The below notice is being sent to individuals who enrolled in ACA plans through Healthcare.gov
Thank you for choosing Sandhills Insurance Group as your local agency and insurance service provider.
As you know, you purchased individual health insurance coverage through the Federally Facilitated Marketplace (aka. the FFM or Healthcare.gov). Any subsidy you received is paying a portion of your monthly premium payments. This IRS approved subsidy was granted to you based on statements you made on your application to Healthcare.gov with respect to your income and other factors related to subsidy eligibility. The amount of subsidy which you initially qualified for was conveyed to you via the Eligibility Notice sent to you by Healthcare.gov in response to your application. You may contact the FFM at to obtain a copy of your Eligibility notice at : (800) 318 – 2596.
As a reminder, when you applied for health insurance through Healthcare.gov, you had the option of having a portion, none, or all of your subsidy amount specified in the Eligibility Notice to be applied to your monthly insurance premium payments. The Insurance Carrier providing your coverage is charging you the difference between the total premium and the portion of subsidy granted in your Eligibility Notice that you requested. The calculation is as follows:
Monthly Insurance Premium
– Subsidy portion amount requested by applicant
= Amount due per month
Therefore, the monthly amount you are paying for your health insurance is directly linked to your election to have some or all of the subsidy you qualified for applied to your monthly payments.
Any changes in income, such as ones caused by a promotion, the loss of a job, or the taking on of additional jobs or work, may impact your eligibility for subsidy and/or the amount of subsidy for which you are eligible. Likewise, changes in other eligibility factors such as the number of dependents claimed, or the addition/ deletion of dependent income can affect your eligibility for subsidy and the amount of subsidy for which you qualify.
Per your Eligibility Notice and your application, you were advised to contact Healthcare.gov if any changes to your income or if any changes to other eligibility factors occur throughout the tax year.
The consequences of not reporting changes in income or changes in other eligibility factors could mean that you might have to repay subsidy amounts you claimed throughout the year at the end of the tax-year for which you took subsidy payments. In the state of South Carolina, it is of particular concern if your income falls below 100% of federal poverty, or if your income rises significantly above the percent of federal poverty you reported you earned at the time you applied for your subsidy via Healthcare.gov. In either case, you could end up owing substantial amounts of subsidy payments you received to the IRS if you fail to report changes to Healthcare.gov.
It is your responsibility to report any changes in your income or changes in other eligibility factors to Healthcare.gov. If your income has changed significantly, if you are no longer claiming dependents you claimed on your application, or if your eligibility otherwise has changed, we urge you to contact Healthcare.gov immediately. Neither Sandhills Insurance Group, nor its agents, nor the Insurance Carrier providing your coverage have any legal authority or legal responsibility to report eligibility changes to Healthcare.gov. Such changes must be reported by the applicant receiving the subsidy.
For more information regarding available ACA plans, to schedule an appointment for the coming open enrollment, or for questions, please email firstname.lastname@example.org. Thank you!
NOTICE TO CONSUMER REGARDING APPLICATIONS FOR INSURANCE COVERAGE
Sandhills Insurance Group, LLC is a fully licensed agency domiciled in South Carolina, agency license # 182413. Licensed agents who write health insurance through the Federally Facilitated Marketplace (FFM) have completed necessary training required by CMS, the federal agency overseeing the appointment of agents to offer insurance plans through Healthcare.gov and to enroll applicants in coverage through Healthcare.gov. In addition, the same complete necessary training required by the carriers offering health insurance and related coverages both on and off the FFM. The licensed agents contracted with or working for Sandhills Insurance Group have authority to represent insurance products, advise applicants on coverage features, and assist in the application process. Representations made on applications for coverage impact both eligibility for coverage and the cost of the coverage. Any material misrepresentation, either intentional or unintentional, could result in delay of or denial of claims, or an adjustment in your monthly premium due. Neither Sandhills Insurance Group, LLC nor its agents are responsible for material misrepresentations made on applications for coverage by applicants. It is the policy, practice, and procedure of Sandhills Insurance Group to provide a copy of the application for coverage to each applicant via physical or electronic means. A copy of an applicant’s application for coverage can be obtained by contacting Sandhills Insurance Group or by contacting the carrier providing coverage. It is the responsibility of the applicant to report any inaccuracies or errors on their application for coverage.
NOTICE TO CONSUMER REGARDING APPLYING FOR COVERAGE THROUGH THE FFM
While Sandhills Insurance Group and its agents may assist consumer’s in applying for coverage through the FFM and navigating the Eligibility application process through , neither Sandhills Insurance Group nor its agents are responsible for misrepresentations made on any application through Heatlthcare.gov. . A copy of an applicant’s application for Eligibility and an applicant’s Eligibility Notice can be obtained by contacting at or calling (800) 318 – 2596. It is the responsibility of the applicant to report any inaccuracies or errors on their application; likewise, it is the responsibility of the applicant to report any changes in status or eligibility to at or calling (800) 318 – 2596.
While Sandhills Insurance Group and its agents may assist consumer’s in applying for coverage through the FFM and navigating the Eligibility application process through Healthcare.gov, neither Sandhills Insurance Group nor its agents are responsible for misrepresentations made on any application through Healthcare.gov. A copy of an applicant’s application for Eligibility and an applicant’s Eligibility Notice can be obtained by contacting Healathcare.gov at https://www.healthcare.gov or calling (800) 318 – 2596. It is the responsibility of the applicant to report any inaccuracies or errors on their application; likewise, it is the responsibility of the applicant to report any changes in status or eligibility to Healthcare.gov at https://www.healthcare.gov or calling (800) 318 – 2596.