Author: Buliah Mae Thomas

Dropping ESI with Employer Consent

Hi; I received this question from a single, working female whose income is at 276.36%.  She pays $90 a month for ESI but wants to cancel because the coverage benefits are horrible and she has chronic medical issues that need to be addressed properly.   An example was the plan does not cover the cost for […]

ESI from two jobs

Hi, I spoke with a gentleman today who asked this question.  Both he and his wife work and have ESI via their perspective jobs.  Neither want to do the family plan because it is too expensive.  Can one of them select the individual plan from their job and the other select a plan through the […]

Does pregnancy count as one?

Hi; I just did an application with a couple who are pregnant.  Does the baby count as one giving them a family of three instead of two?  Their income is $59,678.96 annually.  For a family of three this would make them eligible for a ConnectorCare 3B plan.  For a Family of two it puts them […]

Wrong Approval for Health Connector Plans

Hi, I have a client who was just approved for Social Security disability in January.  She also has a job.  Between the two incomes her FPL is 237.01%.  For some reason her eligibility is for a Health Connector Plan instead of a ConnectorCare 3A plan.  Her premium in 2018 was $44.00.  In January 2019 her […]

2019 Seasonal Worker Income Calculation

Hi, If a client is on unemployment as of January 1, 2019 and has not yet worked his seasonal job for 2019 why should their 2018 seasonal income be included for this year?  They may not be hired back for the 2019 season.  Shouldn’t this income be added once the client starts working again?  And what […]

Seasonal Worker Income

I have a client who worked for seven months on a project for one of the hilltowns.  The total payment for this job was $23,500.  He was paid biweekly.  We submitted an application and he was approved for ConnectorCare 2B.   He enrolled in a plan for $67 a month.  His pay stubs were submitted immediately.  During the […]

+65 versus -65 Self Employed

Hi, I am assisting a client who is over 65 and self-employed.  She is approved for partial HSN instead of full.  The client sent in her 2017 Form 1040 and accompanying schedules.  We called MassHealth to dispute what they are using as her income which takes her over the 150% FPL for HSN.  I thought that income […]

MassHealth Verifications Processing

Hi, Yesterday a client walked into my office stating her husband lost his coverage and she had not received any notification from MassHealth.   Their verifications were faxed to MH on 8/18, 8/29, and 8/31/2017.  My initial thought was that they had not been processed.  I called MH Asst Line and asked the csr if there was a way she […]

NO PREMIUM BILL

Hi, I had four families contact me this week stating they did not receive an invoice from the Connector for December or January.  They subsequently lost their coverage although they paid the premiums without the invoice.  All their coverages were terminated as of November 30.  I checked via the assister portal and all four have 2/1/2018 effective […]