Under the Affordable Care Act (ACA) health care reform law, depending on income, premium tax credits and other cost-sharing reductions may be provided on an advance basis throughout the year to taxpayers who don’t have access to affordable group coverage and who buy individual policies through a state-based health insurance exchange. A critical function of the individual exchanges is to verify that taxpayers are eligible for these advance subsidies.
• HUGE QUESTIONS: What’s to stop an employee who has access to affordable group coverage from gaming the system and getting those subsidies anyway? And how will you know? Two sets of regulations—which, together, impose a regimen of verification, reconciliation and information reporting—begin to answer these questions.
Verification and reconciliation
These final regs apply in the 16 states and the District of Columbia that are setting up their own exchanges.
Under the regs, appl...(register to read more)