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  • Part time employee with an ACA marketplace plan and received a 1095C.

    It appears that you are screwed.  These codes indicate that the employer coverage was minimum coverage and affordable:

    If your adjusted gross income (actually there are a few differences between this and the income for the ACA, but I will presume that this does not apply to you) is over 400% of poverty; if you were a single person in the conterminous USA - i.e., not Alaska or Hawaii - then poverty is $12060.

    According to this

    if your income is not over 400%, then there is a limit to how much you need to pay back.

    Now, all that said, if you were not notified by your employer that you had the ability to get health coverage from you, you might be able to wiggle your way out - or absent that - sue your employer for damages for not informing you that you could get coverage.  I suggest that you go to your employer's Human Resources department and ask for documentation that proves that you were properly notified that you had access to health coverage.  I would also contact your state's department of labor and complain about this; they will get to the bottom of whether you had been properly notified.  You should also contact your US Senator and ask for assistance in this.

  • It's been years now...

    Folks would not have a problem if there were no mandates, both the employer and moreso the individual.  They are also bellyaching about limited networks (for the cheaper policies), but these folks were bitching about how the HMOs did that in the '90s.  And they are understandably mad that the policies seem to cost so much more (even though a lot of folks get a tax credit that makes the cost less) than what they had in the individual market - but they don't understand that those policies were either junky (i.e., didn't really cover anything serious, but they didn't learn about this as they had been healthy and didn't get into the status of needing serious coverage) and/or were based on the fact that they were healthy and so did not represent the actuarial risk of the population at-large (i.e., sick folks weren't able to buy those policies priced for healthy folks), and that the ACA policies mandate unlimited coverage, while their pre-ACA policies had some sort of limit (which may have seemed to be high, but once you get into hard cancer and exotic diseases are not high enough).  I have read that this unlimited provision could be the reason for a whole quarter of the ACA policies.  And finally you have the standard libertarian and conservative curmudgeons who always complain about redistribution and "control from Washington".

    With that said, there are some folks who didn't like the pre-ACA system and rightfully have determined that the ACA doesn't really control costs the way that they think a more market-based system would.  The problem is that once health care is considered an essential human need (like food, clothing, shelter), it cannot be subject to the vagaries of the free market.  The best thing that the ACA has done is satisfy this need, and there is no political way that this need will not be addressed in any replacement, no matter what the about-to-crack-up Republican Party thinks.  And there are some folk who respond that they disfavor the ACA because they are for Medicare-For-All, even though they prefer the having the ACA rather than not.
  • Is there a non-exchange website to get premium data?

    I am trying to find out what is *exactly* the 2nd lowest cost Silver plan for my situation (i.e., location, age, smoking status).  This cannot be done using the Health Care Marketplace without cancelling the current application, which of course is far too onerous.  It is possible to get an "estimate", but that is insufficient.  I understand that some folks have set up website to tap into this data and present it.