What counts as Income?

For purposes of the ACA, your income is based on your projected income for the tax year in which your insurance is. So, for a plan starting 5/1/2021, you will be projecting your estimated income for Tax Year 2021 even though you won’t be covered for the whole year.

Modified Adjusted Gross Income is the magic number. Unfortunately, MAGI is not a number on your tax return, and you’ll probably have to do some digging to find it. MAGI Includes:

  • Gross income from jobs, unemployment, retirement, distributions, capital gains, rental properties, etc
  • Social Security payments (they count BOTH your taxable and nontaxable amounts!)
  • Non-taxable interest and Foreign Earned income
  • If you’re self-employed, your gross income from the self-employment is calculated after expenses (but before taxes)

We always suggest that you speak with your tax preparer and/or financial advisor to help you figure out your projected income.

How long can I cover my kids on my plan?

  • The ACA allows you to cover your children up to age 26. This is the case regardless of whether or not you claim those children on your tax return! Sometimes, though, your child may qualify for tax credits on their own, so it’s worth looking at all the options before choosing.
  • If your adult child is disabled, you may be able to include them on your plan past age 26.

When can I buy insurance? What are Open Enrollment and Special Enrollment periods?

Open Enrollment for ACA plans is from November 1st through January 15th of each year (Colorado). Some states only allow the Open Enrollment until December 15th. During Open Enrollment, anyone who is eligible for a health plan can purchase one, even if you’ve never had insurance before. If you miss the Open Enrollment window, you must either have a Special Enrollment Period (due to a life changing event) or wait until the next Open Enrollment. Learn more about Special Enrollment Periods and Open Enrollment.

Are these Obamacare plans?

In short, yes. All true health insurance plans in Colorado must comply with the ACA regulations. There are a few exceptions such as sharing ministry memberships and grandfathered plans, but overall if you’re looking for a new plan, you’ll be getting an “obamacare” plan.

A common misconception is that “obamacare” requires you to enroll through the exchange and put in your financial information. This is not true. “Obamacare” is the ACA – a set of rules that health insurance plans must comply with.

Rates for true individual insurance plans are set for the entire year. If you’re speaking with someone on the phone and they tell you that your rate is only guaranteed if you “buy now” – be wary! These may be liability only insurance policies and most likely do NOT qualify under the ACA. Before purchasing a plan that looks too good to be true, call us for an analysis!

Do I have to stay on my group plan?

Not necessarily. If your employer-sponsored plan is simply too expensive, or if it’s too pricey to add your family to it, let’s look at some other options. You have choices in your health insurance, and you’re not required to keep your family all covered under the same insurance plan. However, you may be limited to changing your enrollment during a valid Special Enrollment Period.

What’s changing with health care?

Every few months we see some legislation attempts to try and change or update the insurance market. Want to keep up with what’s going on? We suggest following our Legislative Updates page.