If my income is higher at the end of the year than I thought, do I have to pay the Enhanced Silver cost-sharing subsidies back?

No. Unlike premium tax credits, which are reconciled each year based on the income you actually earned, cost sharing reductions are not reconciled Western Poverty Page 177 *  Kaiser Foundation FAQ’s  However, you will have to pay any received premium assistance back up to a certain amount.  Also, you are mandated to report income changes within 30 days. You also promised in the Covered CA application to report income changes within 30 days. Use the search feature ctrl – f and put in “changes.” It’s used 14 times.

Click here for complementary Quote and Subsidy Calculation   

Federal Code of Regulations

Subpart E—Health Insurance Issuer Responsibilities With Respect to Advance Payments of the Premium Tax Credit and Cost-Sharing Reductions

§156.400   Definitions.
§156.410   Cost-sharing reductions for enrollees.
§156.420   Plan variations.
§156.425   Changes in eligibility for cost-sharing reductions.
§156.430   Payment for cost-sharing reductions.
§156.440   Plans eligible for advance payments of the premium tax credit and cost-sharing reductions.
§156.460   Reduction of enrollee’s share of premium to account for advance payments of the premium tax credit.
§156.470   Allocation of rates for advance payments of the premium tax credit.
§156.480   Oversight of the administration of the cost-sharing reductions and advance payments of the premium tax credit programs.

 Related Pages in the MAGI Income Section

Enhanced Silver.com

More on Enhanced Silver   

Income – Federal Poverty Level Chart    

How to change your income on Covered CA   

 MAGI Definition  

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