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When rogue brokers switch people’s ACA policies, tax surprises can follow

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Tax season is never fun. But some tax filers this year face an added complication: Their returns are being rejected because they failed to provide information about Affordable Care Act coverage they didn’t even know they had.

While the concern about unscrupulous brokers enrolling unsuspecting people in ACA coverage has simmered for years, complaints have risen in recent months as consumers discover their health insurance coverage isn’t what they thought it was.

Now such unauthorized enrollments are also causing tax headaches. Returns are getting rejected by the IRS and some people will have to pay more in taxes.

“It’s definitely gotten worse over the past year. We’ve helped three to four dozen people this year already,”said Erin Kinard, director of systems and intake for the Health and Economic Opportunity Program at Pisgah Legal Services in North Carolina, which helps low-income families enroll in ACA plans and get tax help.

Neither the IRS nor the Centers for Medicare & Medicaid Services, which oversees the federal Obamacare marketplace, responded to questions about the problem.

Unauthorized sign-ups can happen in different ways

The IRS did, however, issue an FAQ in February instructing consumers on what to do if their electronically filed returns are rejected because of ACA issues.

Unauthorized sign-ups can happen in several ways, Kinard and others said. Some rogue agents troll online enrollment portals that are accessible only to brokers but are integrated with the healthcare.gov website. When those agents open a new policy or switch an already enrolled policyholder to a different plan, they garner the associated monthly commissions. Other consumers unwittingly sign up when they respond to advertisements touting gift cards or government subsidies then are transferred to agents who enroll them in health coverage. It’s happening even after new rules were put in place requiring agents to get written or recorded consent from clients before making changes.

CMS has not released details on how many consumers have been affected or how many agents have been sanctioned for participating in such schemes.

There’s also no public tally of how many taxpayers are facing problems as a result. And the tax consequences can come as a surprise.

“Many people are finding out when they go to e-file their taxes and it bounces back and the IRS says it can’t accept your return,” said Christine Speidel, an associate professor and the director of the Federal Tax Clinic at Villanova University’s Charles Widger School of Law.

Returns are rejected if the IRS has information indicating the taxpayer has ACA coverage but the returns don’t include forms that help determine whether premium tax credits paid on the policyholder’s behalf to insurers were correct. If their income was misstated by the rogue broker who enrolled them, for example, they might not have qualified for the full amount paid. Or, if they had affordable employer coverage, they would not have been eligible for ACA subsidies at all.

Ashley Zukoski, an ultrasound technologist in Charlotte, North Carolina, had employer coverage but now faces a tax bill for an ACA plan she said she never signed up for. She reached out to KFF Health News after it reported on such unauthorized plan enrollments.

Unbeknownst to her, she said, a broker in Florida enrolled her family in an ACA plan in late February 2023, even though Zukoski had coverage starting that January through her job. The broker listed an income that qualified the household for a full subsidy, so Zukoski never received a premium bill.

Her first inkling that something was amiss came early in 2024 when she received a special form, called a 1095-A, which showed she had an ACA plan. After reporting the problem to the federal marketplace, she sought to get the 1095-A voided so she would not be liable for the plan’s premium subsidies paid by the government to the insurer.

But, because Zukoski’s pharmacy had billed the ACA plan instead of her job-based coverage, her request was denied. She plans to appeal.

In the meantime, the family has filed an extension on their taxes.

“Instead of getting a $4,100 refund, we now owe almost $700 in taxes based on the 1095-A and premium tax credit applied,” Zukoski said.

With the April 15 federal tax filing deadline upon us, there are some important steps for affected consumers to take, tax and insurance experts said.

First, because it could take weeks to get corrected forms, experts recommend filing for an extension to buy more time. When consumers file for that extension, they should also pay any taxes owed to avoid penalties and interest.

In general, consumers who at any point in the year think they are victims of an unauthorized enrollment or plan switch should report it immediately to the relevant federal or state ACA marketplace and request a corrected Form 1095-A. But move fast. Appeals to cancel coverage retroactively must be made within 60 days of discovering the fraudulent enrollment, Speidel said.

Consumers can ask for help filing a complaint with federal or state regulators by contacting their own insurance agents or seeking help from assisters or “navigator” programs, which are government-funded nonprofit groups that help people enroll or deal with insurance problems.

Navigators and assisters are fielding many such cases this year and can submit what are called “complex case forms,” which help federal officials investigate such complaints, said Lynn Cowles, program manager for Prosper Health Coverage, a navigator program in Texas.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.



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U.S. Justice Department demands records from Sheriff after killing of Sonya Massey

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SPRINGFIELD, Ill. — The U.S. Justice Department is demanding records related to the July shooting death of Sonya Massey — an Illinois woman who was killed in her home by a sheriff’s deputy — as it investigates how local authorities treat Black residents and people with behavioral disabilities.

The government made a list of demands in dozens of categories in a letter to the Sangamon County Sheriff’s Office, dated Thursday.

“The Sheriff’s Office, along with involved county agencies, has engaged in discussions and pledged full cooperation with the Department of Justice in its review,” Sangamon County Sheriff Paula Crouch said Friday.

Sonya Massey, a 36-year-old Black woman, was killed July 6 when deputies responded to a call about a possible prowler at her home in Springfield, Illinois. She was shot three times during a confrontation with an officer.

The alleged shooter, Sean Grayson, who is White, was fired. He is charged with murder and other crimes and has pleaded not guilty.

“The Justice Department, among other requests, wants to know if the sheriff’s office has strategies for responding to people in “behavioral health crises,” the government’s letter read. “…The incident raises serious concerns about…interactions with Black people and people with behavioral health disabilities.” 

Andy Van Meter, chairman of the Sangamon County Board, said the Justice Department’s review is an important step in strengthening the public’s trust in the sheriff’s office.

At the time of the fatal shooting, the Sangamon County Sheriff’s Office was led by then-Sheriff Jack Campbell, who retired in August and was replaced by Crouch. 

Deputy Sean Grayson’s history of misconduct 

Grayson has worked for six different law enforcement agencies in Illinois since 2020, CBS News learned. He was also discharged from the Army in February 2016 after serving for about 19 months. He was hired by the Sangamon County Sheriff’s Office in May 2023. 

In an interview with CBS News in early August, Campbell said that Grayson “had all the training he needed. He just didn’t use it.”

In a recording released by the Logan County Sheriff’s Office, where Grayson worked from May 2022 to April 2023, a supervising officer is heard warning Grayson for what the senior officer said was his lack of integrity, for lying in his reports, and for what he called “official misconduct.”

Girard Police Chief Wayman Meredith recalled an alleged incident in 2023 when he said an enraged Grayson was pressuring him to call child protective services on a woman outside of Grayson’s mother’s home. He said Grayson was “acting like a bully.” 

The recording and Meredith’s description of Grayson’s conduct showed how he quickly became angry and, according to documents, willing to abuse his power as an officer.    

Sangamon County Sheriff’s Office history of accusations 

According to a review of court records in 2007, Massey’s killing was the only criminal case in recent history against a Sangamon County Sheriff’s Office deputy for actions on duty. Local officials characterized her shooting as an aberration.  

However, CBS News obtained thousands of pages of law enforcement files, medical and court records, as well as photo and video evidence that indicated the office had a history of misconduct allegations and accountability failures before Grayson. The records challenged the claim that Massey’s death was, as said by the then-sheriff, an isolated incident by one “rogue individual.” 

Local families were confident that Massey’s death was the latest in a pattern of brazen abuse that has gone unchecked for years.

Attorneys for Massey’s family recommended an updated SAFE-T Act that would expand an existing database used to track officer misconduct to include infractions like DUIs and speeding during police chases.



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“CBS Weekend News” headlines for Saturday, Nov. 16, 2024

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“CBS Weekend News” headlines for Saturday, Nov. 16, 2024 – CBS News


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Here’s a look at the top stories making headlines on the “CBS Weekend News” with David Wade.

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How this new car runs without gas or electricity

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How this new car runs without gas or electricity – CBS News


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As climate change intensifies, the race for a more eco-friendly car has revved up. Itay Hod reports on the newest twist on travel.

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