get letters that contradict each other routinely. One letter says I’m covered , the other says I’m not.
    I’ve spent hours on phone with California covered care with people who have questionable English literacy.

    I need a professional to deal with California Covered as they are too disorganized for a non insurance specialist to deal with all their idiosyncratic behavior.

    Can you help me ?

    Thanks,

    Martin

    • Yes, we would be glad to help you. Two things that you need to do to transfer your case to us.

      1. Change your Covered CA agent delegation to use. Here are the instructions. If you have trouble, just send us your user name and password and we can do it.

      2. Email us for the Blue Cross Change of Broker Form Blue Cross though has tricky rules and if you are a “house account” they might not pay us.

      Once we have access to your Covered CA account, we can view all the letters they send you. If Blue Cross won’t recognize us as your agent, then:

      3. Get an ONLINE Member Account and give us the user name and password for that.

      Then we should be fully able to help you. If you were to get additional coverage, like Life Insurance, Long Term Care or Disability that would be a way to compensate us for our time, if you are a “House Account” or you had coverage with Blue Cross prior to 1.2014.

      Steve

  115. I know my friend that I sent you as a referral was concerned about last nights deadline. Glad to know that she would be eligible for a special enrollment period once she gets her 1st paycheck. Is it ok that she is 1099, not w2?

  116. I am going through a divorce that will finalize this year and as a result will lose my health insurance. Last year I filed taxes jointly and thus do not have my own filing for proof of income. I’m only receiving income via spousal and child support. What kind of documentation can I provide as proof of income?

  117. Off exchange plans may not require lawfully present documentation on the part of the prospective health plan member. Any plan sold through the exchange and eligible for APTC can only be sold to lawfully present individuals that can provide proof. Eligibilty conditions for enrollment in a specific health plan can usually be found in the carrier’s Evidence of Coverage.

  118. I have my lady I’ve been with for 25 years that has a social security number …but her immigration status wasn’t fixed…….I am getting the adjustment of lpr [lawful presence?] filed this week….we got married on the dec 31….she’s been here for 35 years. ..

    I need to get her real coverage….I was stuck overseas and just came back yesterday!!!

    What can I do? Help…. she has a cancer…..

  119. If someone loses their job and unemployment states that they can not get unemployment how can they prove they do not have income? How do you verify proof of income if you do not have an income?

  120. I left my previous job in Dec 2015. I am currently out of job. I think I will maintain my out-of-job status till the end of May. So I have no income this point. But my estimated income if I start working in June will be around $45000. Should I qualify for Medi-CAL now? But my estimated income will be higher than the amount of Medi-CAL requires, the CoveredCA gives me an enhanced Silver 87 benefit.

    So what income should I input? and what program should I enroll?

    • Everything comes out in the wash when you file your 2016 taxes. So since your “vacation” is voluntary, I suggest you use the $45k and enroll now. The deadline is Sunday night. If you use a certified agent, the deadline is next Saturday the 6th.

      If you qualify for Silver 87, that’s great. Not only subsidies, but 17% extra benefit that Silver 70. http://enhanced-silver.com/

      You can get quotes, subsidy calculation on this website by clicking here.

      How about using the time to search for a job that includes benefits and see if you can earn say $80K working and contributing more to the economy?

      • I wish I can start searching for the job earlier. But I need to take care of my kids and finish my study. I was taking leave of absence from school to take the job to pay for my kid expense. Now, I have a little bit of saving for us to survive through June this year. Since I voluntarily left my previous job, I am not eligible for my school’s insurance program. Then I have to look for alternatives.

        I am so confused about estimated income. I talked to the agent at CoveredCA. They said since I am not earning income at this moment, I should enroll in Medi-Cal even though my income for the whole 2016 may be higher as I may get penalized for not enrolling Medi-cal if I am eligible to. But then if my whole 2016 income is higher than what is allowed in Medi-Cal, what will happen? I am very confused.

        • Right, kids and studies are important. It’s our future. I’m not sure if you would qualify for Medi-Cal now, that you are unemployed, BUT your estimated 2016 income is too high. I’m running out to go to a concert and then visit my Aunt and Uncle. I will post more on estimated income and Medi-Cal shortly.

          In the end, it’s all based on MAGI Income, line 37 of your 1040.

          Sometimes it’s difficult to get out of Medi-Cal.

          Don’t forget, neither Covered CA or I, am allowed to give tax or legal advise. Since we have a deadline tomorrow or Saturday… You might apply for Covered CA now and then apply for Medi-Cal and see if they accept you. Direct Medi-Cal enrollment is here…

  121. 1. What is the minimum income to qualify for a subsidy? Does withdrawal from ira count as income toward the qualifying amount?

    2. If I receive $12000 from disability and take$5000 from my Ira, do I qualify for a subsidy.(Assuming the qualifying amount is $17000.)

    3. Also, can I revise my previous year income tax and qualify for the previous subsidy as I mis -calculated originally and made $17000 .

  122. I am currently receiving Medi-Cal due to low income (my MAGI is less than 138% FPL).

    On my 65th birthday, I will get to keep Medi-Cal just by being 65 years old, even if my MAGI is greater than 138% FPL. Is this assumption correct ?

    Regards,
    Tom N

  123. If I sell my home and have a capital gain (even after the Sec 121 exclusion), will that gain affect my Modified AGI? Will that gain count toward the income which could push my income high enough to require me to pay back my State Exchange subsidy?

    • I believe so. I’m not a tax attorney. I will check with one though or a CPA. In the meantime, do NOT cite my reply, but check the links to actual law or government publications.

      Here’s more on the Section 121 exclusion, sale of a home – primary residence.

      Gross income shall not include gain from the sale or exchange of property if, during the 5-year period ending on the date of the sale or exchange, such property has been owned and used by the taxpayer as the taxpayer’s principal residence for periods aggregating 2 years or more.
      (b) Limitations….

      So, whatever you have as Capitol Gains in Schedule D, gets added to line 13 of your 1040 and thus increases line 37 where MAGI – Adjusted Gross Income starts then add in, non taxable Social Security, foreign income and exempt interest. See our page on MAGI – Modified Adjusted Gross Income.

      Check out Sale of your home publication #523

      Learn more about paying back subsidies when you do your taxes in Publication 974

      Get free quotes and calculate subsides here.

      It’s possible to that you might have penalties in addition to paying back the subsidy.

  124. 000 Error corrected per agent email

    You may also be aware that our Covered California online application system generated an error message in many instances when 1) submitting a new application with a qualifying life event or 2) processing a renewal. The error has been resolved and the renewal process should be much smoother. We have confirmed with the Agent Service Center and the CEC/PBE Help Desk that they have not received any calls indicating the error. Please continue to help consumers renew their health care coverage and complete special enrollment applications.