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13394: Marketplace Affordability Worksheet (ACA)


ACA

How do I complete the Marketplace Coverage Affordability Worksheets for Form 8965?

Due to changes from the TCJA ,starting in Drake19, screens 8965 and PLUC are not available as the penalty for not having minimum essential coverage is zero starting in tax year 2019.  

The Marketplace Coverage Affordability Worksheet is completed by entries on the Health Care tab, screens 8965 and PLUCScreen PLUC helps you complete screen 8965 so the software can determine if members of a tax household are entitled to a "coverage considered unaffordable" (Code A) exemption from ACA coverage requirements, where a member:

  • did not have minimum essential coverage for some part of the year and 
  • was not eligible for employer-sponsored coverage for that part of the year.

 

The first two columns are for the cost of employer-sponsored coverage. For those months when a tax household member was not eligible for employer-sponsored coverage, the third column requires Marketplace coverage information, which you can derive on the PLUC screen (see below for details). 

Screen 8965 produces worksheet Wks 89653, "Affordability Worksheet," when the cost of employer-sponsored coverage or marketplace coverage is entered on screen 8965. See below for details on the premium amount displayed. 

The PLUC screen produces worksheet Wks 89654, "Marketplace Coverage Affordability Worksheet" (page 11 of the Instructions for Form 8965). The PLUC screen and its link on screen 8965 refer to it as the Marketplace Affordability Worksheet. A separate worksheet is generated for each data entry area you complete.

Screen 8965 and Wks 89653

If an annual premium is entered on screen 8965, that annual premium is displayed for each month. If you enter individual monthly premiums, the software displays the annualized premium for each month.

The Affordability Threshold is an annual threshold. For each month, the annual threshold is compared to the annual insurance rate for the month. To make that comparison, the Wks 89653 displays the effective annual premium for each month. If you enter a single annual premium, that is displayed for each month. If you enter individual monthly premiums, your monthly entry is multiplied by 12.

The individual's exemption status is determined for each month by the comparison.

Screen PLUC and Wks 89654

Use the PLUC screen to look up the lowest cost Bronze plan premiums and the second-lowest cost Silver plan premiums and send the information to the appropriate lines of Form 8965 as well as to the Marketplace Coverage Affordability Worksheet (Wks 89654).

Read the text at the top of the PLUC screen carefully. Use this screen to figure an individual's required contribution for any month in which the individual was not eligible for employer-sponsored coverage. Complete a separate worksheet for each part of the year in which either the individual resided in different geographic rating areas served by the Marketplace or for which the number of people in the tax household who were neither exempt nor eligible for employer-sponsored coverage was different. 

  • Press Page Down for additional screens.
  • Use the Bronze and Silver Plan Lookup link at the top of the screen to determine the amount to enter on the Plan Rates fields of the PLUC screen.
    • Bronze:  Enter the monthly premium for the lowest cost bronze plan that covers everyone in the tax household for whom a personal exemption deduction is claimed, who is not eligible for employer coverage, and who does not qualify for another coverage exemption for the month. (From page 11 of the Instructions for Form 8965)
    • Silver:  Enter the monthly premium for the second lowest cost silver plan premium that covers everyone in your tax household for whom a personal exemption deduction is claimed, who is not eligible for minimum essential coverage (other than coverage in the individual market), and who does not qualify for another coverage exemption for the month. (From page 11 of the Instructions for Form 8965)
  • Click Populate 8965 to carry results to the 3rd column of the 8965 Affordability Worksheet Information section.  The results are also available in View on worksheet Wks 89654.

To price the worksheet in Setup > Pricing look for number 142, Wks 89654, Marketplace Coverage Affordability Worksheet. See the video Premium Lookup (PLUC Screen) for more information and a demonstration. 

PLUC Screen Error 1000:

The error occurs if the automatic look up feature is not accessible. You can access the Federal Bronze and Silver Plan Lookup tool by going directly to www.HealthCare.gov and completing the questionnaire. 

 

If you look up information using the tool on healthcare.gov, you must manually enter the amounts as applicable on the 8965 screen(s). The information figured by the lookup tool may also be used to complete the Second Lowest Cost Silver Plan section on screen 95A



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