Updated 2/10/2016 Essentially, this extension pertains only to individuals who were unable to file because of a taxation issue relating to their tax filing in 2014. If individuals who received subsidized healthcare (Obamacare plans) in previous years prior to this open enrollment season, and they didn’t file a tax return, they may be ineligible to enroll until they file and or amend their tax statements.
Put another way, if you received tax credits for healthcare, but incorrectly stated your income level, or if you didn’t file a tax return at all, well then the IRS needs you to clarify your paperwork. Because “obamacare” is essentially a tax credit, it is directly connected to the IRS and your individual or joint tax filing. Depending on whom is doing the estimating, this extension will apply to approximately 1.2 million consumers within the US to 200,000 consumers.
We were just sent the following email regarding a 2016 Special Enrollment Period. We are trying to determine the authenticity of the information. If the information in this announcement is true, CMS (Centers for Medicare & Medicaid Services) has created a 2016 Special Enrollment Period for some consumers that will run until March 31, 2016. If you would like to read the e-mail we received, verbatim, it is posted below our summary.
In summary, the announcement states that CMS will allow consumers who meet the following requirements to enroll online in a ACA compliant health insurance plan and receive a subsidy, so long as they enroll before March 31st on Healthcare.gov:
- Were enrolled in health insurance in 2014 and received a subsidy
- Attempted but were unable to enroll in health insurance during the 2016 Open Enrollment Period (November 1, 2015 through January 31, 2016) either:
- Because they simply did not enroll; or
- Because the IRS denied them a subsidy for their 2016 plan because they did not file their 2014 taxes or pay back any money they owed the government due to receiving a larger subsidy than they were permitted once their federal income taxes for 2014 were submitted. If you still need to file your 2014 federal taxes or you still need to pay back money that you received as a subsidy towards your 2014 health insurance plan, which you were ultimately not entitled to because you overstated your income on the application and should have received a lesser subsidy, you must do so before you apply for health insurance during the 2016 Special Enrollment Period.
Here is the verbatim e-mail that we received regarding the 2016 Special Enrollment Period:
CMS ANNOUNCES SPECIAL ENROLLMENT PERIOD FOR SOME CONSUMERS THROUGH MARCH 31
The Centers for Medicare and Medicaid Services (CMS) have announced a new one-time Special Enrollment Period (SEP) lasting through March 31, 2016, for consumers who meet the following conditions:
· Attempted to enroll in 2016 coverage during the open enrollment period
· Were determined ineligible for APTC for 2016 due to IRS indicating that they failed to file and reconcile APTC for 2014
· Are not enrolled in 2016 QHP coverage through the FFM as of the end of open enrollment
· File and reconcile APTC for 2014 and attest to having done so on their 2016 Marketplace application
· Will have access to this SEP through their online applications at HealthCare.gov
· This SEP will only be available to consumers after they restore their eligibility for APTC by filing a 2014 tax return, reconciling APTC paid on their behalf in 2014, and returning to the Marketplace to update their application and attest to having filed and reconciled 2014 APTC.
· The effective date of coverage under this SEP will be the first of the month following plan selection
Note: A SEP is not necessary for consumers who are determined ineligible for APTC due to failure to reconcile, but remain enrolled in coverage for 2016. After filing their 2014 tax return and reconciling their APTC, such consumers may return to the Marketplace to update their application and attest to having filed and reconciled. They will then receive an updated eligibility determination and APTC may be applied to their current or new plan prospectively, if they are otherwise eligible.
We will continue to update this page with additional information as it becomes available.