Enrollment and Tax Tips for 2019 Marketplace Coverage

Open Enrollment ends 11:59pm on Saturday, December 15th.

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Insurance Brokers have a somewhat unique perspective on the process of enrollment and the tax implications of holding Marketplace coverage by virtue of having dealt personally with hundreds of others experiences. If you’re looking to or have already enrolled in coverage for this year, check out the tips below, it may save you money or perhaps more importantly, a tax time headache.

1. There are effectively two insurers left in Pasco/Hernando counties on the Marketplace for 2019, BlueCross BlueShield (Florida Blue) and Ambetter (three in Pinellas if you count Molina). For those who are currently enrolled in Marketplace coverage for 2018, if you do nothing, you are generally just re-enrolled in the same plan. Keep in mind that many plans have been reformulated and new plans are available in 2019 that were not in 2018, so it is still best to check every year to see if you are not better served by a different plan (for example, I've seen that most people enrolled in the Ambetter Balanced Care 5 plan with a CSR are generally better served by the Ambetter Balanced Care 11 in 2019)

2. I am tending to see those who are self-employed overestimate their Adjusted Gross Income (AGI) when quoting Marketplace plans, as AGI determines premiums. Remember that self-employed persons need to deduct business expenses when calculating AGI. For example, a 32 year old single male Uber/Lyft driver calculating his income as $34,000/yr would pay $270/mo with a $6k deductible for a silver plan in the Marketplace. If he accurately deducts his expenses as an independent contractor (standard mileage, gas, car payment, car insurance, mobile phone payment, wireless plan) so that his AGI reflects a $20,000 income, he would be eligible for a $74/mo plan with a $0 deductible or a $0/mo bronze plan (catastrophic coverage, better than being uninsured).

3. Count the members of your household. Even if you have dependents that receive health coverage through KidCare or a spouse that receives group coverage (and you are ineligible for spouse's coverage), make sure that you are listing them as household members when quoting coverage. They lower the threshold for premium credits when accounting for your income. This can make a drastic difference.

4. Very important. Make sure you keep your income up-to-date throughout the year! As explained before, premiums are calculated largely by a person's AGI. If you are self-employed and your income varies from year-to-year or you switch jobs during the year, update your account to reflect the changes. If your income rises or falls significantly and you fail to notify the Marketplace, you could be shocked at tax time when you owe a portion of your premium subsidy back.