“NO” Health Insurance in 2014? Now facing a TAX penalty? You may have a “Special Enrollment Period”

By Ulla-Undine Merritt (Dee) National Producer Number (NPN) 8853366

You may still be able to enroll in 2015 coverage “IF”:
• You didn’t know until after Open Enrollment ended on February 15, 2015 that the health care law required you and your household to have health coverage, or you didn’t understand how the requirement would impact you and your household
• You owe the fee for not having coverage in 2014
• You aren’t already enrolled in 2015 coverage through the Health Insurance Marketplace

If all of these apply to you, you can enroll in a 2015 plan between March 15 and April 30, 2015. So there is still hope and we find that many people have gotten frustrated, received misguided information and also did not understand what Modified Adjusted Gross Income is.  Working with a Qualified Licensed Market Places Insurance Agent that is licensed with multiple carriers can be a big help.

Did you know: If you are the only person in your household: Your yearly income is between $11,670 and $29,175, you may qualify for lower premiums and out-of-pocket costs for Marketplace insurance. Income up to $46,680, you may qualify for lower premiums on a Marketplace insurance plan. If there are 2 people in your household: Your yearly income is between $15,730 and $39,325, you may qualify for lower premiums and out-of-pocket costs for Marketplace insurance. If your yearly income is up to $62,920, you may qualify for lower premiums on a Marketplace insurance plan. The list goes on, so hopefully you get the more people in the household the more income you can earn and still qualify for premium tax credit.

Big misunderstanding is that receiving the tax credit gives you less medical coverage or less access to care and doctors. In most cases the plans offered on the Market Place (Exchange) are also offered OFF where you do not receive tax credit. Now there are more plans offered OFF of the Market Place than ON but there are many plans offered and in most cases I find my clients choose the same plan on and off, or tax credit or not. Another big misunderstanding is that your assets are considered, NO just your Modified Adjusted Gross Income.  I am not an accountant and you should check with the IRS Rules or your CPA. Good rule of thumb is it is you’re W2 Wages less pre-qualified deductions, now if you own a business or receive a 1099 you can flow through losses. Again check with the IRS www.irs.gov or CPA.  If you miss this Special Election Period and you don’t enroll in health insurance now, you may be penalized up to 2% of your earnings in 2015. Also you CAN”T BUY qualified health insurance for the rest of this year unless you have a special election period.  Other Special Election Periods are loss of coverage; marriage; child birth or adoption; divorce, etc. visit www.healthcare.gov for rules, timelines and exceptions.

This month is Alcohol Awareness Month: The Affordable Care Act has made addiction as part of the health insurance plans.  Substance Abuse and Mental Health Services Administration SAMHSA is a perfect reference source.  From their website: Get the facts on alcohol and the impact abusing alcohol can have on people.

Slightly more than half of Americans aged 12 or older report being current drinkers of alcohol. SAMHSA’s National Survey on Drug Use and Health (NSDUH) reports that in 2013 there were 136.9 million current alcohol users aged 12 or older, with 22.9% classified as binge drinkers and 6.3% as heavy drinkers. About 17.3 million of these, or 6.6%, met criteria for an alcohol use disorder in the past year. Excessive alcohol use, including underage drinking and binge drinking (drinking 5 or more drinks on a single occasion for men or 4 or more drinks on an occasion for women), can increase a person’s risk of developing serious health problems, including brain and liver damage, heart disease, hypertension, and fetal damage in pregnant women. According to the Centers for Disease Control and Prevention (CDC), alcohol use causes 88,000 deaths a year. Many Americans begin drinking at an early age. According to the SAMHSA report Behavioral Health, United States, 2012, about 24% of eighth graders and 64% of twelfth graders used alcohol in the past year.

According to the NSDUH:
• Men are more likely to report heavy alcohol use (binge drinking for 5 or more of the past 30 days) than women, 9.5% to 3.3%.
• People reporting two or more races had the highest rate of heavy alcohol use at 8.9%, and 7.3% of non-Hispanic whites reported heavy alcohol use. African Americans reported heavy alcohol use at 4.5%, and Hispanics reported it at 4.8%. At 2%, Asian Americans had the lowest rate of heavy alcohol use.
• Only 7.7% of adults with an alcohol use disorder received treatment in the past year.

For more information on alcohol facts and its effects on your brain and body, visit the National Institute on Alcohol Abuse and Alcoholism.

For more information about the treatment of alcohol use disorders, including medication-assisted treatment, visit the Behavioral Health Treatments and Services topic. For more information about alcohol use disorders, see the Mental and Substance Use Disorders topic.

To learn more schedule an appointment contact:
Logical Insurance Solutions
Dee Merritt
239-362-0855
www.Logicalinsurance.com
Dee@Logicalinsurance.com