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I think I made a mistake - or maybe I won't know until next year


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Posted

Client is covered at work, carries his spouse on the coverage.  Client's kids were on state program for insurance.  I have no idea how they got it, because they have 6 figure income for the last three years, but they were on a state program.  In Oct, they got kicked off by the state.  The 1095 comes in from the state showing the kids were covered for 10 months Jan - Oct.  Clients employer 1095 shows Hubby & Wife covered Jan-Dec.  So I ask if he got the kids on the work insurance and the husband says they would not pick his kids up until open enrollment in the spring.  But wife says they got on sooner.  She thought they were covered last year.  But his 1095 from his employer does not say that.  So, I calculated the penalty because I think they did not have a short coverage gap. 

Did I make a mistake?  Can you not be covered the last 2 months of the year and ignore what is going to happen (or what you think is going to happen) in the next year?  Should I have marked the short coverage gap exemption? 

Tom
Newark, CA

Posted

As long as the coverage gap was less than 3 months in 2015 there would not be a penalty for 2015.  Nov and Dec will be considered in 2016 if there is no insurance for Jan 2016.

Posted

I agree. You should have claimed the short gap exemption for the 2015 year. Then, those months are taken into account in 2016 so that the short gap exemption  can't be claimed again for the spring period because the consecutive months of lack of coverage at that point in 2016 does exceed 2 months.

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