Special 2016 Federal Marketplace Enrollment Period for Individuals without Marketplace Insurance Due to Failure to File a 2014 Federal Return and Reconcile

The Center for Medicare and Medicaid Services (CMS) which runs the Federal Marketplace has announced that there will be a special enrollment period that will run from now until March 31, 2016. This special enrollment period is for individuals previously determined to have been ineligible for the Advance Premium Tax Credit (subsidy) in 2016 because they failed to file a 2014 federal return and did not complete the required reconciliation on Form 8962 (Premium Tax Credit).

The special enrollment period specifically applies to individuals who:

• Are not currently enrolled in 2016 coverage through the Federal Marketplace;
• Are not receiving an Advance Premium Tax Credit (APTC) because they failed to file a tax return for 2014 and reconcile their 2014 APTC; and
• Subsequently filed their 2014 federal tax return and reconciled their 2014 APTC on Form 8962.

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Special Federal Marketplace Enrollment Period and Corrected Form 1095-A

The Centers for Medicare Services (CMS) made two announcements on February 20, 2015 concerning a special enrollment period for individuals who did not have health coverage in 2014 and information concerning the number of individuals (who used the Federal Marketplace) that will be receiving a corrected Form 1095-A in March due to incorrect information contained on the original 1095-A that they received around the end of January.

Special Federal Marketplace Enrollment Period for the Tax Season
For individuals who reside in a state that uses the Federal Marketplace, a special enrollment period will be available to those individuals and their families who did not have health coverage in 2014 and are subject to the shared responsibility payment (penalty) when they file their 2014 federal return.

Qualifying individuals will have the opportunity to purchase health insurance from March 15, 2015 through April 30, 2015 if they reside in a state that uses the Federal Marketplace and:

• Are not currently enrolled in 2015 coverage through the Federal Marketplace;
• Attest that they filed their 2014 federal tax return and paid a fee (penalty) for not having health coverage in 2014; and
• Attest that they first became aware of, or understood the implications of the Shared Responsibility Payment (penalty) after the end of open enrollment (February 15, 2015) in connection with preparing their 2014 federal return.

Individuals who are seeking to take advantage of this special enrollment period can find out if they are eligible by visiting the main get coverage page on healthcare.gov.

For more information on this announcement see the CMS Announces Special Enrollment Period for Tax Season press release on the CMS website.

Corrected Form 1095-A for Certain Individuals
CMS has announced that approximately 20 percent of individuals (800,000) who used the Federal Marketplace to obtain their 2014 health insurance and received an advance premium tax credit will receive a corrected Form 1095-A (Health Insurance Marketplace Statement) in early March. These individuals should also receive a phone call explaining that they will be receiving a corrected form 1095-A and that form should be used to complete Form 8962 (Premium Tax Credit) for their 2014 federal tax return.

The original Form 1095-A included the incorrect Second Lowest Cost Silver Plan (SLCSP) Premium amounts. This amount is needed in order to calculate the 2014 Premium Tax Credit on Form 8962, and if it is incorrect, the calculated premium tax credit will also be incorrect.

To find out if an individual is affected, they should do the following:

1. Log in to their account on HealthCare.gov. Once they are logged in, they will see a notice message that will let them know whether they are affected.
2. If their Form 1095-A is affected the individual has not filed their 2014 federal return, they should wait until they receive the corrected Form 1095-A in March. The corrected Form 1095-A can also be accessed via the individual’s account on Healthcare.gov in early March.
3. If their Form 1095-A is affected and the individual needs to file their return now they can do one of the following:
• Look up the Second Lowest Cost Silver Plan Premium amount using the Find 2014 Silver Plan Premium Tool on healthcare.gov.

Or

• Call the Marketplace Call Center at 1-800-318-2596.

For those who have already filed their 2014 federal return (which CMS estimates at 50,000), the Treasury Department and IRS will be providing information soon.

For more information on this announcement see the What Consumers Need to Know about Corrected 1095-As blog posting on the CMS website.