Okay so I received a surprise bill today from my insurance company totaling 1,900 dollars!
It says retroactive adjustments from June 1st to September 30th.
So my husband and I were on the same healthcare plan through the marketplace.
My husband changed jobs and it changed some stuff like our premium tax credit. And I ended up switching to a different plan that better covered my medical condition.
My coverage with the first insurance ended May31st.
And it seems these adjustments come after that period.
Does anyone know what could be happening?
I have sent the insurance a message and plan to call tomorrow.
Posted by Conscious-Good-1456
1 Comment
Are these claim adjustments, or is it something like you had employer insurance available and took a marketplace plan anyway?
If it’s claim adjustments, they should send you new EOBs or letters mentioning their reasoning for the decision.
Employer insurance, it was that, will inevitably cause:
* Coordination of Benefits issues, as even if you didn’t take the plan an employer 1095-B or C was filed with the government…which other insurers and the marketplace also see.
* I.e. the insurer, marketplace, or a private skiptracer hired by either will pull giant databases full of IRS forms, paystubs, and insurance member lists to find anomalies in enrollment or insurer payments.
* Tax credit loss, if employee or the whole household is ineligible if employer insurance that meets both Minimum Value and Minimum Essential Coverage.
* For 2024 and beyond, this is assessed per person but as if each person worked at everyone’s job.
* E.g. if both parents have employer insurance, the “employee only” cost or 8.39% of household income, whichever is higher, is compared against the cost to add you, your spouse, each kid…and then rinse repeat for the other spouse’s job.
* Before 2024, this was subject to the “Family Glitch” where the employee alone, no consideration for others, being eligible nuked subsidies for the whole family.