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  1. #1
    Join Date
    Mar 2019
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    6

    Default Part Time Employee Witn an ACA Marketplace Plan with Subsidy but Received Form 1095c

    I've been with a large national company for 10 years as a part time employee. To my knowledge they don't offer and have never offered health insurance to part time employees for as long as I've been with the company. Therefore to comply with the ACA, I signed up with the Healthcare Marketplace since the law went into effect and received a subsidy toward my premiums since 2014. I've never received a 1095c for prior years. However, this year I received a 1095C with code 1E on line 14 and code 2G on line 16. Which from what I've read means that they offered me affordable minimum coverage. However, I've never been offered anything.


    If my company doesn't offer healthcare for part time employees. And if they did, no one within my company ever notified me of the change and that I was eligible for coverage. How can they send a form saying that they offered me healthcare coverage retroactively, when they literally never offered or informed me that coverage was available? I can't go back in time and sign up for employee sponsored coverage for 2018 and I certainly can't afford to pay back all that subsidy, it's almost $7k. Calling HR was beyond useless. I'm not sure what to do at this point. Any help is appreciated.

  2. #2
    Join Date
    Oct 2014
    Posts
    7,425

    Default Re: Part Time Employee Had an Aca Marketplace Plan with Subsidy but Received a 1095c

    Quote Quoting khow
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    How can they send a form saying that they offered me healthcare coverage retroactively, when they literally never offered or informed me that coverage was available? I can't go back in time and sign up for employee sponsored coverage for 2018 and I certainly can't afford to pay back all that subsidy, it's almost $7k. Calling HR was beyond useless. I'm not sure what to do at this point. Any help is appreciated.
    Unfortunately the answers you need will have to come from your employer. There is no way I can know if the employer offered coverage that you were eligible for and if you were what effort the company made to make that information available to you. Since it matters whether the company did in fact offer a health plan that you were eligible for, you need to find someone in HR knowledgeable about the health care plans and get some answers.

  3. #3
    Join Date
    Mar 2019
    Posts
    6

    Default Re: Part Time Employee Had an Aca Marketplace Plan with Subsidy but Received a 1095c

    Quote Quoting Taxing Matters
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    Unfortunately the answers you need will have to come from your employer. There is no way I can know if the employer offered coverage that you were eligible for and if you were what effort the company made to make that information available to you. Since it matters whether the company did in fact offer a health plan that you were eligible for, you need to find someone in HR knowledgeable about the health care plans and get some answers.
    Unfortunately, my HR department isn't very helpful. I read somewhere that there are tight limits on what employees can be required to pay back regarding the PTC. But I'm not sure if that applies to my situation or just for someone with a higher income than listed on their Marketplace application. Are you aware if there is a way to dispute a 1095C? Because I was never offered or made aware that coverage was available to me.

  4. #4
    Join Date
    Oct 2014
    Posts
    7,425

    Default Re: Part Time Employee Had an Aca Marketplace Plan with Subsidy but Received a 1095c

    If you were not offered the insurance through your employer then the Form 1095-C is incorrect. The best solution to that is to get your employer to amend the form. If you need more time to deal with that you can file an extension to file the income tax return using Form 4868.

    Otherwise, your choices are to (1) file the return using the information on the form and repay the subsidy and then amend it later if you find out that your employer did not offer insurance that you were eligible for; (2) or file the return taking the position that you were not eligible for such a plan and amend the return later to repay the subsidy if you do learn you were eligible for insurance. If you file a return taking the position that you were not eligible for the insurance and the employer does not amend the Form 1095-C you can expect the IRS will contact you later to resolve the difference and at that time you will need to prove to the IRS that you were not eligible for insurance through your employer.

    Eventually, one way or the other, you'll need information from your employer to sort this out.

  5. #5
    Join Date
    Feb 2008
    Posts
    1,145

    Default Re: Part Time Employee Had an Aca Marketplace Plan with Subsidy but Received a 1095c

    how many hours a week did you work on average?

  6. #6
    Join Date
    Mar 2019
    Posts
    6

    Default Re: Part Time Employee Had an Aca Marketplace Plan with Subsidy but Received a 1095c

    Quote Quoting Taxing Matters
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    If you were not offered the insurance through your employer then the Form 1095-C is incorrect. The best solution to that is to get your employer to amend the form. If you need more time to deal with that you can file an extension to file the income tax return using Form 4868.

    Otherwise, your choices are to (1) file the return using the information on the form and repay the subsidy and then amend it later if you find out that your employer did not offer insurance that you were eligible for; (2) or file the return taking the position that you were not eligible for such a plan and amend the return later to repay the subsidy if you do learn you were eligible for insurance. If you file a return taking the position that you were not eligible for the insurance and the employer does not amend the Form 1095-C you can expect the IRS will contact you later to resolve the difference and at that time you will need to prove to the IRS that you were not eligible for insurance through your employer.

    Eventually, one way or the other, you'll need information from your employer to sort this out.
    Thank you for your reply. I'm not sure who determines eligibility for coverage, so I'm not sure how I would prove that to the IRS one way or the other. However, I know for a fact that I wasn't offered any coverage. I would assume that if I was offered coverage that I refused, that I would have had to sign a waiver of some sort. After receiving the subsidy for 4-5 years as a part time employee, I'm not sure why my eligibility would change out of the blue. Anyhow, thanks again for your time

    Quote Quoting hr for me
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    how many hours a week did you work on average?
    Under 30 on average. Last check dated 12/28/18 was regular hours worked 1466. 1466/52= 28.2 avg hours per week. I worked a few more hours the year before in 2017 and didn't receive a 1095C. I averaged 28.85 hours in 2017. I checked the payroll system and FTE is still listed at .50, so technically I'm still part time.

  7. #7
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,098

    Default Re: Part Time Employee Had an Aca Marketplace Plan with Subsidy but Received a 1095c

    My employer offers health insurance to employees working 17.5 hours per week or more, and there's one union who gets some benefits at 16 hours a week. Just because you're part time doesn't AUTOMATICALLY mean you're not eligible.

  8. #8
    Join Date
    Oct 2006
    Posts
    15,657

    Default Re: Part Time Employee Had an Aca Marketplace Plan with Subsidy but Received a 1095c

    Quote Quoting cbg
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    My employer offers health insurance to employees working 17.5 hours per week or more, and there's one union who gets some benefits at 16 hours a week. Just because you're part time doesn't AUTOMATICALLY mean you're not eligible.
    I agree, but he still says that he was never actually offered insurance, and that this is the first time out of 5 years of part time works that he received a 1095-C. I think its more likely that some sort of error was made on the employer's part rather than anything else.


    If he was offered insurance then there is the question of whether or not the insurance was "affordable" under the ACA's definition of affordable.

  9. #9
    Join Date
    Mar 2019
    Posts
    6

    Default Re: Part Time Employee Had an Aca Marketplace Plan with Subsidy but Received a 1095c

    Quote Quoting llworking
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    I agree, but he still says that he was never actually offered insurance, and that this is the first time out of 5 years of part time works that he received a 1095-C.
    This is correct. I've been part time with the company 10 years and they've never offered coverage. When Obamacare was passed I signed up for it to comply and not pay the penalty. In the past I've never had any problems or a 1095C issued to me. In any case, regardless of eligibility for coverage. I would think that they would actually have to notify me or make an offer of coverage. I haven't heard anything from the company regarding eligibility and after 5 years I would have no reason to think that anything would be any different from previous years.


    Quote Quoting llworking
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    If he was offered insurance then there is the question of whether or not the insurance was "affordable" under the ACA's definition of affordable.
    I looked up the codes online. On the 1095C under line 14 it had code 1E : Your employer made a qualifying offer of healthcare coverage to you, your spouse, and your dependent(s).

    And on line 16 it had code 2G :Your employer offered you coverage that was considered affordable based on the federal poverty line, but you did not enroll.

  10. #10
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,098

    Default Re: Part Time Employee Had an Aca Marketplace Plan with Subsidy but Received a 1095c

    It's possible that it was a mistake on the employer's part. It's also possible that he overlooked the offering.

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