Would this Scenario Get a Special Election And/or Subsidy?

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Thanks for any input in advance.

23 year old female making $15k a year, files her own taxes. Currently on her parents group plan that is renewing 8/1/2014. The parents are saying they don't want to pay for her coverage. Would this be eligible for a subsidy and a special election for an 8/1 effective date?

Cheers!
 
No and No.

She is definitely NOT eligible for SEP as there is no involuntary loss of coverage. And since prez O thinks it's such a great thing that you can keep your kids on your group plan until age 26 (access to group coverage), she is not eligible for subsidies either. Isn't this a great law?
 
No and No.

She is definitely NOT eligible for SEP as there is no involuntary loss of coverage. And since prez O thinks it's such a great thing that you can keep your kids on your group plan until age 26 (access to group coverage), she is not eligible for subsidies either. Isn't this a great law?


Thanks, that's what I wasthinking. The father is a group agent and keeps telling me that they do get a subsidy. I am trying to tell him they do not get the subsidy but can't find the wording in the regs to prove it.

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No and No.

She is definitely NOT eligible for SEP as there is no involuntary loss of coverage. And since prez O thinks it's such a great thing that you can keep your kids on your group plan until age 26 (access to group coverage), she is not eligible for subsidies either. Isn't this a great law?

The plot thickens, technically he could drop her from the plan and she would have an involuntary loss of coverage according to healthcare.gov call center. Gotta love this law!
 
I may be wrong, since she files her own tax return:

Options For Young Adults: Stay On The Folks

Q. Can a young adult qualify for subsidies on the exchange even if she has access to health insurance on the job or through her parents' plan?

A. It depends. Assume for the moment that the young adult is not claimed as a dependent on her parents' tax return. Even if she has access to her parents’ insurance, she can shop for a plan on the state marketplace. In addition, if her income is between 100 and 400 percent of the federal poverty level, she may qualify for subsidies as long as she doesn't have an offer of good health coverage through her own job.

If her own job offers health insurance that meets the ACA's standards for affordability and adequacy, however, she wouldn’t be eligible for subsidies on the exchange. Under the ACA, a plan is considered affordable if self-only coverage costs no more than 9.5 percent of a person's income, and adequate if it pays for at least 60 percent of covered medical expenses.
 
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Thanks for any input in advance.

23 year old female making $15k a year, files her own taxes. Currently on her parents group plan that is renewing 8/1/2014. The parents are saying they don't want to pay for her coverage. Would this be eligible for a subsidy and a special election for an 8/1 effective date?

Cheers!

Something to note.....her share of the group coverage would probably be cheaper than her buying it on her own....unsubsidised.

Also, parents have the option to continue to have their children on their policy until 26 in most cases...but they are not required to.

IMO if she was dropped from the group plan (parents choice not hers) that means a loss of coverage. If she is removed from the group plan, group wouldn't be available as an option i.e. not being offered by her employer / disqualifier for a tax credit.

While the sittuation is a bit sticky to say the least, have someone at HC.gov assist you with the clients applicaiton to reduce any liablity you may face.
 
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Readers Ask: What Options Do Parents Have To Get Coverage For Their Kids? - Kaiser Health News

Q. My 21-year-old son is a college student, and I know the Affordable Care Act has made him eligible to remain on my employer-based insurance plan until age 26. However, if it's cheaper for him to get subsidized coverage through the health insurance marketplace, can he do so?

A. It depends. Almost anyone can shop for coverage on the health insurance marketplace. But your son will only be eligible for subsidies to reduce the cost of coverage under certain circumstances. If you don't claim him as a dependent on your tax return and his own income is between 100 and 400 percent of the federal poverty level ($11,490 and $45,960 in 2013), he could be eligible for premium tax credits on the exchange. But if you do claim him as a dependent, his eligibility for subsidies will be based on your family's income, not just his own.
 
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