If your actual total annual income is different than the estimate you used when applying for health insurance on the marketplace, you may be required to make adjustments when filing your taxes. Specifically, if your income is higher than expected, you may be responsible for paying for an additional portion of your premium because you no longer qualify for the same tax credit amount. You can submit this expense as a reimbursable health insurance claim in your ZaneHealth account by filling out the normal claim form with the information below.

1. Requesting reimbursement for:

Choose “Health Insurance Premium” from the drop down menu and then click “Submit a new premium”.

2. Source of Policy:
Choose the option from the drop down menu that most accurately describes where you purchased your policy.
3. Insurance Provider:
Choose your insurance provider from the drop down list or type the name of your insurance company.
4. Primary Policyholder:
Choose the correct name from the drop-down list or click the ‘Add dependent’ button if the primary policyholder isn’t shown.
5. Premium Billing Schedule:
Choose “monthly” from the drop down menu.

6. Premium Amount Billed:
Enter the amount of your tax credit adjustment you are responsible for each month.

7. Premium Billing Period:
Choose the month that your tax credit adjustment began (i.e. January 2018).

8. Additional Comments:
This field is optional. Include any comments that will be helpful to your claims processor.

9. Supporting Documents:
You will need to submit IRS Form 1095-A and IRS Form 8962 (completely filled out). 

Submit for Review

Once the form is completely filled out and the documentation is either attached or you have selected to send it to via fax, scroll down to the bottom of the page and click Submit for Review.

Note: You will get a warning stating that your claim may not be approved if one of your coverage dates is more than 180 days before the day you are submitting your claim. As long as you are submitting your claim within 90 days of the end of your plan year, your claim is approvable (pending proper documentation).

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