- Sep 25, 2001
whats the theory behind insurance companies cant charge premiums for elderly more than 25% of young people?
Keep the costs down until they are able to qualify for Medicare.whats the theory behind insurance companies cant charge premiums for elderly more than 25% of young people?
I believe the ACA says temp workers are subject to the "common-law test" to determine their employer for the purposes of who is responsible for providing insurance. Under the common-law test, whichever entity exerts more influence over hiring, firing, pay, when the employee works, etc. is deemed the employer.Interesting question that is on the boundaries of the ACA.
There are contracting companies for temp workers that pay with W2 (Ex: Nationwide - Kelly, Robert Half, etc and I am sure that each major metro area has a slew of local companies).
That classifies them as employees under IRS tax rules. Taxes are withheld and they are eligible for un-employment
Are there insurance exceptions or are these companies required to provide insurance for those that work full time for the end clients.
that would clear the contracting agencies then, because they are just a money pipeline.I believe the ACA says temp workers are subject to the "common-law test" to determine their employer for the purposes of who is responsible for providing insurance. Under the common-law test, whichever entity exerts more influence over hiring, firing, pay, when the employee works, etc. is deemed the employer.
It's a bit of a complicated answer and gets a bit esoteric and involved in parsing language, so forgive me if the explanation isn't the best. For the sake of simplicity, let's assume that you are single, no dependents, and make $5,000 (net of payroll tax but gross of income tax). You have no tax issues and can file an EZ form.So lets say someone makes $30k a year and has to buy their insurance on the exchange. Clearly, they're not paying much in Fed taxes after they send in their taxes for the year (or more likely, collect their tax return for the year). Can the subsidy that is their reduced tax burden actually see them getting a tax refund that puts them at more than $0? As in, they have paid negative taxes?
It depends. IF they somehow pay 100% of the premium out of pocket during the year then yes, they can get the money paid to them when they file their taxes. Assuming that most people at those income levels can't afford the premiums until they file their taxes, you can get it paid in advance in monthly installments, but only if the money goes directly to the insurer.So does that mean if they choose the Silver (and why not, Silver is higher than Bronze I'd assume), and they are at -$12,520, they actually receive $12,520? Or is their plan sent that money from the Fed directly?
Impossible to tell. The tax credit is based on modified adjusted gross income and not taxable income. There are enough potential exemptions, deductions and credits between those two numbers that taxable income for any given MAGI may range from 0 to MAGI.EDIT: As an edit, is there a break even for the Fed on single no deduction folks for the 2nd lowest cost Silver? Such as, and I'm completely making up a number, at $45,323 someones taxes have covered at least their subsidy?
Yes.I'm curious then, how does the Gov know that I would have insurance and that I've had insurance all year that I've been paying on? Does the insurance company send them some kind of tax form at the end of the year that indicates months covered and premiums paid?
I don't follow your question.Ok, that's good to know...I'd say something snide here but since I want this thread to not be trashed I'll bite my tongue.
So my last (I think) question is: Where is the money coming from to subsidize people who have plans that are paying less in taxes than the plans cost?
I can't get too far into specific scenarios for people for a variety of reasons. I can say that since New Jersey accepted the Medicaid expansion money they can't just "close" enrollment. When you speak of "the website" which one are you referring to? Healthcare.gov? Which website is it "dumping" you in to? I found that they should be able to apply online at http://www.njfamilycare.org/apply.aspx. The website is pretty bad (from a layouf POV) but it seems to be functional. Any other options available to them would depend on their incomes.This thread is awesome. Thanks.
So, my son and several of his friends are still trying to access the website. What happens is that they are dumped into a place to apply for Medicaid. But this is NJ, so they are told that NJ no longer takes applications for Medicaid.
I'm curious, since NJ got a lot of federal $ to expand Medicaid, and our darling Mr Christie took the $ and put it elsewhere, is something bad going to happen to NJ - What about the other similar states?
And on a practical note, how else can my son and his friends get affordable health insurance?
Eligibility for a tax credit and cost-sharing subsidy is based on annualized income. It's also dependent upon whether your state expanded Medicaid eligibility, since there is a 100% FPL minimum to qualify.Can someone who does not qualify for medicaid and is unemployed due to relocation (DNQ for unemployment benefits) receive subsidies? If so, how?
Tax penalties are calculated on a per-month basis and everyone gets a single lapse of two months or less forgiven.If not, assuming they don't get insurance, how will their fine be assessed if they get a job with healthcare coverage sometime later in the year. Will they prorate the fine?
Funny you should ask, I'm learning quite a bit about Rx pricing recently...Sacto-
Do you know if the ACA has anything to do with drug prices going up so much? My son's insulin has went from $135 a vial to $240 a vial.
I really appreciate your informed answers on this stuff.Funny you should ask, I'm learning quite a bit about Rx pricing recently...
We've got a (state level) proposal to "lock" prescription drug formularies, so that whatever the formulary is on January 1 is the formulary for the whole year, with a few exceptions. There has been quite a bit of pushback from our insurers who allege that premiums will go up.
Not getting too deep into the weeds, it looks to me like the ACA is having little direct effect on Rx prices. One of the laments of certain healthcare reform proponents was that the ACA did little or nothing to reform prescription drug pricing in the US, which has been alleged to be heavily skewed in the advantage of "big pharma."
There may be indirect effects, such as the somewhat recent media reports of insurers using tiered formulary design as a stand-in for certain discriminatory underwriting practices.