Connect for Health Colorado Insurance Exchange Representatives Misinform
If you are hoping to get health insurance through one of the newly minted marketplace health insurance exchanges, beware, some of the information posted on the government websites may mislead you. Worse yet, representatives answering your questions may give you incorrect information.
I live in Colorado and Colorado does not participate in the HealthCare.gov Health Insurance Marketplace, a federal health care exchange set up to implement the Affordable Care Act on the Federal level. Instead, in response to Obamacare, Colorado has opted to build its own health insurance exchange, ConnectForHealthCo.com Connect for Health Colorado, Colorado's Health Insurance Marketplace.
According to recent press, Colorado health care insurance exchange marketplace does not have nearly the problems of its Federal equivalent. It does, however, have other problems, which have not yet been reported in the mass media - it appears that the exchange representatives have not received proper training in order to be able to correctly answer your questions related to the Affordable Care Act. So, even if they act as if they know the answers, they often don't.
For example, I asked a Colorado health care insurance marketplace representative the following question: "A family of 4 has Modified Adjusted Gross Income (MAGI) of $3,000/month and otherwise qualifies when they apply for health insurance through the marketplace exchange. They receive the Advance Premium Tax Credit (APTC) applied in equal installments directly to their monthly insurance payments through the first 8 months of 2014. Then in September of 2014 their MAGI goes up to $20,000/month and remains at this level for the remainder of the year. They report this change to the health insurance marketplace within the 30 days, as required. Will they have to pay back the amount of APTC subsidy they received during the first eight months of 2014, when they file their taxes with the IRS?"
The Colorado health insurance exchange marketplace representative answering my question said that no pay back would be required. She was 100% convinced that she was correct even when I challenged her answer and she stood by it.
Worse yet, when I asked a sales representative from my current health insurance company, Rocky Mountain Health Plans, the same question, she had the same answer. And when I asked her how she knew this answer, she told me that her company's representatives were trained by the Colorado health insurance exchange marketplace.
I didn't stop there and went off to the federal health insurance exchange, armed with the same question. I attempted to get an answer from several of the Federal marketplace representatives and none of them professed that they knew the answer. One of the federal marketplace representatives I talked to, wanted to escalate the issue and have someone get back to me and the other referred me to the IRS.
I also tried the IRS, but after about an hour of trying to get through unsuccessfully gave up.
The bottom line is, IRS is the agency responsible for administering Affordable Care Act and they will not care, if you relied on erroneous information provided by other government agency's (or even their own agency's) representatives. So, be careful out there. And BTW, the correct answer to my question is that the IRS will, no doubt, claw back every last penny of that Advance Premium Tax Credit subsidy at tax time!