Your clients may qualify for new health coverage outside open enrollment through Pennie if they’ve experienced a qualifying event.
Qualifying Life Events (QLE's) include:
- Lost Medicaid or CHIP
- Lost employer coverage
- Moved to a new state or county
- Married or divorced
- Had a baby or adopted a child
- Turned 26 and aged off a parent’s plan
- Lost COBRA
- Income changes
- Path-to-Pennie
If any of these happened to a client in the last 60 days, they may be eligible to get covered now.
Tax season is here, which means it’s time to remind your Pennie clients about important requirements related to APTC (Advanced Premium Tax Credits).
A quick outreach now can prevent IRS issues, ensure subsidy accuracy, and strengthen your client relationships.
What you need to know:
- Form 1095‑A comes from Pennie, not the IRS
- Every client who received subsidies in the prior year will receive a 1095‑A from Pennie. They need this form to file taxes and reconcile subsidies.
- Clients MUST file taxes if they received APTC
- If a client received any amount of subsidy, they are required to:
- File a federal tax return
- Include Form 8962 (Premium Tax Credit)
- Failure to file = loss of APTC eligibility next year.
- If a client received any amount of subsidy, they are required to:
- Income accuracy matters
- If clients estimated income too low or too high, tax filing will:
- Reconcile monthly subsidies
- Determine repayment or additional credit
- This is why agents should encourage clients to report income changes during the year.
- If clients estimated income too low or too high, tax filing will:
If you have any questions, I'm here to help! Give me a call at 717-216-8047.
