Upload
others
View
4
Download
0
Embed Size (px)
Citation preview
Elizabeth ColvinProgram Director
Arianna AnayaSenior Enrollment Manager
Eliana BrantVolunteer Coordinator
Highlights of 20165,118 individuals enrolled in health coverage
95% of those enrolled received financial assistance
$13.9 million claimed to make health insurance affordable
1,521 musicians accessed healthcare coverage through a partnership between Foundation Communities and Health Alliance for Austin Musicians
Recognized by the Wall Street Journal in October 2015as “one of the most high‐profile sign‐up groups.”
Open All YearEducation
• Offer presentations to service providers and community groups• Provide one‐on‐one education to consumers • Educate consumers on next steps after they enroll
Enrollment• Marketplace Health Insurance, aka Obamacare • Exemptions • Medicaid & CHIP• Central Health’s Medical Access Program (MAP)
Problem Solving• Evaluate options for patients with complex medical needs • Submit the right documents to the Marketplace
Call us first, before you call the
Marketplace!
Enrollment Services in 7 Steps
1. Consent & Survey Info2. Offer of Employer Coverage?3. Estimated income for 2017?4. Who is in tax household?5. Complete application & review eligibility letter6. Educate on plan options & Enroll7. Post‐enrollment: Next steps for consumer
We have lots of tools to assist you with each step!
Resources and Tools1. Resource Page = Webpage with “how to” info
2. Site Manager
3. Volunteer Leadership Team
4. Volunteer “Tax Experts”
5. Bilingual Volunteers and Staff
6. Language Line
7. Not familiar with insurance? See page 33.
EncourageReferrals !
North @ 5900 Airport:M – Th 9am to 7pmF – Sat 10am to 4pm
South @ 2600 W Stassney:M – W 9am to 7pmTh – Sat 10am to 2pm
Extended hours for our busiest weeks: Dec 15 & Jan 31
OE4 Advertised Schedule
Quick Intro to Forms
© 2016 Foundation Communities
Pages 1‐5
Consent Form & Signature PagePages 1‐2
Tracking FormPages 3‐4
Envelope (draft)Page 5
Health Insurance TermsPage 33
ACA The Basics
© 2016 Foundation Communities
ACA Basics
1. Reforms that make insurance more accessible• Comprehensive coverage• Can’t deny for pre‐existing condition• Pricing not based on your health• Subsidies that make insurance more affordable
2. Individual mandate to have coverage (+ exceptions)
3. Created a Marketplace to buy insurance
ACA Basics - REFORMS
10 Essential Benefits1. Outpatient care2. Emergency services3. Hospitalization4. Mental health 5. Prescription drugs6. Maternity/newborn care
7. Rehab service & devices8. Lab services9. Preventative services &
chronic disease mgmt10. Pediatric services
Not required to cover for adults & doesn’t work like health insurance:
o Dentalo Basic Vision: routine preventive eye exam &
discount on glasses/contactsACA Basics - REFORMS
ACA Basics - REFORMS
Marketplace = healthcare.gov
5 Types of Plans on Marketplace
MetalLevel
Avg amount of costs that are
covered
Platinum 90%
Gold 80%
Silver 70%
Bronze 60%
Catastrophic < 60%ACA Basics - REFORMS
Higher premiums,Lower deductibles,
Pay less out‐of‐pocket
Lower premiums, Higher deductibles,
Pay more out‐of‐pocket
ACA Basics - REFORMS
Insurance Companies offering plans in our area in 2017
Ambetter from Superior Health Plan Blue Cross Blue Shield Idealcare from Sendero
? Humana
ACA Basics - REFORMS
News Stories
• United & Aetna leaving Marketplace
• Premiums are going up
• You can be automatically re‐enrolled
ACA Basics - REFORMS
United & Aetna Data
United & Aetna Marketplace plans represent 15% of enrollments in Texas
From data on our enrollments:Aetna 49 (1%)United 142 (4%)Humana 389 (12%)
Who Benefits Most from ACA Reforms
Most anyone can buy full‐price health insurance
but you only get subsidies if you can’t get insurance through your employer, your spouse’s employer, Medicaid, CHIP or Medicare.
ACA Basics - REFORMS
MEET MARK
PICTURE OF MARK HAS BEEN REMOVED
FOR THE ONLINE TRAINING VERSION
Mark's Marketplace Plan
Age: 50
County: Travis
No tobacco use
Single, no children
Part‐time job at ACC
Full‐time ACC student
Est 2017 income =$15,000
Mark’s Insurance Options
His insurance premium is based on 3 factors:
1. Age 2. County where he lives 3. Tobacco use
Mark's Marketplace Plan
If Mark’s premiums increase in 2017
Mark’s Premium Tax Credits increase
Mark's Marketplace Plan
Mark’s Premium Tax Credit
Mark selects a SILVER plan that costs
$253/mo
Mark’s Premium Tax Credit
$227 / mo$26/month premium for Mark to pay
Government sends tax credit to insurance company each month.
Mark's Marketplace Plan
2nd Subsidy (if pick SILVER plan)
makes using insurance affordable
Example: With Subsidy
With NO Subsidy
Deductible $500 $4,600
Maximum Out of Pocket $750 $6,300
Mark's Marketplace Plan
ACA Basics – SUBSIDIESMark's Marketplace Plan
Benefit of Insurance
Total amount Mark owes for year = $750
+ continue paying $26/month for premium
Hospital Bill = $53,000
Mark’s Marketplace PlanMaximum Out‐of‐Pocket = $750
Mark's Marketplace Plan
ACA Basics – SUBSIDIES
What you need to know about ELIGIBILITY for:
1) Marketplace insurance
2) Premium Tax Credits
3) Cost Sharing Reductions
Marketplace EligibilityAnyone can buy full‐priceMP health plan except:
1. Undocumented2. DACA / Dream Act / Dreamers3. Incarcerated4. Enrolled in free Medicare Part A
ACA Basics – SUBSIDIES
BUT…most need PREMIUM TAX CREDITS to afford it.
2 Subsidies 1. Premium Tax Credits (PTC) reduce monthly premium cost
• Household income = 100 – 400% FPL*• Not eligible for full Medicaid, free Medicare Part A, or
“affordable and adequate” employer insurance• Purchase any metal level: Bronze, Silver, Gold or Platinum
2. Cost Sharing Reductions (CSR) reduce out‐of‐pocket costs to use insurance (deductible, out‐of‐pocket maximum, copays) • Eligible for Premium Tax Credits PLUS• Household Income = 100 – 250% FPL*• Must purchase Silver Plan
* Limited eligibility below 100% FPL based on immigration status.
ACA Basics – SUBSIDIES
Who Qualifies for Subsidies[Step 2] Can’t get health insurance via employer,
Medicaid, or free Medicare Part A.
[Step 3] Estimated household income within range: Premium Tax Credits: 100 – 400%
Cost Sharing Reductions: 100 – 250%
Certain immigrants qualify below 100% FPL.
Agrees to file taxes for coverage year
Won’t file “Married Filing Separately” (with some big exceptions so not a common issue)
* Certain immigrants with incomes below 100% FPL also qualify. ACA Basics – SUBSIDIES
2 tools to determine Eligibility for Subsidies
1. Tracking Form (pages 3‐4)
2. Federal Poverty Level Chart (page 7)
ACA Basics – SUBSIDIES
ACA Basics – SUBSIDIES
Tracking Form Page 3
ACA Basics – SUBSIDIES
Page 7
2017 Federal Poverty Levels & Brackets for Marketplace Subsidies
Tracking Form Step 2: Offer of Employer Coverage?
Does anyone in tax household have OFFER of employer coverage? *
Need to determine if employer’s offer meets ACA’s definitions of (1) Adequate & (2) Affordable.
ACA Basics – SUBSIDIES
YES NO
Fill out Step 2 on tracking form.Go to Step 3: Est income.
* It doesn’t matter if accepted employer’s coverage or not. It doesn’t matter if missed employer’s open enrollment period.COBRA, retiree or student coverage ≠ offer of employer coverage
Adequate = real comprehensive insurancemeets MINIMUM VALUE
(1) Adequate
ACA Basics – SUBSIDIES
What is NOT adequate?x Prevention plan onlyx Indemnity planx Pays $‐‐‐ per day for hospital staysx AFLACx Accident Only coverage
Is this offer adequate?
ACA Basics – SUBSIDIES
Pages 9‐11
Pages 9‐11
ACA Basics – SUBSIDIES
Page 9
Sounds good, but what are they really saying?
ACA Basics – SUBSIDIES
Page 11
ACA Basics – SUBSIDIES
Pages 9‐11
If you are enrolled in ABM’s insuranceno penalty on tax return because meets Minimum Essential Coverage
But ABM coverage is not “real insurance.”It is NOT ADEQUATE and doesn’t meet
Minimum Value standard.
Now know ABM is not adequateComplete Step 2 of Tracking Form
ACA Basics – SUBSIDIES
Page 3
ABM (not adequate coverage ‐ indemnity plan)
X 11/1 250
Insurance is AFFORDABLE if amount employee has to pay for lowest cost “real insurance” for employee‐only is≤ 9.69% of the estimated household income for 2017.
(2) Affordable
ACA Basics – SUBSIDIES
NOTE: CMS training not updated. Correct % for 2017 is 9.69%.
YES = Affordable NO = UNaffordableEmployee NOT eligible for subsidiesbut can buy full‐price MP plan.
If SPOUSE offered insurance by that employer, NOT eligible for subsidiesbut can buy full‐price MP plan.
Dependents NOT eligible for subsidiesbut can buy full‐price MP plan or may qualify for CHIP/Medicaid.
Eligible for subsidies on Marketplace if meet income & other requirements.
ACA Basics – SUBSIDIES
Tool on Resource PageLetter for consumer to take to HR.
ACA Basics – SUBSIDIES
Allison works full‐time for Austin Independent School District.
Allison’s wife Abby is self‐employed as a singer‐songwriter.
Allison and Abby have 3 children.
Step 1: Get consent + survey info
Step 2: Allison has insurance through AISD.All 3 children have CHIP. AISD offers insurance to spouses.
Exercise 1:Page 13
ACA Basics – SUBSIDIES
Is it Adequate? Page 13
ACA Basics – SUBSIDIES
Is it Affordable? Page 13
Allison has choice of 2 “adequate” plans that cost employee $0.
Answer:
ACA Basics – SUBSIDIES
• Allison’s employer offers “real” insurance = Adequate
• That insurance is offered to Spouse and Children
• Cheapest “adequate” option would cost Allison $0
$0 ≤ 9.69% of Household Income = Affordable
Insurance is (1) Adequate and (2) AffordableOffered to both spouse and children
Allison, Abby, kids are NOT eligible for subsidies
Abby’s Options:
ACA Basics – SUBSIDIES
• Buy full‐price Marketplace plan (no subsidies)
• Buy full‐price plan outside of Marketplace
• Buy Catastrophic or Bronze plan (may be cheaper than employer plan)
• Sign up for Allison’s insurance during AISD’s next enrollment period.
• Ask Allison’s employer if Abby can enroll now
• Remain uninsured
• Abby may not pay penalty for being uninsured if Abby’s insurance cost > 8.16% of household income
Offer is unaffordable if > 9.69%
Exempt from penalty if plan cost > 8.16%
ACA Basics – SUBSIDIES
of 2017 household income.
Exercise 2: Could I be eligible for subsidies?
ACA Basics – SUBSIDIES
Page 14
UPDATED Question 3:
1. Which plans are ADEQUATE?
2. Which premium cost do you use to determine affordability?
ACA Basics – SUBSIDIES
Page 14
Step 3: Estimating Income
© 2016 Foundation Communities
Tracking Form = Enrollment Steps1. Consent & Survey Info2. Offer of Employer Coverage?3. Estimated income for 2017?4. Who is in tax household?5. Complete application & review eligibility letter6. Educate on plan options & enroll7. Post‐enrollment: Next steps for consumer
Pages 3‐4
Impact of Estimated IncomeImpact of Estimated Income
Page 7
Two-step process every year:Estimate then Reconcile at Tax TimeTwo-step process every year:Estimate then Reconcile at Tax Time
MP application estimates 2017 income.
Premium Tax Credits paid to insurer based on estimate.
Tax return shows actual 2017 income. Correct, final Premium Tax Credit amount is calculated & reconciled against credits consumer got the benefit of during the year.
2017
Income to Estimate:Modified Adjusted Gross Income (MAGI)Income to Estimate:Modified Adjusted Gross Income (MAGI)
NOT INCLUDEDNOT INCLUDED
• SSI (Supplemental Security Income – will have Medicaid)• Student Loans• Bank Loans• Cash gifts• Child Support• VA Benefits• Workers Compensation• Scholarships used for tuition/books
• SSI (Supplemental Security Income – will have Medicaid)• Student Loans• Bank Loans• Cash gifts• Child Support• VA Benefits• Workers Compensation• Scholarships used for tuition/books
Page 3
Modified Adjusted Gross Income (MAGI)Modified Adjusted Gross Income (MAGI)
• SSI (Supplemental Security Income – will have Medicaid)• Student Loans• Bank Loans• Cash gifts• Child Support• VA Benefits• Workers Compensation• Scholarships used for tuition/books
• SSI (Supplemental Security Income – will have Medicaid)• Student Loans• Bank Loans• Cash gifts• Child Support• VA Benefits• Workers Compensation• Scholarships used for tuition/books
See income list on Tracking Form: Page 3
Income that is NOT included in MAGIIncome that is NOT included in MAGI
Cash Income is Taxable
Must be on MP application & tax return even if:
• I haven’t declared it in the past.
• I don’t get a Form 1099 for it.
• I get paid under the table.
WEIRD INCOME? STOP & ASK!WEIRD INCOME? STOP & ASK!
Not sure if income will be included on tax return?
Ask anyone with “Tax Expert” on their nametag!
Not sure if income will be included on tax return?
Ask anyone with “Tax Expert” on their nametag!
Consumer's PerspectiveConsumer's Perspective
Accustomed to providing PAST or CURRENT income. Remind: We’re looking at FUTURE income for all 2017.
Know the amount they take home, not gross earnings.Remind: We need amount earned before taxes.
Unsure if they get Social Security, SSDI or SSI. If they have Medicaid = SSIRetired = Social Security Retirement Disability = SSDI
Accustomed to providing PAST or CURRENT income. Remind: We’re looking at FUTURE income for all 2017.
Know the amount they take home, not gross earnings.Remind: We need amount earned before taxes.
Unsure if they get Social Security, SSDI or SSI. If they have Medicaid = SSIRetired = Social Security Retirement Disability = SSDI
Helpful Questions to Get StartedHelpful Questions to Get Started
How do you earn your income?
What are your current sources of income?
Will your income in 2017 be similar to what you made in 2016?
How do you earn your income?
What are your current sources of income?
Will your income in 2017 be similar to what you made in 2016?
ALWAYS KEEP IN MINDPAST income is not necessarily a predictor of the FUTURE.
What You Learn:
Mark is single.
Quit his old job last month and has his final paystub.
He has new job as of Nov 1 but doesn’t have paystub yet.
New job is his only income.
His new job is at a small business with 5 employees.
His new employer does not offer health insurance.
Estimate Mark’s 2017 Income
Estimate Mark’s 2017 Income
Questions You Ask Mark:
What is your current hourly rate? $10
How many hours do you work a week? 35 – 40Do you plan to work all of 2017? Yes, I hope so.
Any overtime or unpaid time off? They don’t allow overtime. I don’t plan to take time off.
Your First Calculation:
$10/hour x 38 hours/week x 52 weeks = $19,760
Ask Mark: Does $19,760 look right for what you’ll make before taxes are taken out in 2017?
If Mark says NO, ask: Do you think you will make less or more?
Dig deeper: Why does Mark think he’ll make more or less?
What have you missed? What is off in the first calculation?
Your response:“Estimate based on what you know now:
o What you made last month OR o What you made the past few months OR o Income you expect to earn in 2017
You can adjust estimate as things change in 2017. We are open all year to help with any changes you need to make.
Your response:“Estimate based on what you know now:
o What you made last month OR o What you made the past few months OR o Income you expect to earn in 2017
You can adjust estimate as things change in 2017. We are open all year to help with any changes you need to make.
“I can’t predict my 2017 income. What if my album goes Platinum?”
~ Optimistic Musician
“I can’t predict my 2017 income. What if my album goes Platinum?”
~ Optimistic Musician
Helping the Self-Employed who don’t know what to estimate for 2017Helping the Self-Employed who don’t know what to estimate for 2017
If struggling to estimate 2017 income:
1. Print blank ledger from Resource Page.
2. Ask to fill in business income & expenses.
3. Capture info from past or upcoming month.
If struggling to estimate 2017 income:
1. Print blank ledger from Resource Page.
2. Ask to fill in business income & expenses.
3. Capture info from past or upcoming month.
Reminder: Use profit after expenses for self-employed!
When estimate is below 100% FPL(and not eligible for credits below 100% FPL)
State the facts:
When estimate is below 100% FPL(and not eligible for credits below 100% FPL)
State the facts:
“Because Texas decided not to expand Medicaid, you must be
able to make more than [100% FPL] in 2017 to get help paying for
insurance. At your estimated income, you can’t get subsidies but
you can purchase a full-price plan and may be eligible for HAAM
services (if musician) or MAP (if lives in Travis County).”
Ask: Is it important to you to get insurance coverage for 2017?
If yes: Do you have a way to make more income in 2017?
Could you pick up more hours or additional shifts or gigs?
“Because Texas decided not to expand Medicaid, you must be
able to make more than [100% FPL] in 2017 to get help paying for
insurance. At your estimated income, you can’t get subsidies but
you can purchase a full-price plan and may be eligible for HAAM
services (if musician) or MAP (if lives in Travis County).”
Ask: Is it important to you to get insurance coverage for 2017?
If yes: Do you have a way to make more income in 2017?
Could you pick up more hours or additional shifts or gigs?
A “JUSTIFIABLE” ESTIMATE FOR 2017 A “JUSTIFIABLE” ESTIMATE FOR 2017
If YES, can make more: Ask open ended questions: How much more do you think you can make in 2017?
Don’t ask (household of 1): Can you make $11,880 in 2017?
Explain: You may have to submit proof of how you will
earn this amount but you have 90 days to submit it. I’ll
explain more after we finish your application.
If YES, can make more: Ask open ended questions: How much more do you think you can make in 2017?
Don’t ask (household of 1): Can you make $11,880 in 2017?
Explain: You may have to submit proof of how you will
earn this amount but you have 90 days to submit it. I’ll
explain more after we finish your application.
Estimate is below 100% FPLEstimate is below 100% FPL
Artist is living with several roommates. Has never earned more than $10,000/year. Does part-time catering, odd jobs, and art. Guesses she will make $8,000 in 2017. Her mom gives her $200/month to help out. She says she struggles with depression & can’t work more.
Artist is living with several roommates. Has never earned more than $10,000/year. Does part-time catering, odd jobs, and art. Guesses she will make $8,000 in 2017. Her mom gives her $200/month to help out. She says she struggles with depression & can’t work more.
When estimate is below 100% FPL:When estimate is below 100% FPL:
Explain the facts.
Complete application for exemption number.
Does she want to purchase a full-price plan?
Does she live in Travis County? Schedule MAP appointment.
Provide resource card with info on sliding fee scale clinics.
If your income changes, come see us within 60 days.
NOTE: $200 from mom = GIFT, not earned income, so not included
Explain the facts.
Complete application for exemption number.
Does she want to purchase a full-price plan?
Does she live in Travis County? Schedule MAP appointment.
Provide resource card with info on sliding fee scale clinics.
If your income changes, come see us within 60 days.
NOTE: $200 from mom = GIFT, not earned income, so not included
Currently UnemployedCurrently Unemployed
It’s a snapshot. Not the whole picture.Estimating total income for ALL of 2017.
Consider:# months expect to be unemployed in 2017# months expect to be employed in 2017Average salary or hourly rate at previous jobsJob history
It’s a snapshot. Not the whole picture.Estimating total income for ALL of 2017.
Consider:# months expect to be unemployed in 2017# months expect to be employed in 2017Average salary or hourly rate at previous jobsJob history
Two-step process every year:Estimate then Reconcile at Tax TimeTwo-step process every year:Estimate then Reconcile at Tax Time
MP application estimates 2017 income.
Premium Tax Credits paid to insurer based on estimate.
Tax return shows actual 2017 income. Correct, final Premium Tax Credit amount is calculated & reconciled against credits consumer got the benefit of during the year.
2017
3 Consumer Protections for Reconciliation between
Estimated Income and Actual Income
• No reconciliation of Cost Sharing Reductions
• If final income for year is below 100%, treated as if eligible for tax credits.
• If underestimate income, there are limits to the amount you have to repay.
Consumer Protection if income ends up below 100%
• If you reasonably project income above 100%, you are protected if 2017 doesn’t go as planned and you make less than anticipated.
• IRS acts as if you are eligible for tax credits.
• You will NOT have to repay your tax credits as long as you were otherwise eligible.
Consumer Protections with Reconciliation
Maximum Repayment Amount Single Filing Status / Other Filing Status
Under 200% FPL $300 / $600
200% ‐ 299% FPL $750 / $1,500
300% ‐ 399% FPL $1,275 / $2,550400% FPL and above Must repay full amount owed
Actual Income when you prepare tax return
If you underestimate income, consumer protections limit how much
you have to pay back on your tax return.
On 2017 MP application, Mark estimated $19,760.
Premium tax credits = $293/ mo for Mark’s insurance.
In 2017, Mark worked more hours + earned $4k on side job.
Final income on Mark’s 2017 tax return = $24,000.
Correct amount of premium tax credits = $243/mo
Mark’s Reconciliation on 2017 Tax ReturnMark’s Reconciliation on 2017 Tax Return
Tax credits on estimated $19,760 = $ 3,516
– Tax credits on actual $24,000 = $ 2,916 Excess tax credits that = $ 600Mark repays on tax return
Repayment cap at 200 - 300% FPL = $750
Mark’s Reconciliation on 2017 Tax ReturnMark’s Reconciliation on 2017 Tax Return
Exercise #3 on Estimating IncomeExercise #3 on Estimating Income
Page 17
Step 4: Tax Household
© 2016 Foundation Communities
We don’t expect you to become a tax expert.
The purpose of this section is to familiarize you with tax terms.
4 resources to answer your tax questions
1. Volunteers with “Tax Expert” on their nametag.
2. Foundation Communities’ staff with many years of tax experience.
3. Tax Guide for Assisters by Center on Budget & Policy Priorities (link will be on Resource Page & we’ll email upon request)
4. Website: Health Reform Beyond the BasicsAlso produced by Center on Budget & Policy Priorities
Eligibility Questions
Step 2: Offer of Employer Coverage?Step 3: Estimated income for 2017?Step 4: Tax Household?
Use household size & income to find FPL %.Or go to http://kff.org/interactive/subsidy‐calculator/
Overview of Tax Basics
Why Taxes?
Filing Status
Tax Household & who can be claimed as a dependent
Why Taxes?Marketplace (MP) follows IRS tax rules when determining household size and income & MP results are reconciled on the tax return.MP application estimates household & income on future tax return.
Tax return captures actual household & income.
2017
What to Ask
Other than yourself (and spouse) how many other people are going to be on your tax return for the
upcoming 2017 year?
Filing Status RequirementsSingle Not married.
Married Filing Jointly Married, whether living together or apart, and file taxes together. Can be married via common law or courthouse.
Married Filing Separately Married, whether living together or apart, and file taxes separately.
Head of Household Unmarried or “considered unmarried” for tax purposes. Must pay more than half of the costs of keeping up the home for a qualifying person whom s/he will claim as a dependent.
Qualifying Widow(er) with Dependent Children
Special rules for a person whose spouse passed away in the tax year or the 2 previous tax years.
Married Filing Separately (MFS) in 2017
Victim of domestic abuse OR
Abandoned by spouse OR
Qualifies to file as Head of Household (most common)
1
MFS are generally NOT awarded tax credits BUT there are 3 BIG EXCEPTIONS to get PREMIUM TAX CREDITS:
2
3
If exception, answer NO to “Are You Married?” because he is “considered unmarried” for IRS purposes.
!
Think someone is MFS? Talk to tax expert on Volunteer Leadership Team!!
Head of Household RequirementsA married person is “considered unmarried” and eligible to file Head of Household if answers YES to all these questions for 2017:
Will you file taxes separately from your spouse?
Will you live separately from your spouse from July 1 to Dec 31, 2017?
Will you pay more than half of the cost of keeping up your home?
Do you have a child, stepchild, or foster child (of any age) who lives with you for more than half the year?
Will either you or the child’s other parent claim the child as a dependent?
If YES to all, answer NO to “Are you married?” because you are “considered unmarried” for IRS purposes.
Two Types of Dependents included on tax return
Qualifying Child
1
2
Qualifying Relative / Qualifying PersonImportant! Does not have to be related to filer but must meet certain requirements!
Qualifying Child= Filer’s child, step child, adopted child, brother, sister, niece, nephew or grandchild if s/he…
Is a US citizen or resident of US, Canada or Mexico
Lives with tax filer for more than half the year (2017) (except for temporary absences)
Meets AGE requirement: Under 19 at end of 2017 orunder 24 if a full‐time student for 5 months in 2017 orany age if determined disabled
Qualifying Child does not provide more than half of his/her own support in 2017 (rare)
Qualifying Relative (think “Qualifying Person”)
= Relative, step relative, in‐law, or full‐time member of tax filer’s household in 2017
Cannot be claimed as a Qualifying Child
US citizen or resident of US, Canada or Mexico
Receives more than 50% of his/her support from tax filer
Related to tax filer or lives in tax filer’s home all of 2017
Must earn less than ~ $4000 taxable income in 2017
Watch for people with $0 income:Ask: How are you supporting yourself?
Is someone paying your bills?Who do you live with?
Likely a DEPENDENT if US tax filer is paying their bills.
NOT a dependent if supporting self with income / savings from another country or support from family outside US.
Our Volunteer Leadership Team can help you determine tax household and if someone is a dependent.
Dependents In Mexico
• Can be dependents on tax return• May have ITINs or SSNs
Dependents who are not US citizens must reside in US, Mexico or Canada
to be included on tax return.
Individual Taxpayer Identification Number (ITIN)IRS issues for tax purposes if you don’t qualify for SSN
Spouses can live anywhere and get ITIN.
Dependents must live in US, Mexico or Canada
Undocumented?
Apply for an ITIN when you file your tax return.
Married to someone who is undocumented? Include that person on MP application & refer to our free tax services to apply for ITIN.
Immigration
© 2016 Foundation Communities
Page 7
Tool on Resource PagePages 19‐20
Who is Eligible for subsidies below 100% FPL?Certain Legal Permanent Residents (LPR):
• LPR less than 5 years • LPR 5+ yrs but not 10 yrs of work history / Social Security credits
Most Employment Authorization Card holders (Except for DACA or humanitarian status)
Certain Visas: F, J and O Visas (NOT B visas)
US Citizens 65+ who do not qualify for FREE Medicare Part A:• Do not have a work history in United States. • Have not lived in United States for at least 5 years.
Pages 19‐20
Exercise 4: Immigration Status & Eligibility
Page 18
ACA BASICS TRAINNGEXERCISE 4 – IMMIGRATION STATUS & ELIGIBILITY
1: LUCIA
2: AISHA & MOHAMMED
3: MARY & LEVI