One
commenter asked that we clarify whether electronic sources would
be used for verification, and if so, asked that we add language
to explain that applicants do not need to submit documentation
until they are notified that electronic verification was
unsuccessful.
|
The
final rules in subpart G of 45 CFR part 155 discuss verification
procedures for exemptions. Where the applications specify that
documentation must be provided initially, this is because
electronic verification is not a primary option at this time. HHS
remains committed to maximizing the use of electronic
verifications for eligibility for exemptions.
|
Commenters
asked that we rename the application for members of Indian tribes
and other individuals who are eligible for services through an
Indian health care provider.
|
We
are renaming this application, “Application for Exemptions
for American Indians and Alaska Natives and Other Individuals Who
Are Eligible to Receive Services from an Indian Health Care
Provider”.
|
One
commenter asked that we include the eligibility criteria for
services through an Indian health care provider.
|
We
will be adding this in instructions that are posted alongside the
application at a later date, after we have the opportunity to
consult with stakeholders.
|
Commenters
stated that the existence of multiple exemption applications did
not minimize paperwork.
|
We
opted to create separate applications because the information
needed for each type of exemption is different. A combined
application would have been significantly longer and all
individuals would have had to skip many sections. Accordingly, we
are maintaining the existing approach.
|
Commenters
asked that we remove the optional race and ethnicity questions
from the application for members of Federally-recognized tribes
and other individuals who are eligible to receive services from
an Indian health care provider.
|
We
opted to include these questions initially in order to promote
consistency among the exemptions applications and to assist HHS
in ensuring that all communities have equal access to the
Marketplace. However, given the focus of this particular
exemptions application, we have decided to remove these
questions.
|
Commenters
asked that we remove questions and language regarding tax
households from the application for members of
Federally-recognized tribes and other individuals who are
eligible to receive services from an Indian health care provider.
|
Tax
household information is needed so IRS can recognize an exemption
certificate that is granted by a Marketplace on an individual's
tax return. Accordingly, we are retaining these questions.
|
Commenters
asked that the exemption for individuals who are eligible to
receive services from an Indian health care provider be available
from IRS through the tax filing process, in addition to being
available through the Marketplace.
|
This
is outside of the scope of this PRA package. We anticipate that
IRS will make information available about the Marketplace process
on tax forms and instructions.
|
Commenters
asked that we allow the Indian Health Service (IHS) to apply on
behalf of individuals who are in IHS patient registration
records.
|
As
we have previously discussed, we are committed to working with
IHS to establish an electronic verification system that can be
used for exemptions. However, we do not believe that the
authority exists to facilitate having IHS apply on behalf of
individuals, particularly without their knowledge or affirmative
consent. We are working closely with IHS to help IHS providers
quickly issue documentation that can be used by consumers as part
of an application for an exemption.
|
Commenters
asked that we revise the application for members of
Federally-recognized tribes and other individuals who are
eligible to receive services from an Indian health care provider
to use the term, “Indian tribe”, instead of “member
of a Federally-recognized tribe”.
|
We
note that the language that is used in the statute is, “member
of an Indian tribe, as defined in section 45A(c)(6) of the
[Internal Revenue] Code”, and that we have previously used
“member of a federally-recognized tribe” as a
plain-language variation of this definition. With that said, we
are modifying the application to use, “member of an Indian
tribe”, noting that the change in phrase does not change
the eligibility rules for exemptions.
|
Commenters
asked for clarification regarding whether the Marketplace would
issue separate exemption certificate numbers for each member of a
tax household who was found eligible for an exemption.
|
The
Marketplace will provide a separate exemption certificate number
for each individual who is determined eligible for an exemption.
|
Commenters
asked whether an individual could list American Indian or Alaska
Native languages in response to the preferred language question,
and whether the application could inform individuals that
assistance will be provided in tribal languages.
|
The
application is designed to allow an individual to write in any
language in response to the preferred language question. However,
for the first year of operations, the Federally-facilitated
Marketplace will only provide written notices in English,
although the notices will include tag lines to enable individuals
to obtain assistance via phone in a number of different
languages. In addition, Navigators and certified application
counselors with different linguistic capabilities will provide
assistance with exemptions applications.
|
Commenters
asked that we use the term, “tax penalty”, instead of
“shared responsibility payment”.
|
“Shared
responsibility payment” is in line with the language used
in section 5000A of the Code. As such, to minimize confusion, we
are maintaining this language.
|
Commenters
asked that we clarify the first page of the application for
members of Federally-recognized tribes and other individuals who
are eligible to receive services from an Indian health care
provider to clarify that the application is for two categories of
exemptions.
|
We
have modified the application accordingly.
|
Commenters
asked that we clarify on the first page of the application for
members of Federally-recognized tribes and other individuals who
are eligible to receive services from an Indian health care
provider that applicants must provide documents.
|
We
have modified the application accordingly.
|
Commenters
asked that we allow for online submission of the exemption
application.
|
As
discussed in the final exemptions rule, the Federally-facilitated
Marketplace is unable to support online submission for the first
year of operations. We remain committed to establishing an
electronic process in the future.
|
Commenters
asked that we specify that a shareholder certificate or other
proof of enrollment in an Alaska Native Claims Settlement Act
regional or village corporation would be sufficient to document
eligibility for an exemption.
|
This
is currently under review with the HHS Office of General Counsel.
When the issue is concluded, we will update instructions and
educational materials accordingly.
|
Commenters
asked that we add language to further clarify that if the
Marketplace approves an exemption, the Marketplace will issue an
exemption certificate number.
|
We
have added language to clarify that after an application is
completed, if an individual is determined eligible for an
exemption by the Marketplace, the eligibility determination
notice will include an exemption certificate number for use
during the tax administration process.
|
Commenters
asked that we remove the question regarding an applicant’s
relationship to the household contact.
|
We
have removed this question from all applications except for the
applications for the exemptions for individuals who are unable to
afford coverage, since this question is only critical for those
exemptions.
|
Commenters
asked that we remove the question about whether an individual
needs an exemption on the application for members of
Federally-recognized tribes and other individuals who are
eligible to receive services from an Indian health care provider
and replace it with a check-box on the signature page. Another
commenter asked that we remove this question on the application
for individuals who are unable to afford coverage in a state with
a state-based Marketplace and the hardship exemption application.
|
This
question is designed to facilitate situations in which a tax
filer is not requesting the exemption, but they are requesting it
for a tax dependent. If this is not checked, then the person is
being provided only to establish the tax relationship, and is
instructed that they can skip the remaining questions. If we
shift this to the end of the application, it increases the risk
that individuals will complete unnecessary questions.
Accordingly, we are retaining it.
|
Commenters
asked that we remove the question on the application for members
of Federally-recognized tribes and other individuals who are
eligible to receive services from an Indian health care provider
that asks an applicant who knows that his or her eligibility for
services from an Indian health care provider will end to provide
the end date.
|
Without
this question, the Marketplace will erroneously provide an
exemption for months during which an individual is not eligible
for services through an Indian health care provider. The majority
of individuals who never lose eligibility can skip this question.
Accordingly, we are maintaining it here.
|
Commenters
asked that we remove the language on the signature page for the
application for members of Federally-recognized tribes and other
individuals who are eligible to receive services from an Indian
health care provider that specifies that an applicant must report
any changes in the information that is listed on the application,
unless specific examples can be provided.
|
This
language is needed in order to ensure that individuals who may
only be temporarily eligible to receive services through an
Indian Health Care provider understand that they need to notify
the Marketplace when their eligibility ends, so as to ensure that
they are not in receipt of an exemption when they are ineligible
for it. Accordingly, we are maintaining this language.
|
Commenters
asked that we remove the language specifying that applicants
could submit an appeal online.
|
We
have removed this reference as the online appeal function will
not initially be available.
|
Commenters
asked that we re-label Appendix C as Appendix A.
|
We
have modified the applications accordingly.
|
Commenters
asked that we provide a list of documents that would be
sufficient to establish eligibility for services through an
Indian health care provider.
|
We
appreciate this suggestion, and are working on a list that we
plan to include as part of an instructions package that will
accompany the application.
|
One
commenter asked that we specify on the application that
individuals must notify the Marketplace of any changes within 30
days.
|
We
have included language regarding the requirement to report
changes on all of the applications for which the underlying
exemption has a change reporting requirement. Information on
change reporting will also be included in eligibility notices for
exemptions.
|
One
commenter asked that we establish guidelines for Marketplaces to
use to review applications for fraudulent information.
|
We
appreciate this comment. However, this is outside of the scope of
this Paperwork Reduction Act package.
|
One
commenter asked that we assure that paper applications would be
available for all exemptions.
|
Per
45 CFR 155.610(d)(3), paper exemption applications will be
available for all types of exemptions that are available through
the Marketplace.
|
One
commenter asked that we provide clear explanations regarding
which exemptions are available through IRS, which are available
through the Marketplace, and which are available through both.
|
We
have included this information on each form, and will also look
to make it available through educational materials and
instructions.
|
One
commenter asked that we specify that an applicant must provide a
Social Security number (SSN). The commenter also asked that we
maintain and expand the use of language that specifies that it is
helpful, but not required, to supply a SSN.
|
We
have expanded the language on each application to clarify that if
a person is requesting an exemption for themselves and he or she
has a SSN, he or she must provide the SSN.
|
One
commenter asked that we specify that application information will
be verified electronically, and that personal information will be
protected.
|
The
applications include standard language regarding privacy,
consistent with the single, streamlined application for
enrollment in a QHP through the Marketplace and insurance
affordability programs. We anticipate providing additional
information as we expand the use of electronic verification.
|
One
commenter asked that the applications be revised to support
individuals with lower levels of literacy.
|
The
Exemption applications follow the literacy level approved and
established for the coverage applications – in fact, most
of the language in the Exemption applications comes directly from
the coverage applications which have been extensively
consumer-tested.
|
One
commenter asked that HHS provide states with minimum standards
for State-based Marketplaces regarding accepting the exemption
application.
|
We
clarify that for 2014; State-based Marketplaces that are opting
to have HHS administer the exemption process are not required to
accept applications. Rather, they need to provide consumers with
information regarding how to submit an application to HHS.
|
One
commenter asked that we simplify the titles of the applications.
|
We
have reviewed the titles of the applications and will be
generally maintaining them, to ensure specificity about which
application is for which exemption. We will explore ways to
provide clear guidance on this topic through healthcare.gov and
other educational materials.
|
One
commenter asked that we create a separate form for consumers who
are applying for an exemption because employer coverage is
unaffordable.
|
After
considering this comment, we have opted to maintain one
application for individuals in FFM states and one application for
individuals in SBM states, each of which addresses individuals
regardless of whether they have employer-sponsored coverage. We
took this direction because we know that there are situations in
which an employer offers coverage only to the employee, in which
case having separate applications for those with and without an
offer of employer-sponsored coverage would result in families
needing to submit multiple applications.
|
One
commenter suggested that we add page numbers to the applications
and increase font size.
|
We
have added page numbers. Due to space constraints, we were unable
to further increase the font size.
|
One
commenter asked that we remove the request for an application
filer to initial at the top of each page.
|
We
have removed this in accordance with the comment.
|
One
commenter asked that we specify that an individual is eligible
for an exemption even without a Social Security number, and that
we use “Tax Identification Number” instead of Social
Security number.
|
The
Marketplace does not use any type of taxpayer identification
number besides a Social Security number. Accordingly, as we have
on the single, streamlined application for enrollment in a QHP
and insurance affordability programs, we ask only for a SSN. We
do clearly describe that SSN is not required to obtain an
exemption, and we are retaining this language.
|
One
commenter stated that we should not ask for citizenship or
immigration status information on exemptions applications. The
commenter also asked that we remove the language on the second
page of the application for the exemption for individuals who are
unable to afford coverage in certain states with a State-based
Marketplace advising consumers that they do not need to provide
information regarding immigration status for family members who
don’t need an exemption, the recommendation on the first
page of the same application to have document numbers for legal
immigrants who are asking for an exemption available as part of
the application process, and the language on the last page of the
same application specifying that information will be shared with
the Department of Homeland Security.
|
Citizenship
and immigration status information is only requested on the
application for the exemption for individuals who lack affordable
coverage in states in which there is a Federally-facilitated
Marketplace, since this is the only exemption where the
information is needed. It is needed for this exemption since a
component of the exemption is determining the cost of the
lowest-cost bronze plan net of advance payments of the premium
tax credit, which requires the evaluation of eligibility for
enrollment in a qualified health plan, Medicaid, and CHIP. As
with all Marketplace processes, citizenship and immigration
status information will be safeguarded and only used for the
purpose of eligibility.
With
that said, since the Marketplace does not need immigration status
for anyone who is using the application for the exemption for
individuals who are unable to afford coverage in certain states
with a State-based Marketplace, we have removed all language
addressing immigration status from that application.
|
One
commenter asked that we add language indicating that an
individual whose application for an exemption is approved should
retain the exemption certificate number provided by the
Marketplace.
|
We
have added language on the cover page and on the second page
consistent with the comment.
|
One
commenter asked that we move language regarding the right to
appeal to the first page.
|
We
are retaining appeals language on the signature page, consistent
with the single, streamlined application for enrollment in a
qualified health plan through the Marketplace and insurance
affordability programs.
|
One
commenter asked that we add language on the first page of each
application to explain who should use each particular
application.
|
We
have included this information in a section on the front page
called, “Who can use this application?”
|
One
commenter asked that we clarify on each application that
taxpayers with income below the filing threshold are already
exempt, and as such, do not need to apply separately for an
exemption.
|
We
are adding clarifying language on each application.
|
One
commenter asked that we specify that one application can be used
to request an exemption for everyone in a tax household.
|
We
have added this language.
|
One
commenter supported the existing language regarding keeping
personal information secure and asked that we add information
regarding the specific agencies with which the Marketplace would
share information for verification purposes.
|
We
are retaining this statement. We strive to maximize secure
electronic verification, and may enhance capabilities in this
area during the year. The most updated information on data
matching can be found within the privacy statement and system of
records notice.
|
One
commenter asked that we reverse the order of the race and
ethnicity questions; that we add “South America” and
“Central America” under “Hispanic/Latino”;
and that we add separate check-boxes for “South Asian”
and “Southeast Asian” and remove “Asian Indian”
and “Other Asian”.
|
We
are retaining this section as provided for public comment. We are
maintaining the order of the questions to ensure operational
consistency with the single, streamlined application for
enrollment in a qualified health plan through the Marketplace and
insurance affordability programs, and we are maintaining the
proposed categories as they follow recommendations from the HHS
Office of Minority Health in accordance with section 4302 of the
Affordable Care Act.
|
One
commenter asked that we change appeals language on the signature
page of the application to say, “If you don’t agree
with the decision” instead of “If you don’t
agree with what you qualify for”.
|
We
agree that the proposed language was unclear, and have modified
it to read, “If you don’t agree with the results of
your application”.
|
One
commenter asked that we define “affordability” on the
applicable exemption applications, and that we add examples to
illustrate when various coverage would be affordable or
unaffordable.
|
We
will consider adding this as part of educational materials and
instructions.
|
One
commenter asked that we add language to the applications for
exemptions for individuals who are unable to afford coverage
explaining that the applications are for individuals who did not
have minimum essential coverage for the past tax year.
|
These
applications are intended to be filed prospectively, so we are
maintaining the language as proposed.
|
One
commenter asked that we add language to the applications for
exemptions for individuals who are unable to afford coverage
specifying that there are also hardship exemptions available. The
commenter also asked that we add language to the hardship
exemption application to provide examples of who should not use
the hardship exemption application.
|
We
anticipate providing information regarding the range of available
exemptions on healthcare.gov.
|
One
commenter asked that we remove the section of the application for
individuals who are unable to afford coverage in certain states
with a State-based Marketplace that asks consumers to provide
information regarding the lowest-cost bronze plan net of advance
payments of the premium tax credit, and instead gather this
information directly from the State-based Marketplace. The
commenter also asked that we provide a single application for the
exemption for individuals who lack affordable coverage instead of
having one for individuals in certain states with state-based
Marketplaces and another for individuals in states with a
Federally-facilitated Marketplace.
|
The
Federally-facilitated Marketplace does not have access to
person-specific information regarding eligibility for advance
payments of the premium tax credit in a State-based Marketplace,
due to states having their own rating information and
state-specific eligibility rules for Medicaid and CHIP.
Accordingly, we anticipate working with State-based Marketplaces
to provide assistance to consumers in obtaining this information.
The fact that the Federally-facilitated Marketplace does not have
access to this information is why it is necessary to have
separate applications for individuals in states with a
State-based Marketplace and individuals in states with a
Federally-facilitated Marketplace; if we were to use a single
application, individuals in states with a State-based Marketplace
would need to skip over the significant number of questions that
are needed to determine the cost of the lowest-cost bronze plan
for individuals in states with a Federally-facilitated
Marketplace. Accordingly, in order to limit burden on
individuals, we are maintaining separate applications.
|
One
commenter asked that we delete references to, “the
exemptions process” on the first page of applications.
|
We
have removed this language.
|
One
commenter asked that we modify the information on the first page
regarding next steps to specify that a decision will be rendered
within 1-2 weeks and that the individual can immediately appeal
the decision if he or she so desires.
|
We
believe that the language on the first page is adequate, and that
the information regarding appeals is covered on the signature
page, which is where it is more relevant. We are also concerned
about adding redundant information to the front page, since this
might require reducing the overall font size. Accordingly, we are
maintaining the language as is.
|
One
commenter asked why the application for the exemption for
individuals who are unable to afford coverage in certain states
with a State-based Marketplace includes language advising
consumers to obtain the policy numbers of any job-related health
insurance.
|
This
was included erroneously. As such, we have removed it.
|
One
commenter asked that we add a worksheet to the applications for
the exemptions for individuals who are unable to afford coverage
to assist with calculating annual income, and why the
applications collect annual income on a person-by-person basis.
|
The
approach to obtaining income information is identical to what is
used in the paper version of the single, streamlined application
for enrollment in a qualified health plan through the Marketplace
and insurance affordability programs, and was developed and
tested with consumers. This process is what resulted in a
person-by-person income approach, which avoids some of the
inaccuracy that is possible when asking for a lump sum of income
across multiple family members and jobs. Accordingly, we will
retain it for use in the exemptions process. As we gain
experience from both the coverage and exemptions processes, we
will look at ways to increase the usability of the income
questions on both types of applications.
|
One
commenter asked that we add explicit language regarding the
requirement to report changes within 30 days to the applications
for the exemptions for individuals who are unable to afford
coverage.
|
As
specified in 45 CFR 155.620(a) and (b), there is no change
reporting requirement for these exemptions. The eligibility
standards described in 45 CFR 155.605(g)(2)(vi) specify that
these exemptions are provided for all remaining months in a
coverage year, notwithstanding any change in an individual’s
circumstances. Accordingly, we are not adding this language.
|
One
commenter asked why information provided by an individual as part
of an application for the exemptions for individuals who are
unable to afford coverage would be shared with a consumer
reporting agency, objected to this data sharing, and stated that
if the data sharing was necessary, then the consumer should
explicitly consent to it.
|
The
Federally-facilitated Marketplace uses a consumer reporting
agency as part of the income verification process, in accordance
with 45 CFR 155.615(f)(2)(i). As specified, the income
verification process is the same as is used for eligibility for
advance payments of the premium tax credit and cost-sharing
reductions. Using information from the consumer reporting agency
reduces the number of individuals who need to submit
documentation to support their attested income, and does not
affect an individual’s credit rating.
|
One
commenter asked that the information in the application regarding
the appeals process be provided in a frequently-asked-questions
document.
|
We
appreciate the comment, and intend to incorporate appeals
information along with other relevant information in supporting
materials on healthcare.gov.
|
One
commenter asked that we remove the request for an individual’s
employer identification number (EIN), which is included in the
applications for the exemptions for individuals who are unable to
afford coverage. The commenter also asked that we revise the
questions regarding the minimum value and cost of
employer-sponsored coverage, that we revise the question
regarding expected changes in an employer’s offerings and
that we rename the employer coverage tool.
|
EIN
is used by the Marketplace to verify access to employer-sponsored
coverage. Consistent with the electronic application for
enrollment in a qualified health plan through the Marketplace and
insurance affordability programs, we have added language to the
applications that clearly notes that EIN is optional. The
questions regarding minimum value, the cost of employer-sponsored
coverage, and changes in employer offerings are based on what is
used in the single, streamlined application for enrollment in a
qualified health plan through the Marketplace and insurance
affordability programs, and as such, we will be maintaining them
for consistency. This is also the case for the name of the
employer coverage tool. As with all of our applications, as we
gain experience with the process, we will make appropriate
modifications to enhance the consumer experience.
|
One
commenter asked whether an employer could be an authorized
representative for an individual who is seeking an exemption.
|
Nothing
precludes an employer from serving as an authorized
representative, provided that the standards specified in 45 CFR
155.225 are met.
|
One
commenter asked that we remove the questions regarding foster
care and incarceration from the application for the exemption for
individuals who lack affordable coverage in states in which there
is a Federally-facilitated Marketplace.
|
The
foster care question is included for use in determining whether
an individual who is applying for this exemption is eligible for
advance payments of the premium tax credit, which is necessary to
calculate the cost of the lowest-cost bronze plan. If an
individual is eligible for Medicaid, including as a result of
former status as a foster child, he or she will be ineligible for
advance payments of the premium tax credit, which will affect the
cost of the lowest-cost bronze plan. Similarly, the question
regarding incarceration is needed to determine whether an
applicant is eligible for enrollment in a qualified health plan.
Accordingly, we are maintaining these questions. We have,
however, updated the incarceration question to be consistent with
the single, streamlined application for enrollment in a qualified
health plan and insurance affordability programs.
|
One
commenter asked that we clarify at the top of the application
whether a consumer should use a hardship exemption form instead
of an affordability exemption form.
|
We
are making changes to make the hardship criteria more prominent.
By making the hardship criteria more prominent, we believe that
individuals will be clearer on which form to use. In addition, we
anticipate providing educational information on healthcare.gov.
|
One
commenter asked that we add language to the hardship application
to specify that applicants have three years to request a hardship
exemption.
|
We
agree that this is useful information, and intend to incorporate
it in frequently-asked-questions or other guidance that is
provided along with these applications.
|
One
commenter asked that we eliminate the reference to catastrophic
coverage in the hardship exemption application.
|
We
are maintaining this information in order to fully inform
applicants of their potential eligibility for catastrophic plans
after receiving a hardship exemption through the Marketplace.
|
One
commenter asked that we add language to the first page of all
applications to explain that if the Marketplace needs more
information, it will notify the applicant.
|
We
have added this language to the applications.
|
One
commenter asked that we delete the question from the hardship
exemption application that asks whether an applicant is still
experiencing the hardship, as well as the request for
documentation.
|
We
have clarified that the question regarding whether the hardship
is still in effect is only needed if the applicant does not
provide an end date. This information is needed to define the
duration of the exemption. The request for documentation is
needed to ensure that the consumer submits the documentation
described in table A in support of his or her application.
|
One
commenter asked that we change the column width in table A of the
hardship exemption application, move the appendix to be the
second page of the application, and add #13 for “Other”.
|
We
are modifying the column width of the table and moving it to be
the second page, in accordance with the comment. Consistent with
guidance, we are adding one category to the hardship application,
for an individual who received a notice saying that his or
existing health insurance is being cancelled, and who considers
available plans unaffordable. We have also modified the table to
include “Other” as an option.
|
One
commenter asked that we explain the procedure for individuals who
are applying for a hardship exemption and do not have required
documentation.
|
We
expect to disseminate these procedures through supplementary
guidance and through contact with the call center. Accordingly,
we have added language to the hardship exemption application that
instructs applicants who cannot obtain the specified
documentation to call the call center.
|
One
commenter asked that we specify that an applicant can document a
fire, flood, or other natural or human-caused disaster that
caused substantial damage to his or her property via a news
report.
|
We
have added this to the hardship exemption application.
|
One
commenter asked that we develop an electronic method to obtain
proof of a Medicaid or CHIP denial from the applicable state
agency for the purpose of administering the hardship exemption
related to children for whom an adult who is not claiming the
child as a tax dependent is legally required to provide health
insurance, instead of requesting proof of the denial from an
applicant.
|
We
support the commenter’s recommendation for electronic
verification. Unfortunately, there is currently no electronic
method through which HHS can obtain information regarding denials
that are not associated with an application submitted to the FFM.
We will consider this in the future.
|
One
commenter asked that we not request documentation to substantiate
an application for a hardship exemption based on a denial of
eligibility for Medicaid because the applicant’s state did
not expand Medicaid.
|
Without
proof of denial based on non-expansion, HHS will be unable to
assess whether the individual actually applied for Medicaid, and
whether or not he or she met the financial or non-financial
eligibility criteria for Medicaid, since HHS is not conducting an
eligibility determination as part of the hardship exemption
process. We note that the Federally-facilitated Marketplace
already provides this exemption in an automated fashion as part
of the eligibility process for insurance affordability programs
for individuals who submit an application to the FFM.
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Commenters
asked that we eliminate language on the first page of the
application for the exemption for members of recognized religious
sects and divisions that paraphrases the language of the Internal
Revenue Code regarding conscientious opposition to acceptance of
the benefits of private or public insurance, including Medicare
or Social Security.
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We
have modified the language to more closely track the legislative
language and ensure that the range of individuals who are
eligible for this exemption is clear.
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One
commenter asked that we include a list of the religious sects and
divisions whose members qualify for the exemption for members of
recognized religious sects and divisions.
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The
list of approved religious sects is maintained by the Social
Security Administration, and as such HHS does not have the
authority to provide it to the public on its own.
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One
commenter asked why an applicant for the exemption for members of
recognized religious sects and divisions would be asked when they
became a member of a sect and when membership ended.
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In
accordance with 45 CFR subpart G, this exemption is generally
provided on an ongoing basis, with the exception being any time
period during which the individual was not a member of a
recognized religious sect or division. These questions are
designed to allow those individuals who gained or ended
membership to provide that information, so that the Marketplace
will provide the exemption certificate for only the actual time
period of membership. Further, an applicant who has always been a
member and plans to always be a member can skip these questions.
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One
commenter asked that we add language to the application for the
exemption for members of recognized religious sects and divisions
to indicate that the approved list of organizations is maintained
by the Social Security Administration.
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We
have added this language.
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One
commenter asked that we use a more common name for IRS Form 4029
on the application for the exemption for members of recognized
religious sects and divisions.
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The
application includes the common name, “Application for
Exemption from Social Security and Medicare Taxes and Waiver of
Benefits” on the front page, which we believe is
sufficient.
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