Tuesday, June 11, 2024

Does Unemployment Count As Income For Covered California

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Update: A Simple Guide To Getting The Most Tax Credithere

Medicare Matters: What Counts as Income?

A lot of the enrollment process centers aroundincome now since that’s the key driver forhealth subsidies with ACA plans.

The differencebetween getting and not getting a subsidy canmean $1000’s of dollars each year so we reallywant to understand the income section.

Let’slook at what the Exchange will request in termsof income.

B How Much You Are Entitled To In Unemployment Benefits In California

1. If I am a laid-off employee, how much in unemployment benefits am I entitled to?

The normal amount you are entitled to for unemployment benefits ranges from $40 per week to $450 per week, plus the $600 per week provided by the Federal CARES Act . The EDD has an online calculator to help you determine the exact amount.

2. How much can independent contractors, gig workers, self-employed individuals, or freelancers get in PUA/unemployment benefits?

In order to provide benefits as quickly as possible, payments will be issued by the EDD in phases. If you qualify for PUA , the initial payments you will receive are as follows:

  • $167 per week, for each week from February 2, 2020 to March 28, 2020, that you were unemployed due to a COVID-19 related reason.
  • $167 plus $600 per week, for each week from March 29, 2020 to July 25, 2020, that you are unemployed due to a COVID-19 related reason.
  • $167 per week, for each week from July 26, 2020 to December 26, 2020, that you are unemployed due to a COVID-19 related reason, up to a total of 39 weeks .

If you qualify for your claim to be backdated to an earlier PUA effective date based on your last day of work, you could receive payment for prior weeks you were unemployed due to COVID-19. You will be required to provide the EDD eligibility information every two weeks. This is known as certifying for benefits.

TOTAL: $3,569

4. Are unemployment insurance benefits taxable to the recipient?

G Appealing An Adverse Decision On An Unemployment Claim

1. How do I appeal a decision from the EDD on my unemployment claim?

You have the right to appeal the EDD’s decision to reduce or deny you benefits. You must submit your appeal in writing within 30 days of the mailing date on the Notice of Determination and/or Ruling .

You can download the Appeal Form or use the copy included with the Notice of Determination that you receive. Mail your appeal to the return address shown on the decision notice.

If you dont have a copy of the Appeal Form , or cannot print a copy, you can write a letter to the EDD to notify the Department that you want to appeal the decision to reduce or deny you benefits.

If you choose to write a letter, include all of the following information:

  • Full name
  • The name and mailing address of any representative
  • The reason for your appeal
  • A copy of the decision you are appealing or the date of the decision
  • Any request for language assistance or special accommodations

2. What happens after you file an appeal?

The EDD’s Office of Appeals will notify you of the time and location of your hearing at least 10 days in advance. An Administrative Law Judge will conduct the hearing, and give employers and claimants a chance to present their evidence.

Note: If you live outside of California, your appeal will be conducted by phone.

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Government Programs For Children: Obamacare Information Guide And Wage Limits

Adults qualify for Medi-Cal with a household income of less than 138% of FPL. However, according to the Covered California income guide, children who enroll on Obama Care California plans may qualify for Medi-Cal when the family has a household income of 266% or less. The children must be under 19 years of age to qualify. Also, C-CHIP, the County Childrens Health Initiative Program, offers health care coverage for children when the family income is greater than 266% up to 322% of FPL.

Do I Qualify For Cost Assistance Through Covered California

SDI State Disability

If you make between 138 and 400% of the FPL areeligible for premium tax credits. In addition to qualifying for a subsidy, youwill also qualify for a California Silver Plan.

  • If you make > 138to 150% of the FPL, you will qualify for the Silver Enhanced 94 Plan, which covers 94% of the average annualcost of health care.
  • If you make > 150to 200% of the FPL, you will qualify for the Silver Enhanced 87 Plan, which covers 87% of the average annual cost of health care.
  • If you make > 200to 250% of the FPL, you will qualify for the Silver Enhanced 73 Plan, which covers 73% of the average annual cost of health care.

The California Silver Plans are a popular choice because they tend to have affordable monthly premiums and mid-sized deductibles. They also have discounted fees for common medical services. The California Silver Plans may be best suited for those who are relatively healthy, mainly receive routine care during doctor visits, and take generic drugs.

You can compare the benefits and costs of the California Silver plans through e-Health, by checking out Individual and Family Health Insurance plans, selecting Affordable Care Plans, answering a few questions about yourself and your coverage aims, and letting us help you find the most affordable plans that match your needs.

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Obamacare Income Guidelines Chart Based On The Federal Poverty Level

According to Covered California income guidelines and salary restrictions, if an individual makes less than $47,520 per year or if a family of four earns wages less than $97,200 per year, then they qualify for government assistance based on their income. If the family has a lower household net income, then a greater amount of government assistance is available to the family. Tax deductions can lower your income level. View the Covered California income limits chart below.

What If Youre Eligible For Medicaid

Its important to understand that Medicaid eligibility is not affected by the change in how income is counted for people who are receiving unemployment compensation this year.

ARP Section 9663 temporarily adjusts the rules relating to ACA Section 36B and ARP Section 2305 temporarily adjusts the rules relating to ACA Section 1402 . In both cases, the legislative text that disregards income above 133% of FPL for 2021 is clear in noting that its for purposes of this section, meaning that the persons income above 133% of FPL would not be disregarded for other purposes, such as determining Medicaid eligibility, Basic Health Program eligibility , or whether an offer of employer-sponsored coverage is considered affordable.

If a person is eligible for Medicaid based on their regular ACA-specific modified adjusted gross income, they would continue to be eligible for Medicaid in 2021 even if theyre receiving unemployment compensation. In states that have expanded Medicaid, eligibility for adults under the age of 65 extends to 138% of the poverty level . This could potentially cause some confusion in terms of the financial assistance for which people are eligible if theyre receiving unemployment compensation in 2021. But the crux of the matter is that the externally imposed temporary income cap of 133% of the poverty level does not apply for the determination of Medicaid eligibility, whereas it does apply for the determination of premium subsidies and cost-sharing reductions.

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What If I Dont Qualify For A Subsidy

If you do not qualify for a subsidy, you may have topay for your health insurance on your own. Many people who make just over thesubsidy cut off have a difficult time affording their coverage. This which isreferred to as TheSubsidy Cliff mostly affects middle-income individuals and families.

Additionally, California has passed an individualmandate law at the state level. This means that if you dont qualify for anexemption and go without health insurance for the 2020 coverage year you mayhave to pay a tax penalty at the end of the year. This tax penalty is $696 peradult or 2.5% of householdincome, whichever is larger. You can learn more about the penalty in our breakdownof the changes to California health insurance.

However, with eHealth you can use our free onlinetools to help compare government plans to private health insurance plans to seeif private health insurance is more affordable option for you. Even if youdont qualify for subsidies, eHealth has affordable options that are right forboth your health insurance coverage and budgetary needs.

To start comparing health insurance options onlinewith eHealth, enter your zip code below.

Make Sure To Report Any Mid

Unemployment Accounts Suspended As California Sorts Through Fraud

If you or anyone in your household experiences anysignificant income changes throughout the coverage year, make sure to reportthem as soon as possible. You may become eligible or ineligible for subsidiesdepending on how your income changes.

If you experience a significant increase in youryearly income and become ineligible for subsidies, you may have to pay yoursubsidies back during tax season the following year. This is why its importantto try to be as accurate as possible when reporting your income when you applyfor subsidies at the start of the year.

Make sure to report any income changes as soon aspossible to avoid missing out on coverage or owing money at the end of theyear.

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How Can I Keep My Medi

During the public health emergency, the state will continue all Medi-Cal coverage until the end of the COVID-19 public health emergency.17 Counties must ensure people keep their Medi-Cal.18 This means, Counties cannot terminate or decrease your Medi-Cal benefits.19

If your Medi-Cal benefits terminated or decreased after April 1, 2020, then you should call your County to request that your Medi-Cal be reinstated back to April 1, 2020.20 For this request, Counties should not require you to submit additional documents, verifications and/or information to reinstate your benefits.21 Counties must prioritize these requests to reinstate Medi-Cal benefits that have been terminated or decreased.22 In addition, you may flag the countys erroneous decrease or termination of Medi-Cal benefits for the Department of Health Care Services by sending an email to . In the initial email to DHCS, do not share your personal and confidential information. Instead, ask DHCS to send you an encrypted email response so you can share your specific confidential information.

Government Programs And Assistance Based On Income Ranges

For adults, the following Covered California income restrictions apply:

  • 0% 138% of FPL: You qualify for Medi-Cal.
  • > 138% 400% of FPL: You qualify for a subsidy on a Covered California plan.
  • > 138% to 150%: You also qualify for the Silver Enhanced 94 Plan.
  • > 150% to 200%: You also qualify for the Silver Enhanced 87 Plan.
  • > 200% to 250%: You qualify for the Silver Enhanced 73 Plan.

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Will Getting Coronavirus Testing Treatment Or Vaccines Hurt My Immigration Status

No. The former Trump administrations public charge rule has been completely rescinded. It neverapplied to testing, screening, treatment, and vaccines for COVID-19. If you receive COVID-19 treatment under Medi-Cal, it will not harm your immigration status. For more information on Medi-Cal coverage options regardless of immigration status, .

Under federal guidelines, all health care facilities including vaccine distribution sites are off limits for immigration enforcement agents. This means Immigration and Customs Enforcement should not arrest people or enforce immigration rules at health care facilities and vaccine sites.

For more information, check out:

I Have Private Insurance Does My Insurance Have To Cover Coronavirus Tests Ortreatments

unemployment counts as income for Covered CA, MAGI subsidies

Yes! Under the federal CARES Act law, all health insurance plans in California are required to cover coronavirus testing , screening, and vaccine administration.

The California Department of Managed Health Care requires its managed health care plans or HMOs to cover screening and testing for COVID-19 for free when the plan finds that testing is medically necessary, and for essential workers. Plans must cover testing for people who have symptoms, who have had known contact with someone with COVID-19, or who are essential workers. For all others, DMHC plans may charge cost-sharing for screening and testing services.

The California Department of Insurance requires licensed insurance plans to cover screening and testing for COVID-19 at no cost to enrollees, and must waive prior authorization requirements for services related to coronavirus testing and screening.

This means that many Californians will not have any out-of-pocket expenses, co-pays or deductibles, even if they receive testing and screening at hospital emergency rooms and urgent care facilities.

Find a testing site at the states COVID-19 Testing Sites website. You can also contact county public health departments and your local clinic to receive information about your options for testing and screening.

Additional information is available at www.covid19.ca.gov, the California Department of Public Health, and the Centers for Disease Control & Prevention.

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How To Estimate Your Income

Any financial help you get is based on what you expect your household income will be for the coverage year, not last years income. When you calculate your income, youll need to include the incomes of you, your spouse, and anyone you claim as a dependent when you file taxes.

You can start by using your adjusted gross income from your most recent federal income tax return, located on line 8b on the Form 1040. Add any foreign income, Social Security benefits and interest that are tax-exempt. Then, add or subtract any income changes you expect in the next year.

Some people, especially those who are self-employed or unemployed, have unpredictable incomes. In that situation, its best to estimate as accurately as possible, and then report changes in income throughout the year in your account.

If you file taxes the following year and you collected financial help you shouldnt have, the amount you owe will need to be paid then.


How Can I Get Or Keep Covered California Or Other Health Insurance

  • Covered California: A special enrollment period is open until May 15, 2021 at www.coveredca.com. You can always sign up for Covered California within 60 days of losing your job or health coverage and during annual Open Enrollment .
  • Recovery rebate payments do not count for Covered California eligibility.
  • Other health insurance : If you have insurance through your job or former job , many deadlines are extended. You have more time to decide to enroll in COBRA, more time to file appeals under your employer-provided insurance, and other extra time. Check out the Department of Labors FAQs for more information.

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If I Cancel My Cobra Coverage Will That Be Counted As A Qle

No. Canceling your COBRA because it is too expensive or you have changed your mind is not considered involuntary, so it is not a QLE. As a result, it is wise to explore your options, including Covered CA plans, before you elect to take COBRA.

Please note, if you applied for a Covered CA plan within your 60-day window of time from your loss of coverage date, and you find out that your insurance wont start right away, you can opt to take your COBRA coverage for a month or two to fill in the gap. Just be sure to cancel your COBRA when your Covered CA plan is supposed to start.

Exhibit 1 2021 Coverage Year Percent Of Household Income Paid For Covered California Benchmark Silver Premium

Top mistakes people make when filing for unemployment benefits with EDD in California
Income Range

Notes:* Individuals with income at or below 138% FPL are generally eligible for Medi-Cal. In certain limited circumstances, however, they are eligible for the federal premium tax credit and the California state subsidy program.** Under the ARP, Covered California enrollees receiving Unemployment Insurance in 2021 are treated as though their income is no more than 138.1% FPL for the purposes of the federal premium tax credit meaning their required contribution for a benchmark plan will be 0%.*** Eligibility for the California state subsidy program ends at 600% of the federal poverty levelSource: Covered California, March 2021 Board Meeting

The ARP will provide additional subsidies for the 1.35 million Californians already enrolled with subsidies through Covered California as of . Without the ARP, these Californians would have received subsidies worth an average of $411 per person per month in 2022 through a combination of ACA and California-specific subsidies under the ARP, they will get an additional $91 per month.

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Health Insurance Loss During The Coronavirus Pandemic

Since the beginning of the COVID-19 outbreak, there have been over 1 million reported cases and over 50,000 associated deaths in the United States. As COVID-19 continues to impact communities across the country, people need access to health care more than ever. Unfortunately, many people including Californians have lost their health insurance coverage during this difficult time.

Social distancing and self-isolation have become important tools in preventing the spread of the coronavirus. However, the need to stay home has also led to millions of job losses both temporary and permanent. For people who receive private health insurance coverage through an employer, this means their ability to access health care may be at risk.

To minimize the impact of pandemic-related job losses, Covered California has opened a Special Enrollment Period for qualifying individuals. If you have lost health insurance coverage due to COVID-19, Health for California is here to help you navigate your options.

What If I Have No Health Insurance

You should call your local hospital or clinic and ask if they can enroll you in Medi-Cals special COVID-19 coverage program. That will cover screening, testing, treatment, and vaccines for COVID-19 at no cost to you.

There are no income, resource, immigration, or other requirements to qualify. The coverage starts when you apply for this program. It lasts for 12 months or until the end of the month when the public health emergency expires . Coverage is available retroactive to April 8.

  • Find your nearest provider at this link. You can search by your address. Any of the clinics, hospitals, and doctor offices should enroll you in the COVID-19 coverage program. Instructions for medical providers are here.
  • For help finding a provider that can enroll you in this program, call the Medi-Cal nurse helpline at: .

Important: Even if you do not enroll in the COVID-19 coverage program, you can get COVID testing, treatment, and vaccines for free. Almost all medical providers can bill to a special federal program instead of charging you. For more information, check out these flyers in English and Spanish.

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