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Why is there a difference in the premium/subsidy that was quoted for this client and what is showing after they have enrolled?
Why is there a difference in the premium/subsidy that was quoted for this client and what is showing after they have enrolled?
Ricky Phipps avatar
Written by Ricky Phipps
Updated over a week ago

There are a few items that could impact a premium amount compared to what the client was originally quoted:

  1. Whether or not the client smokes: smoking can add up to $200 more to the premium price depending on the age of the client.

  2. The age of the dependent(s) the client is claiming on their taxes but do not need coverage for: the Marketplace application does not ask about dependents that are 19 years old or younger that do not need coverage which would impact the household size.

  3. If anyone in the household between the ages of 18-22 needs coverage and is a full-time student at a university: Universities tend to offer blanket coverage for its students (fees are included in the tuition) so the full-time student that is applying for coverage may get a lessened subsidy amount per month as they are already offered coverage through the school.

  4. If the household members are citizens or legal residents of the US: sometimes if this question is skipped for a household member this could impact the subsidy amount granted.

  5. How the question is answered about prior premium tax credits being reconciled: if you answer no to this question, this would take away the subsidy.

  6. If the client is planning on filing their taxes next year, and if they are married, are they filing jointly: clients need to file their taxes for the year that they are purchasing coverage and they need to file jointly if they are married to account for their entire household income in order to be subsidy eligible.

If you notice a large disparity in what was quoted on our website versus what is quoted on Healthcare.gov, please let our Agent Support team know by  giving us a call at 888-684-1373 or emailing us at agent_support.com so that we can investigate and the issue.

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