Seasonal Work with Benefits Question

[G.Gordon]

Wife works 6 months/year, has group benefits available for her and spouse, but the day they lay her off every year in March, the benefits end.


Q: Since she only works six months which is ~120 days or less, can she legally answer NO to benefits available and question on the application and get a subsidy?

 

[Yagents]

No. But losing group will create SEP each year and they can say no at that point

 

[G.Gordon]

Just did a live chat with Healthcare.gov, trust them as far as Medicare.gov, but the chat said NO, they are not considered full time with benefits available.

 

[Yagents]

Bc.gov doesn't ask if full time, just asks if group avail. Clawback danger danger

 

[G.Gordon]

What about this: We wait until they lay her off in March, if later use SEP, apply for coverage the earliest possible. If they have coverage for say April 2013 and on, do they ever have to answer or qualify again? Is the subsidy an annual event?

 

[Yagents]

do they ever have to answer or qualify again? Is the subsidy an annual event?

I believe so........................but the HC.gov account will already be set up. It should be rather easy if you keep their username/password handy. Log in, update income, pick plan.

 

[G.Gordon]

Lets go from this angle.


Affordability: insurance for her at work, $40/week while working, $450/mo when not. That is about $3750/year in premium to stay insured. Doing reverse math, she would have to make over $39k/year for that to be "affordable". She only makes $14k at work, then unemployment is less than that for the rest of the year.


What say the gallery?