Confused on Income for the Health Insurance Marketplace? Welcome to the Club. We are having hats made.

Right now, millions of Americans have unfortunately lost their jobs and are trying to determine the cost of their health insurance.  And its not as easy as it looks.  (Or should be, but that’s a different post for a different day!)

If you’ve lost your job, I am truly sorry.  To determine the next steps, start here:

1.  Call 211 to determine if you are eligible for Medicaid.  (A consumer can get way lost in the weeds here trying to determine this on your own.  A quick call to 211 will smooth the path).
2. Determine your COBRA Costs.  If a company has more than 20 employees (full and part time combined), they are required to offer COBRA.  If the company has less than 20 employees, some states have “State Continuation”.  Contact your former employer for more information.
3. Determine your Marketplace Costs.  Here’s where it gets tricky.  To determine your cost for Marketplace Coverage, you have to give them your projected 2020 income.  More information below.
4. Determine your eligibility dates!!!  You have a 60 day window from the day you coverage ends to activate Marketplace coverage.  So if your coverage ends on April 30th, you have until June 30 to apply for COBRA or Marketplace coverage.

Below are some examples and screen shots using healthsherpa.com to determine subsidy information and how to correctly put in your income.  If you are shopping for health insurance, I highly recommend healthsherpa.com in 49 states.  In Texas, try https://www.healthsherpa.com/?_agent_id=jennifer-chumbley

Example 1:  Kellie

Kellie is single with no dependents.  She makes $36K annual salary and her last paycheck was 3/31.

Here is question 1:  Current income.  The answer is YES

Question 2:  Select an Income Type.

Select Job.

Put in your former employer name and phone number.

Then use your Year to Date Income.  Kellie has made $9K this year.  So put $9K and Annual.

Select Add New Income

Assuming you are a W2 employee (More about 1099 and Gig Workers later), your Unemployment Compensation can be “guesstimated” at $20K.  This assumes you will make around $950 every 2 weeks for 5 months plus the additional $600/week for 4 months.   However, you probably don’t have the information about the $600, yet.

****The Marketplace is adding the $9600*****

So the information for unemployment should read $950 every two weeks.  HINT:  Put the state and end date in.

Example 2

Madison is a wedding planner.  She works for herself and doesn’t have any W2 income.  She currently has Marketplace coverage, but since she makes more than $50K annually, she was not subsidy eligible prior to the Pandemic.

In 2020, she has made $5K and is eligible for the $600 federal unemployment insurance.  But if she puts the unemployment in for $600, the Marketplace will automatically add an additional $9600.  So here is how her income information should look:

Self Employment:  $416 Monthly.  (You cannot do annual income if you are self employed)

Unemployment:  $390 every 2 weeks.  I realize that isn’t correct.  You are getting $600 a week for 4 months.   However, you have to use the system to get the correct final number of around $15K.  And $390 every two weeks accomplishes that goal.

(Please note the KG Rule here.  Its HEALTH INSURANCE.  Health Insurance and LOGIC are mutually exclusive terms.  Once you accept that fact, it gets a little easier.)

None of this is legal advice, just some helpful hints.  Your results may vary.  If you are in Texas and would like some help, please feel free to contact us.