Part time employee goes to full time - Help me out please

[BulldogTom]

TP has a family of 5.  On January 1, he is working part time and spouse works full time.  Neither is eligible for health insurance through their employer. 

 

2 of the dependents (spouses children from previous marriage) have coverage through their father per divorce decree.  One dependent (child of the TP) is not covered.

 

At the beginning of the year, they check the cost of a policy on the exchange and find that it exceeds 8% of their family income.  They do not purchase. 

 

In May, TP moved to full time with his employer.  Significant increase in pay.  Son (full time student, dependent) also gets a job when he starts college.  TP enrolls his family (himself, spouse and 1 dependent) in employer plan.  Has to wait for coverage to kick in.  Policy is effective 8/1/14.

 

So we have 7 months of non-coverage, for which I was able to calculate the penalty tax.  That was pretty straight forward.

 

I I am struggling with the affordability exemption.  I want to give it to them if they qualify, but I don't want them to get audited if I screw it up.  And I think they are right on the line for qualifying.  I am getting lost in the affordability worksheet.  Do I compare 8% of their full year income to the cost of a bronze level plan for a full year to see if they qualify for the affordability exemption, or the second highest silver plan?  It makes a difference.

 

They come out to 3.82 times the federal poverty level, if that is important.

 

I thought I had this stuff down, but now I am spinning from going through the worksheets.

 

Thanks for your help.

 

Tom

Newark, CA

Edited January 30, 2015 by BulldogTom

[jklcpa]

Tom, the Affordability Worksheet shown on pg 10 of the instructions for form 8965 uses the lowest cost plan available in the marketplace for the area and that would be the lowest cost bronze level premium.  However, the way I read the instructions, I think you should be using the worksheet on pg 11 of the instructions called Marketplace Coverage Affordability Worksheet to calculate the figures that will be used for comparison.  That worksheet on pg 11 is to be used for person(s) who were not eligible for their employer's insurance plan, and it uses both the lowest cost bronze and second lowest silver premiums in the calculations. The worksheet on page 11 calculates the amount to enter on the worksheet on page 10.  

 

Disclaimer - I haven't done one of these yet and hesitated all day to answer, but I keep coming back to the same answer each time I've looked at it. 

[kcjenkins]

That's how it looks to me, too Tom.  

[BulldogTom]

This shit should not be this hard.  Excuse my French.

 

Thanks Ladies.

 

Tom

Newark, CA

[BulldogTom]

I think I have it figured out now.  It is just the way the instructions are written that got my boxers in a bunch.

 

Thanks for pointing me in the right direction.

 

Tom

Newark, CA

[B. Jani]

My understanding is that if everyone MUST apply to the market place. If their income so low or cannot afford, they may qualify for the MEDICAID. Hence most of the problems would have been solved. BUT most of the people did not apply with a view that it is expensive or cannot afford it. Now we have to deal with all this CRAZY situation.