OCI Consumer Alert
More Health Insurance Exchange Problems
Some Consumers Have Incorrect Premium Tax Credit or Wrong Plan
Madison, WI—Unfortunately, many consumers are facing additional problems caused by the federal health insurance exchange including incorrect tax credits and consumers enrolled in plans that are not available in their area.
OCI has received reports that thousands of consumers have incorrect tax credit information in their file, and the problems have not yet been fixed by the health insurance exchange. OCI has identified three specific areas of concern. First, some consumers are in plans that were incorrectly priced by the insurer, and healthcare.gov has not yet made adjustments in the premium tax credit amount. Second, some consumers have not correctly verified their income through healthcare.gov. Finally, consumers who have seen their income change, need to report that change to healthcare.gov but healthcare.gov has not been able to adjust their tax credit.
"Consumers receiving advanced premium tax credits need to make sure their income information is reported correctly," stated Insurance Commissioner Ted Nickel. "Incorrect information can result in a surprising and unpleasant additional tax liability down the road."
Commissioner Nickel recommends that you first contact healthcare.gov to make changes. If the federal exchange is unable to make the necessary changes, consumers should calculate the difference, and make plans to pay for the difference in the upcoming tax year. The difference between their current advanced premium tax credit and the advanced premium tax credit the consumer should be receiving will be due when they pay their 2014 tax bill.
OCI has also continued to receive reports of consumers enrolled in incorrect plans, as we highlighted in a previous alert. Unlike the previous alert "Ensure You're Insured," the problem causing the issue has yet to be identified. This happened when consumers entered their information and the federal Web site showed plans that should not have been available based on where the consumer lives. Once a consumer enrolled in a plan, the information was sent to the insurer. In some cases, consumers have enrolled in a plan with a network of medical providers that do not practice anywhere near them. This can require significant travel time or more expensive medical care. Consumers were also allowed to purchase a plan not available in their region which will result in having no medical providers in their area.
"We are working with the insurers and the exchange to ensure as smooth a transition as possible," continued Commissioner Nickel. "Consumers who have not had their enrollment verified or have not received enrollment materials in a timely manner should contact the insurer directly to verify enrollment."