The American Rescue Plan Act (ARPA) special enrollment period ends August 15—so now’s the time to check in with your clients. Ensure they have the coverage they need, or help them consider a plan change. The ARPA provides a premium tax credit to eligible individuals with an income above 400% of the federal poverty level (FPL) for 2021 and 2022. With no upper income limit for these 2 years, higher income individuals have now had access to premium tax credits if their benchmark plan premium exceeds 8.5% of their household income and they’ve enrolled in an individual plan through a health benefit exchange.
The ARPA provides:
- An increase in subsidies to eligible individuals by reducing the individual’s contribution for their premium. Individuals with incomes at 100% and up to 150% of FPL will be eligible for very low and, in some cases, zero-dollar premium coverage.
- A maximum Advance Premium Tax Credit (APTC) subsidy for individuals that receive 2021 unemployment benefits by treating their income as not greater than 133% of FPL. (Individuals need to attest to being approved to receive unemployment compensation.)
How does a Kaiser Permanente member take advantage of these subsidies?
It varies depending on the state where a member has coverage. For most existing exchange members, no action was needed if the member’s situation hadn’t changed (the local state-based exchange will automatically apply eligible subsidies). If your clients are currently in an off-exchange plan, help them apply for an on-exchange plan if they want to take advantage of new subsidies.
Work with your clients to help them determine the best Kaiser Permanente plan for them:
- On-exchange members currently receiving APTC may be eligible for increased APTC.
- Off-exchange and on-exchange non-APTC members may be newly eligible for APTC
or a premium tax credit when they file their 2021 taxes in 2022.
Please contact our KPIF Producer Support team at email@example.com or 1-800-474-1079, option 1, with any questions, including application receipt and effective date deadlines.