I had an insurance plan from Humana for LESS than one month that was purchased through the Marketplace in 2016. The effective date of that policy was 6-1-2016. I called Humana to CANCEL the policy on 6-10-2016 and they told me to cancel through the “Marketplace” (which, incidentally, takes 14 days) because I’d SIGNED UP THROUGH them. No problem. Almost two weeks later, I received the “Welcome to Humana” package and official “Summary of Benefits and Coverage” or “SBC” (the BOUND PACKET of information that covers MY INDIVIDUAL POLICY including my PERSONAL info/policy number). I flipped through it just to see what all the policy would’ve covered, and on the second or third page of the SBC there was a page explaining my “Right to return policy”:
“You have the right to return this policy within 10 calendar days after the day we mailed this policy to you. If you choose to return this policy to us within the 10 day period, we will refund any premium that you have paid.”
This “Right to return policy” is SIGNED by the PRESIDENT OF THE COMPANY, Bruce Broussard. Seems legit. In any case, it didn’t matter much to at the time because
Fast forward to January 2017. My husband and I are filing our taxes. We use TaxAct.com so the process is usually pretty straightforward, but also very thorough. It covered questions about many factors, including health insurance: did both of us have qualifying coverage for the entire year and did either of us purchase a plan through the Marketplace? Answer #1: YES, we both had qualifying coverage for the entire year. Answer #2: NO, I did NOT purchase the Marketplace policy, I CANCELED it according to the requirements in the “Right to return policy”. There were no payment records for MY portion of the premium (because I didn’t MAKE any) OR from the Marketplace. And I never received ANY documents or tax-related correspondence that suggested otherwise. I answered the question correctly and truthfully. We completed our tax return on January 31, 2017. On February 20, 2017, we received a letter from the IRS:
“According to our records, advance payments of the premium tax credit were made for health care coverage from the Health Insurance Marketplace for you or someone listed on your return.”…”You should have received [I DIDN’T] a Form 1095-A, Health Insurance Marketplace Statement, from the Health Insurance Marketplace.”
The letter requested a completed Form 8962 and a copy of my Form 1095-A. I logged on to healthcare.gov (as instructed by the LETTER) and sure enough, THERE was a Form 1095-A showing a $205.83 “monthly advance payment of premium tax credit” made in June 2016…which I found odd because my PTC was actually $247, making my monthly premium a whole $34.45. The Marketplace made a payment TO Humana for a POLICY that I CANCELED during the 10-day timeframe covered by a “Right to return policy”. The MARKETPLACE processed the cancellation which I requested on 6-10-2016, yet THEY STILL SENT THE ADVANCE PAYMENT?? And what about the so-called “Right to return policy” that I was supposedly covered by according to Humana? Oddly, there are TWO transactions showing on my Humana account on 6-12-2016. One was a PRICING ADJUSTMENT of “-$46.91”, and the other is an ADVANCE PREMIUM TAX CREDIT ADJ for “$41.17”. My premium tax credit was $247.00 but according to the form 1095-A, the Marketplace reported a “Monthly advance payment of premium tax credit” of $205.83. Hmmmm…wait a minute!! What a coincidence that $247.00 – $41.17 = $205.83. Could it be that the $41.17 “ADVANCE PREMIUM TAX CREDIT ADJ” is what Humana sent back to the Marketplace within TWO DAYS of my cancellation??!
So, as part of my insurance plan, Humana PRETENDS to offer a 10-day “Right to return policy” when they KNOW D@#% WELL the MARKETPLACE takes 14 days to process a cancellation. They randomly send $41.17 BACK to the Marketplace 2 days after I request to cancel the policy….WHY? WHO KNOWS?!! But it doesn’t look like a REFUND for the POLICY I supposedly had the “Right to cancel”. I guess they just, what, KEEP THE REST FOR THEMSELVES?? And the Marketplace DUMPS the difference on ME TO PAY BACK?? Nice “RIGHT TO RETURN” policy!!! HOW is this even LEGAL for an insurance company to DO?!!!????
I called the IRS to get more information because THAT’S what the letter FROM THE IRS said to DO if I had questions ABOUT the letter. That phone call was the biggest FAIL of all fails. Ever. In all history. So there really wasn’t much I could do except call the other involved parties: the Marketplace and Humana. So began the biggest WASTE of time in my entire LIFE, thus far: THREE DAYS of calling back and forth, being put on endless hold, being transferred to different WRONG departments over and over, there was even a comical conference call including BOTH the Marketplace and Humana (during which the two representatives incessantly bickered and picked on each other like 5-year olds). The first call I made was to the Marketplace. I gave them a very condensed summary of the situation: I signed up THROUGH THEM for a policy COVERED by Humana, I canceled the plan during the 10-day “Right to return policy” window, but the Marketplace sent Humana an advance payment anyway. Now the IRS wants ME to pay. Their response: “call Humana because there’s nothing we can do to help you”. Then I called Humana, and after TWO HOURS of dealing with NO LESS than 10 different people in 5 different departments, I was told to “call the Marketplace because there’s nothing we can do to help you”. Everything went downhill from there.
I CANCELED THE HUMANA POLICY ON 6-10-2016. PERIOD. If the Marketplace wants to take 2 weeks to complete a process that can probably be done in a DAY (or less), that’s THEIR choice. I signed up for HUMANA insurance THROUGH the MARKETPLACE…because that’s how I was REQUIRED to do it, NOT by CHOICE. So, THEY can’t get THEIR acts together to PROPERLY coordinate policies and procedures between THEMSELVES, they BOTH just DODGE and EVADE ANY OBLIGATION, RESPONSIBLITY, or ACCOUNTABILITY, which the IRS just ALLOWS WITHOUT QUESTION, and the TAXPAYER is left to foot the bill??
Sorry for the LONG rant, but I am SICK AND TIRED of these HUGE companies and corporations and government agencies that do WHATEVER they want and won’t even follow their OWN POLICIES (but by God the TAXPAYERS sure have to “follow policy”, OR ELSE). And when they get cornered and caught in their own web of lies, suddenly NOBODY is able “understand” what the problem is or how to fix it, they start transferring you between 20 different departments over the course of a 4 hour long call, or you get put on eternal hold. OR the call just gets “DISCONNECTED”… Absolutely disgusting.