Q: How does the American Rescue Plan impact healthcare insurance?
A: The American Rescue Plan (ARP), which was signed into law on March 11, 2021, temporarily makes health insurance coverage more affordable for more people. It:
- Reduces the percentage of household income that you contribute to your monthly Marketplace benchmark plan premium in 2021 and 2022, regardless of income level.
- If your household income is between 100-150 percent of the Federal Poverty Level (FPL), you may be able to get a plan with no premium costs.
- Many people will be able to find a plan for $10 or less after advanced premium tax credits (APTC) are applied.
- Some people will be able to find a Silver plan for $10 or less after APTC. Applicability for PTC increase: 2021 and 2022 plan year
- Provides tax reconciliation forgiveness for the 2020 tax year.
- Subsidizes COBRA premiums in 2021.
- Expands Medicaid and Children’s Health Insurance Programs (CHIP) to include coverage for women up to 1-year postpartum.
Q: When do American Rescue Plan changes take effect?
A: These changes took effect on April 1, 2021.
- If you are submitting a new Marketplace application or are re-submitting an existing application, your eligibility results show the advanced premium tax credit (APTC) you qualify for beginning the first day of the month your insurance coverage begins.
- The new APTC amount will be applied to your coverage starting May 1, if you update your application and enroll by April 30.
- The Marketplace will not be providing retroactive APTCs for months prior to May 2021, but you will get the credits when you file your federal income tax returns.
Q: I have a Marketplace plan. How do I lower my premium?
A: If you already have a Marketplace plan, you can update your application and enrollment to get new eligibility results. Here’s what you need to do:
- Log in to HealthCare.gov.
- Select your name in the top right of the screen, and select My Applications and Coverage.
- Under Your existing applications, select your 2021 application.
- On the left navigation menu, select Report a life change.
- Scroll down and select Report a life change.
- Select Report a change in my household’s income, size, address, or other information, and select CONTINUE.
- Continue through the application and review and update any necessary information.
- Sign and submit the application to complete the update and view the new results.
- Select View eligibility notice to open the updated eligibility determination notice and review the information.
- Select Continue to enrollment to enter the plan selection/update area.
- You can either re-select the plan you have now or choose a new plan.
- If you change plans, your deductible and out-of-pocket maximum may be reset to $0. That means the amount you already paid toward meeting that plan’s deductible and out-of-pocket maximum may not count toward your new plan. You would owe the full amount of the new plan’s deductible and out-of-pocket maximum.
- Go through all steps in the plan comparison and selection process to ensure your update is confirmed.
- Sign the application to confirm your updated APTC amount.
If you need help, email American Exchange at firstname.lastname@example.org or call 1.888.995.1674.
Q: I do not have a Marketplace plan. When should I sign up?
A: You should sign up as soon as possible so you get insurance coverage. Your coverage begins on the first day of the month after you apply.
|Applied for Marketplace Coverage||Date Your Coverage Starts|
|April 1-30||May 1, 2021|
|May 1-31||June 1, 2021|
|June 1-30||July 1, 2021|
|July 1-31||August 1, 2021|
|August 1-15||September 1, 2021|
Q: What happens if I don’t update my information?
A: If you have an existing Marketplace plan and choose not to resubmit your application, you will receive the premium tax credit amount you’re eligible for when you file and reconcile your 2021 federal income taxes in 2022.
If you don’t update your information, you could miss out on other savings. You may be able to choose a plan with lower out-of-pocket costs for the same price or less than what you’re currently paying.
Q: My income is more than 400% of the Federal Poverty Level (FPL). Do I qualify for savings?
A: Yes. Premium tax credits (PTCs) are available to consumers with household incomes above 400 percent FPL for 2021 and 2022 plan years. The American Rescue Plan also caps the household income your family will pay toward the premium for a benchmark plan at 8.5 percent.
Q: Do I have to reconcile my 2020 taxes?
A: The IRS announced that, for the tax year 2020, taxpayers with excess Advanced Premium Tax Credit (APTC) for 2020 are not required to file Form 8962, Premium Tax Credit (PTC), to reconcile their APTC with the amount of PTC they may claim for 2020. They should not report an excess advance Premium Tax Credit repayment on 2020 Form 1040 or Form 1040-SR, Schedule 2, Line 2, or file Form 8962. Eligible taxpayers claiming a net Premium Tax Credit (net PTC) must file Form 8962 when they file their 2020 tax return. If the PTC computed on your return is more than the APTC paid on your behalf during the year, the difference is a net PTC. See Form 8962, and its instructions for more information.
Q: I already filed my 2020 taxes. Should I refile them?
A: No. If you have already submitted your 2020 taxes, the IRS instructs you not to file an amended return until it releases guidance. Find more information about this at: IRS.gov/newsroom/irs-statementamerican-rescue-plan-act-of-2021.
Q: I have a COBRA plan. Can I sign up for a Marketplace plan?
A: Individuals who have COBRA coverage because of their own or a family member’s reduction in hours or involuntary termination from employment may be eligible for full premium subsidies that cover the entire cost of COBRA. This premium subsidy is available from April 1 until September 30, 2021.
If you are eligible for the extended COBRA election period, you will receive notice no later than May 31, 2021. The notice will provide additional details about premium assistance and how to request it. You will have 60 days after you receive the notice to elect COBRA.
Once you enroll in an extended coverage COBRA plan, you must notify your plan immediately if you become eligible for coverage under another group health plan (not including excepted benefits, a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA), or a Flexible Spending Arrangement (FSA) or Medicare). Failure to notify the Marketplace could result in a tax penalty.
Q: I declined COBRA coverage. Can I enroll in a Marketplace plan?
A: If you were offered COBRA but declined coverage, or elected COBRA and later discontinued it, you may have another opportunity to elect COBRA coverage and get the full premium subsidy. You must still be within the period of time that you could have had COBRA coverage (generally 18 months from the employee’s reduction in hours or involuntary termination).
This extended election period does not extend the period of COBRA continuation coverage beyond the original maximum period. COBRA coverage elected in this extended election period begins with the first period of coverage beginning on or after April 1, 2021.
Q: How do I know when my COBRA extended election coverage ends?
A: If you enrolled in a plan during the COBRA continuation coverage period, the plan must provide you with a Notice of Expiration of Period of Premium Assistance 15-45 days before your premium assistance is ending (whether due to the expiration of the COBRA continuation coverage or the expiration of the period of premium assistance). The notice will explain that your premium assistance is ending, the date it will end, and provide available coverage options.
Note: You will not receive this notice if your premium assistance is ending because you become eligible for another group health plan (not including excepted benefits, a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA), a Flexible Spending Arrangement (FSA), or Medicare.
Q: I elected COBRA continuation coverage. Can I switch to a Marketplace plan?
A: If you elect COBRA continuation coverage, you can switch to a Marketplace plan during a Marketplace open enrollment period. You may end your COBRA continuation coverage early and switch to a Marketplace plan if you have another special enrollment period qualifying event, like getting married or having a baby.