Liability of Giving "Tax Advice" to ACA Clients

ARios

New Member
19
Well the first maiden year of ACA is behind us. Tax season is ramping up and now I feel I'm on the hot seat for all the individuals I enrolled and who qualified for APTC.

Yesterday a client came to see me who told me last year he made $27,000 for his family of three. He brought a 2013 Tax Return for verification.
(He had originally told me $33,000 this time last year)

This client qualified for a $1000/month APTC in 2014 based on the info he originally provided me.

To make matters worse, he had a Schedule C that reduced his AGI to $12,000 in 2013. Had I known this last year he would have qualified for expanded Medicaid in my home state of Kentucky.

I feared he would have to pay back the $1000/month APTC at 2014 tax time, but have since learned that their is a cap on what citizens should have to payback if they "underreport" their MAGI. In his case $600 (another blow to the nose for us taxpayers!).

My question is: I feel exposed from the liability of signing up people on ACA plans that qualify for APTC. Does anyone use a "waiver" or something for clients to sign to CYA ?

Should I be concerned?
 
There's a thread on the Health Care Reform forum, that talks about proposed rules for 2016, and CMS thinking about a proposed rule that would penalize agents who help clients "fib" about their income (their phrase, not mine). They would impose large fines ($25000 - $250000 per case).

The point is - I believe the objective here is to eliminate the agent from participating across the board. If they do adopt rules to come after the agent, I know I won't deal with subsidized people anymore at all.
 
You're looking at 2K13 numbers and not 2K14 which is what is used to reconcile the APTC for the 2K14 plan year. 2K13 would have been used as a litmus as to what they may qualify for APTC wise.

Now on to the penalty, If a person estimates their income to be higher than what they actually made then as long as they were above the FPL threshold for the Medicaid expansion states then they would be due additional APTC amount come tax time. However, it's my understanding (please someone correct me if I am wrong) that if said consumer was far short of the expected income and fell below the 100% FPL that they wouldn't be responsible for the clawback\penalty.

As for a way to reduce the liability from a phone call style enrollment make sure that the calls are recorded. Self Service web apps should be able to record the IP address. Good quality Security cameras in office would help protect you in a face to face environment.

I hope this helps.

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http://www.insurance-forums.net/for...form-8962-no-clawback-under-100-a-t72096.html
 
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