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Memo to the Biden Administration Transition Team
Memo to the Biden Administration Transition Team From: Trish Riley, National Academy for State Health Policy Executive Director Re: State-based marketplace strategies for insurance market stabilization and improvement Nov. 20, 2020 The National Academy for State Health Policy (NASHP), in close consultation with executives from state-based health insurance marketplaces (SBMs), has developed a list of priority actions that may: ● Lower costs and bring stability to individual and small group health insurance markets; ● Improve access to health insurance coverage; and/or ● Improve consumer experience when purchasing small group or individual market coverage. NASHP is home to the State Health Exchange Leadership Network, a consortium of state leaders and staff dedicated to operation of the SBMs. This list draws upon the experience of SBM leaders who have spent the past decade building and operating successful platforms for the procurement of health insurance coverage. These recommendations reflect NASHP’s collective discussions with SBM leaders, but do not reflect consensus across all SBMs. States value flexibility to design their programs to meet local needs and circumstances. For additional information specific to each state, please see Appendix A, which includes references to comments submitted by SBMs in response to various policy changes. We have also included the contact information for SBM executives who can provide additional information specific to their states. NASHP is ready to provide any additional information that may be helpful as you deliberate critically important issues related to health care coverage. Thank you for your time and consideration. Sincerely, Trish Riley Executive Director National Academy for State Health Policy 2 Monument Square, Suite 910, Portland ME 04101 1233 20th St NW, Suite 303, Washington, DC 20036 Phone: (207) 837-4815 State-Based Marketplace Recommended Areas for Priority Administrative Action in 2021 I. -
Publication 974, Premium Tax Credit (PTC)
Userid: CPM Schema: tipx Leadpct: 100% Pt. size: 10 Draft Ok to Print AH XSL/XML Fileid: … tions/P974/2020/A/XML/Cycle04/source (Init. & Date) _______ Page 1 of 80 16:23 - 16-Apr-2021 The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing. Department of the Treasury Contents Internal Revenue Service Future Developments ....................... 1 Publication 974 Reminders ............................... 2 Cat. No. 66452Q Introduction .............................. 2 What Is the Premium Tax Credit (PTC)? ......... 3 Premium Tax Who Must File Form 8962 .................... 3 Who Can Take the PTC ...................... 4 Credit (PTC) Terms You May Need To Know ............... 4 For use in preparing Minimum Essential Coverage (MEC) ........... 8 Individuals Not Lawfully Present in the United 2020 Returns States Enrolled in a Qualified Health Plan ... 19 Determining the Premium for the Applicable Second Lowest Cost Silver Plan (SLCSP) ... 27 Allocating Policy Amounts for Individuals With No One in Their Tax Family .............. 27 Allocation of Policy Amounts Among Three or More Taxpayers ....................... 28 Alternative Calculation for Year of Marriage .... 38 Self-Employed Health Insurance Deduction and PTC ............................. 57 How To Get Tax Help ...................... 76 Index .................................. 80 Future Developments For the latest information about developments related to Pub. 974, such as legislation enacted after it was published, go to IRS.gov/Pub974. What’s New Health reimbursement arrangements (HRAs). Begin- ning in 2020, employers can offer individual coverage health reimbursement arrangements (individual coverage HRAs) to help employees and their families with their medical expenses. If you are offered an individual cover- age HRA, see Individual Coverage HRAs, later for more information on whether you can claim a PTC for you or a member of your family for Marketplace coverage. -
Serving American Indians and Alaska Natives In
Centers for Medicare & Medicaid Services Serving American Indians and Alaska Natives in Connecticut, Maine, Massachusetts, and Rhode Island Centers for Medicare & Medicaid Services (CMS) staff work with beneficiaries, health care providers, state government, CMS contractors, community groups, and others to provide education and address questions. American Indians and Alaska Natives If you have questions about CMS programs in relation to American Indians or Alaska Natives: email the CMS Division of Tribal Affairs at [email protected], or contact the CMS Native American Contact (NAC). For a list of Native American contacts and their information, visit https://go.cms.gov/NACTAGlist To contact Indian Health Service in these states, contact the Nashville Area Office at 615-467-1500 or at https://www.ihs.gov/nashville/contactus/ Why enroll in CMS programs? When you sign up for Medicaid, the Children’s Health Insurance Program, or Medicare, the Indian health hospitals and clinics can bill these programs for services provided. This opportunity brings money into the health care facility, which they can use to hire more staff and pay for new equipment and building renovations, and saves Purchased and Referred Care dollars for other patients. Patients who enroll in CMS programs are not only helping themselves and others, but are also supporting their Indian health care hospital and clinics. State-by-state assistance Find information about coverage and Indian health facilities in your state. The map in the center of this booklet shows the -
Dispute Form 1095-A for Covered California Consumer If You Need Help in Spanish, Or Would Like This Form in Spanish, You Can Call 1-800-300-0213
Dispute Form 1095-A for Covered California Consumer If you need help in Spanish, or would like this form in Spanish, you can call 1-800-300-0213. If you need help in a language other than English or Spanish, please see the final page of this document for language-specific telephone numbers. If you would like more information about Form 1095-A, please visit: www.coveredca.com. If you would like more information about filing your taxes, please visit: www.irs.gov/aca. Free tax advice is also available through Volunteer Income Tax Assistance at 1-800-906-9887 or if you are over 60 years old there is free Tax Counseling for the Elderly at 1-800-906-9887. Instructions: You may use this form to dispute the information on the Form 1095-A or request a Form 1095-A if you did not receive one. Based on any corrections you show on this form, Covered California will review and check the new information you report. If, after review, Covered California determines that the updated information you provided is correct, we will send you a new, corrected Form 1095-A. To help with our review, please include any supporting documents with this form. Supporting documents could include invoices from your health plan that show the amount of premium assistance (tax credits or APTC) you received and monthly premium you paid, or Covered California notices that show how much premium assistance you were eligible for. Do I have to use this form to make all changes to information on my Form 1095-A? No. -
Rhode Island's 1332 Waiver Application
Rhode Island’s 1332 Waiver Application July 08, 2019 Zachary W. Sherman, Director HealthSource RI 501 Wampanoag Trail East Providence, RI 02915 (401) 383-7771 www.healthsourceri.com Dr. Marie Ganim, Health Insurance Commissioner Office of the Health Insurance Commissioner 1511 Pontiac Ave, Building #69 First Floor Cranston, RI 02920 (401) 462-9517 www.ohic.ri.gov This page is intentionally left blank. This page is intentionally left blank. Table of Contents Table of Contents .......................................................................................................................................... 1 Executive Overview ...................................................................................................................................... 3 Request ...................................................................................................................................................... 3 Basis for Request and Goal of the Proposed Rhode Island Reinsurance Program ................................... 3 Early and Ongoing Impacts of the ACA ............................................................................................... 3 Ensuring Ongoing Success in Rhode Island ......................................................................................... 4 Operation, Funding, and Impact of the Rhode Island Reinsurance Program ............................................ 4 Compliance with Section 1332 ................................................................................................................ -
New Health Insurance Tax Credits in Idaho
New Health Insurance Tax Credits in Idaho Families USA Help Is at Hand: New Health Insurance Tax Credits in Idaho © April 2013 by Families USA This publication is available online at www.familiesusa.org. Families USA 1201 New York Avenue NW, Suite 1100 Washington, DC 20005 Phone: 202-628-3030 Fax: 202-347-2417 Email: [email protected] www.familiesusa.org Cover Design: Nancy Magill, Families USA Help Is at Hand: New Health Insurance Tax Credits in Idaho tarting in 2014, the Affordable Care Act will extend health coverage to millions of Americans. This will be done, in part, by Soffering tax credits to help low- and middle-income Americans afford private coverage. These new tax credits, which will offset a portion of the cost of health insurance premiums, will soon become a reality, allowing many previously uninsured Idahoans to purchase quality health coverage. This report takes a closer look at these premium tax credits in Idaho, which will help Idahoans with incomes up to four times the federal poverty level ($94,200 for a family of four in 2013)1 afford coverage. The unique structure of the tax credits means that people will be protected from having to spend more than a set percentage of their income on health insurance premiums. These premium tax credits will take effect in January 2014, following open enrollment that begins in October 2013. Families USA commissioned The Lewin Group to use its widely respected Health Benefits Simulation Model to estimate how many people in Idaho and across the country could benefit from the new premium tax credits in 2014. -
The Kentucky Marketplace's Internal Controls Were Generally Effective In
Department of Health and Human Services OFFICE OF INSPECTOR GENERAL THE KENTUCKY MARKETPLACE’S INTERNAL CONTROLS WERE GENERALLY EFFECTIVE IN ENSURING THAT INDIVIDUALS WERE ENROLLED IN QUALIFIED HEALTH PLANS ACCORDING TO FEDERAL REQUIREMENTS Inquiries about this report may be addressed to the Office of Public Affairs at [email protected]. Daniel R. Levinson Inspector General October 2015 A-04-14-08036 Office of Inspector General http://oig.hhs.gov The mission of the Office of Inspector General (OIG), as mandated by Public Law 95-452, as amended, is to protect the integrity of the Department of Health and Human Services (HHS) programs, as well as the health and welfare of beneficiaries served by those programs. This statutory mission is carried out through a nationwide network of audits, investigations, and inspections conducted by the following operating components: Office of Audit Services The Office of Audit Services (OAS) provides auditing services for HHS, either by conducting audits with its own audit resources or by overseeing audit work done by others. Audits examine the performance of HHS programs and/or its grantees and contractors in carrying out their respective responsibilities and are intended to provide independent assessments of HHS programs and operations. These assessments help reduce waste, abuse, and mismanagement and promote economy and efficiency throughout HHS. Office of Evaluation and Inspections The Office of Evaluation and Inspections (OEI) conducts national evaluations to provide HHS, Congress, and the public with timely, useful, and reliable information on significant issues. These evaluations focus on preventing fraud, waste, or abuse and promoting economy, efficiency, and effectiveness of departmental programs. -
Health Insurance Marketplace
TAX YEAR 2021 Health Care Reform Health Insurance Marketplace Norman M. Golden, EA 1900 South Norfolk Street, Suite 218 San Mateo, CA 94403-1172 (650) 212-1040 [email protected] Health Insurance Marketplace • Mental health and substance use disorder services, in- cluding behavioral health treatment (this includes coun- The Health Insurance Marketplace helps uninsured people seling and psychotherapy). find health coverage. When you fill out the Marketplace ap- • Prescription drugs. plication online the website will tell you if you qualify for: • Rehabilitative and habilitative services and devices (ser- • Private health insurance plans. The site will tell you vices and devices to help people with injuries, disabili- whether you qualify for lower costs based on your house- ties, or chronic conditions gain or recover mental and hold size and income. Plans cover essential health ben- physical skills). efits, pre-existing conditions, and preventive care. If you • Laboratory services. do not qualify for lower costs, you can still use the Mar- • Preventive and wellness services and chronic disease ketplace to buy insurance at the standard price. management. • Medicaid and the Children’s Health Insurance Pro- • Pediatric services, including oral and vision care. gram (CHIP). These programs provide coverage to mil- lions of families with limited income. If it looks like you Essential health benefits are minimum requirements for all qualify, the exchange will share information with your Marketplace plans. Specific services covered in each broad state agency and they’ll contact you. Many but not all benefit category can vary based on your state’s require- states have expanded Medicaid to cover more people. -
Spanish 2020 National Health Interview Survey (NHIS) Questionnaire
2020 National Health Interview Survey (NHIS) Questionnaire Contents 1. Introduction This National Health Interview Survey (NHIS) questionnaire report provides the questions administered to NHIS respondents in the order they were asked. It is organized hierarchically into these parts: Contents, Index, and NHIS questionnaire, which in turn includes the Roster, Adult and Child modules. 2. Section Index A section index is provided for each of the three modules: Roster, Adult, and Child. The index can be navigated via the Bookmarks pane to quickly get information about the different sections in the module. The display pane lists information about each section in the module including the three-letter section name, the section description, the type of content in the section (annual core, rotating core, sponsored or emerging content) and the page range in this document for each section for ease of printing. 3. NHIS questionnaire: Roster, Adult and Child modules The questionnaire is the main part of the report and provides detailed information about each question in the survey. The hierarchy in the Bookmarks pane has three levels: module (Roster, Adult, Child), sections within each module, and questions within each section represented by the variable name in the instrument. The sections and questions are listed in questionnaire order. Selecting a specific question in the Bookmarks pane will display a detailed report for that question in the display pane while selecting a section abbreviation will display the report for the first question in the section. In the question text field of the report, text displayed in bold and in blue font is an interviewer instruction which is sometimes followed by optional text in gray, italic font. -
Publication 5187, Affordable Care
Affordable Care Act: PUBLICATION What You and Your 5187 Family Need to Know Tax Year 2020 Get forms and other information faster and easier at: IRS.gov (English) IRS.gov/Chinese (中文) IRS.gov/Russian (Pусский) IRS.gov/Spanish (Español) IRS.gov/Korean (한국어) IRS.gov/Vietnamese (TiếngViệt) Table of Contents Introduction . 3 Affordable Care Act Overview . 4 Individual Shared Responsibility Provision . .. 5 Premium Tax Credit and Advance Payments . 9 U .S . Citizens Living Abroad . 15 Summary . 16 Glossary . 17 2 AFFORDABALE CARE ACT: WHAT YOU AND YOUR FAMILY NEED TO KNOW Introduction This publication covers some of the tax provisions of the Affordable Care Act (ACA). It provides information about the individual shared responsibility and the premium tax credit. A glossary is included to help taxpayers understand some terms related to the health care law. What’s New? Under the Tax Cuts and Jobs Act, passed December 22, 2017, the amount of the individual shared responsibility payment is reduced to zero for months beginning after December 31, 2018. Beginning in tax year 2019 and beyond, Forms 1040 and 1040-SR will not have the “full-year health care coverage or exempt” box and Form 8965, Health Coverage Exemptions, will no longer be used. You need not make a shared responsibility payment or file Form 8965, Health Coverage Exemptions, with your tax return if you don’t have minimum essential coverage for part or all of the year. Reminder from the IRS: If you need health coverage, visit HealthCare.gov to learn about health insurance options that are available for you and your family, how to purchase health insurance, and how you might qualify to get financial assistance with the cost of insurance. -
We Offer High Quality Health Insurance at the Lowest
Don’t wait - enroll now Open Enrollment runs November 1–December 31 * Health insurance is now required in the state of RI for 2020. Sign up today to avoid a tax penalty later. If you are You may qualify for An individual making Free coverage through less than $17,236 or a Medicaid family of four making “The Affordable Care Act less than $35,535 has changed my life… An individual making A tax credit to help between $17,236 and pay for insurance I‘m now on medication $49,960 or a family of four making between that will dramatically $35,535 and $103,000 improve the quality of my life…Thank you!” If you have a life changing event (such as marriage, birth, job loss) you might be able to - Kikea, Providence enroll after December 31. Call us to learn more. We offer high HealthSource RI • For individuals, families and small quality health businesses Get started today • insurance at the Your source for comparing and purchasing health insurance Enroll online: • HealthSourceRI.com lowest prices in RI Offes a range of quality health insurance options Visit us: • Financial help is available, 401 Wampanoag Trail, East Providence depending on your income and family size Call us: • 8 out of 10 customers received 1-855-840-HSRI finanicial assistance Monday - Friday 8:00 am - 7:00 pm Saturday 9:00 pm - 12:00 pm (in Nov & Dec) Why HealthSource RI? Get started now • We help you find the best health insurance option for you and your family How to begin • Your source for finanical help to reduce the cost Visit HealthSourceRI.com or call of health insurance 1-855-840-HSRI. -
Consumer Decisionmaking in the Health Care Marketplace
Research Report Consumer Decisionmaking in the Health Care Marketplace Erin Audrey Taylor, Katherine Grace Carman, Andrea Lopez, Ashley N. Muchow, Parisa Roshan, Christine Eibner C O R P O R A T I O N For more information on this publication, visit www.rand.org/t/rr1567 Library of Congress Cataloging-in-Publication Data is available for this publication. ISBN: 978-0-8330-9505-3 Published by the RAND Corporation, Santa Monica, Calif. © Copyright 2016 RAND Corporation R® is a registered trademark. Limited Print and Electronic Distribution Rights This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited. Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial use. For information on reprint and linking permissions, please visit www.rand.org/pubs/permissions.html. The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest. RAND’s publications do not necessarily reflect the opinions of its research clients and sponsors. Support RAND Make a tax-deductible charitable contribution at www.rand.org/giving/contribute www.rand.org Preface For this report, researchers conducted a literature review to better understand how consumers make choices about health insurance enrollment and to assess how website design can influence choice when consumers select plans online.