If a customer fails to reconcile the APTC received on their annual tax return for 2 consecutive years, what will Pennie do?

When a customer fails to reconcile the Advance Premium Tax Credit (APTC) received on their annual tax return for two consecutive years, Pennie takes action by removing their financial assistance for the upcoming year. This is based on the principle that reconciliation is essential for ensuring that the APTC is being utilized appropriately and that applicants are maintaining compliance with the requirements of their financial assistance.

The APTC is designed to help eligible individuals lower their premium costs for health insurance coverage through the marketplace. However, when there are discrepancies or failures to report income and household information accurately, it can lead to potential overpayments or underpayments of the APTC, which the federal government requires to be reconciled.

Removing the financial assistance serves as a safeguard to ensure that the APTC is administered correctly and encourages consumers to engage in the reconciliation process to keep their financial assistance intact in the future. It is a necessary step to maintain the integrity of the program and ensure that assistance is provided only to those who accurately report their eligibility.