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Patient Protection and Affordable Care Act (PPACA) Better known as ACA

Patient Protection and Affordable Care Act (PPACA) Better known as ACA. Status. The following presentation is an overview of the Affordable Care Act ( ACA ) Forms and specific documentation are in draft form and could change Implementation in TaxWise is unknown at this time.

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Patient Protection and Affordable Care Act (PPACA) Better known as ACA

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  1. Patient Protection and Affordable Care Act (PPACA) Better known as ACA

  2. Status • The following presentation is an overview of the Affordable Care Act (ACA) • Forms and specific documentation are in draft form and could change • Implementation in TaxWise is unknown at this time 2014 TRS Webinar – September 2014

  3. Presentation Outline • Applicable document and forms • Three main elements of ACA (Overview) • Three flow charts • Interview flow chart • Instructor topics 2014 TRS Webinar – September 2014

  4. ACA Documentation and Forms • Addendum being written for Pub 4491 which will be identified as Pub 5157 • Good description of ACA • ACA Tab being created for Pub 4012 • Decision Tree and Charts • Form 1095-A Health Insurance Marketplace Statement – Issue by Marketplace 1/31/15 • Form 8962 – Premium Tax Credit • Form 8965 – Healthcare Coverage Exemptions • Changes to Form 1040 2014 TRS Webinar – September 2014

  5. Three Main Elements 1. Everyone must have Healthcare Insurance • Exemptions are available (Form 8965) 2. Financial Hardship? • Assistance may be available (Form 8962) 3. No Insurance? • May be penalized 2014 TRS Webinar – September 2014

  6. 1. Acceptable Insurance • Employer Provided • Affordable (does not exceed 9.5% of household income) • Minimum Value (covers at least 60% of expected medical expenses) • Medicare • Medicaid • Purchased via Health Insurance Marketplace 2014 TRS Webinar – September 2014

  7. Exemptions Available • Income Below Income Tax Filing Threshold • Unaffordable (Premium >9.5% household income) • Short Coverage Gap (No coverage <3 months) • Not lawfully present in US 2014 TRS Webinar – September 2014

  8. Exemptions Available (cont) • Member of a: • Health Care Sharing Ministry • Federal recognized Indian Tribe • Recognized religious sect conscientiously opposed to accepting insurance benefits • Incarcerated 2014 TRS Webinar – September 2014

  9. 2. Financial Hardship – Assistance May be Available • Premium Tax Credit (PTC) – Refundable Credit • Advance available to help pay premiums • Exchange can estimate PTC at time of purchase • PTC can be paid in advance to insurance company OR applied as refundable credit on 2014 federal tax return • Must be reconciled on 2014 tax return • Form 1095-A and Form 8962 2014 TRS Webinar – September 2014

  10. Premium Tax Credit Eligibility • Must buy Health Insurance through Marketplace • Employer coverage NOT eligible • Household income within limits (100% – 400% of government federal poverty guidelines) • Not eligible for coverage in Government Program • Cannot file MFS • Cannot be claimed as a dependent 2014 TRS Webinar – September 2014

  11. Verification • Taxpayer must notify Marketplace of • Changes in Household Income • Changes in Household • Marriage or Divorce • Birth or Death • Eligibility for other Programs • Advance payments adjusted 2014 TRS Webinar – September 2014

  12. 3. No Insurance? May be penalized • If taxpayer or any dependent doesn’t have Minimum Essential Coverage (MEC) and doesn’t have an exemption must: • Must make a Shared Responsibility Payment (SRP) with tax return • Effective January 1, 2014 2014 TRS Webinar – September 2014

  13. Documentation and Forms Three Main Elements 1. Everyone must have Healthcare Insurance • Exemptions are available (Form 8965) 2. Financial Hardship? • Assistance may be available (Form 8962) 3. No Insurance? • May be penalized • QUESTIONS ?????? 2014 TRS Webinar – September 2014

  14. Three Conditions to Consider – See charts in ACA Tab Pub 4012 • Chart A – Taxpayer, Spouse and Dependents had insurance all year • Chart B – Taxpayer, Spouse and Dependents had NO insurance all year • Chart C – Taxpayer, Spouse and Dependents had insurance part of the year 2014 TRS Webinar – September 2014

  15. Chart A – Taxpayer, Spouse and Dependents Had Insurance All Year 2014 TRS Webinar – September 2014

  16. ACA Tab Pub 4012 – 2014 Federal Tax Filing Requirements Thresholds 2014 TRS Webinar – September 2014

  17. Chart A – Taxpayer, Spouse and Dependents Had Insurance All Year 2014 TRS Webinar – September 2014

  18. Examples – Minimum Essential Coverage – ACA Tab Pub 4012 2014 TRS Webinar – September 2014

  19. Example – Does Not Qualify for Minimum Essential Coverage – ACA Tab Pub 4012 2014 TRS Webinar – September 2014

  20. Minimum Essential Coverage 2014 TRS Webinar – September 2014

  21. Form 1095-A 2014 TRS Webinar – September 2014

  22. 2014 TRS Webinar – September 2014

  23. Premium Tax Credit (PTC) • Refundable Credit • Must buy Health Insurance through Marketplace • Household income within 100%–400% of government federal poverty guidelines • Exchange will send Form 1095-A to taxpayer by 1/31/15 to allow reconciliation on tax return – Form 8962 2014 TRS Webinar – September 2014

  24. Household Income for PTC • Modified adjusted gross income plus that of every other individual in their family for whom they can properly claim a personal exemption deduction and who is required to file a federal income tax return PLUS • Any excluded foreign income, nontaxable SS (including tier 1 RRR) and tax-exempt interest received or accrued during the taxable year. 2014 TRS Webinar – September 2014

  25. Chart A Summary – Taxpayer who had Insurance All Year • If Taxpayer had insurance that qualified as minimum essential coverage and insurance was purchased through the Marketplace, then there is the potential to qualify for Premium Tax Credit. • Premium Tax Credit is calculated on Form 8962 with information provided by the Marketplace on Form 1095-A • QUESTIONS – ????? 2014 TRS Webinar – September 2014

  26. Chart B Summary – Taxpayer Had No Insurance All Year • If the taxpayer qualifies for exemption – Form 8965 must be completed • If taxpayer does not qualify for exemption, then shared responsibility payment may be required to be submitted on 2014 Form 1040. 2014 TRS Webinar – September 2014

  27. Form 8965 2014 TRS Webinar – September 2014

  28. Form 8965 Part I Marketplace-Granted Exemptions 2014 TRS Webinar – September 2014

  29. Shared Responsibility Payments for TY 2014 • Greater of: • 1% Household Income above filing threshold for filing status • $95.00/adult + $47.50/dependent child capped at $285.00 for family • Computed amount is capped at an amount equal to the national average premium for a bronze level health plan (included in Pub 4012 Tab ACA) • Payments reported in payments section of Form 1040 2014 TRS Webinar – September 2014

  30. Be Aware of Increased Shared Responsibility Payment in Future 2014 TRS Webinar – September 2014

  31. Chart B Summary – Taxpayer Had No Insurance All Year • If the taxpayer qualifies for exemption – Form 8965 must be completed • If taxpayer does not qualify for exemption, then shared responsibility payment may be required to be submitted on 2014 Form 1040. • QUESTIONS – ?????? 2014 TRS Webinar – September 2014

  32. SRP Partial Year Essential Health Insurance Coverage • Refer to ACA Tab Pub 4012 • Worksheet for partial year coverage • 2014 National Average Bronze Plan Premium Table • 2014 Federal Tax Filing Requirement Thresholds 2014 TRS Webinar – September 2014

  33. 816 2014 TRS Webinar – September 2014

  34. 204 2014 TRS Webinar – September 2014

  35. 2014 TRS Webinar – September 2014

  36. 204 2014 TRS Webinar – September 2014

  37. Chart C – Summary Part Year Coverage QUESTIONS???? 2014 TRS Webinar – September 2014

  38. Counselor Interview Flow Chart 2014 TRS Webinar – September 2014

  39. Counselor Interview Flow Chart Prepare Return in Normal Manner 2014 TRS Webinar – September 2014

  40. Counselor Interview Flow Chart Special Processing Required 2014 TRS Webinar – September 2014

  41. Instructor Training • Webinars • Significant Training of Instructors required at Workshops • Understand Pub 4012 ACA Tab • Understand Pub 5157 • Terminology • Understanding of ACA Rules • Interview Questions • Quality Review 2014 TRS Webinar – September 2014

  42. Instructor Training • Understanding of Tax Law/Forms • 1095-A • 8962 • 8965 • Shared Responsibility Payment • TaxWise Application • What will TaxWise Handle? • How to work with taxpayer 2014 TRS Webinar – September 2014

  43. Terms that have meaning in ACA – Patient Protection and Affordable Care Act PPACA ACA – Affordable Care Act – Premium Tax Credit PTC ISRP – Individual Shared Responsibility Provision – Shared Responsibility Payment SRP – Federal Poverty Line FPL – Health Insurance Marketplace Statement Form 1095-A – Premium Tax Credit Form 8962 – Health Care Coverage Exemption Form 8965 2014 TRS Webinar – September 2014

  44. ACA QUESTIONS???? 2014 TRS Webinar – September 2014

  45. 2014 TRS Webinar – September 2014

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