When Are You Legally Required to Report "Life Changes" to the Pennsylvania Health Insurance Exchange?
Are you planning to get married, change jobs, or move to a new state? If so, you might have to share your big news with HealthCare.gov.
Which Changes Must You Report?
If you buy a health insurance plan through the Pennsylvania marketplace, the Affordable Care Act requires you to report changes that may affect your insurance coverage. These changes include:
- moving to a new state or insurance coverage area
- significant changes in income
- getting new health coverage through a job
- signing up for Medicare or Medicaid
- getting married or divorced
- becoming pregnant, having a child, adopting a child, or placing a child for adoption
- losing or gaining a dependent
- becoming disabled, and
- other changes that affect your income or household size.
Under the law, you must report most changes to HealthCare.gov within 30 days. (See 45 CFR § 155.330(b)(1).)
If you don’t report a change yourself, there’s a chance that the marketplace will discover the change and contact you. If this happens, you’ll have 30 days to review any notice and make necessary corrections to the information. (45 CFR § 155.335.)
Report Changes to Avoid Tax Shock
One of the most important reasons to report life changes -- aside from compliance with the law -- is to avoid a financial wallop when you file your taxes. If you are getting insurance subsidies to lower your monthly premiums, a life change could reduce your eligibility for financial help. If you don’t report the change and adjust your benefits during the year, the IRS will ask you to pay the government back at tax time.
On the other hand, if your income falls and you don’t report it, the IRS may owe you money because of the tax credit.
If you need to update your marketplace coverage because of a significant life change, you generally have 60 days to do so. (See 45 CFR § 155.420(C) and How do I report life changes to the Marketplace? on Healthcare.gov.)
How to Contact HealthCare.gov to Report Changes
To contact Pennsylvania’s exchange to report a life change and make changes to your insurance plan, use the contact information in How to Get Help from Pennsylvania's Health Insurance Exchange.
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