Shared policy allocation & related question re why TurboTax is saying filer who made under 100% of poverty line qualifies for premium tax credit

[tibbons2]

My family and I are dealing with a shared policy allocation, premium tax credit (PTC) situation and have a question regarding how TurboTax is handling a tax filer who reports earning less than 100% of the poverty line.

By way of background, in 2022 (and again in 2023) my husband enrolled himself, me and both of our sons in an ACA health care plan (as a sole proprietor, with a plan to claim the premiums as a self-employed health insurance deduction). It wasn't until very late 2023 that we realized that one of our sons made too much to be considered our dependent for either tax year.

Much research and many months later, I was just finalizing returns for us all (2022 and 2023 for our non-dependent son and 2023 and an amended 2022 for us), with a shared policy allocation of 100% to my husband's and my joint returns and 0% to our non-dependent son's returns. This allocation decision was made in part because we assumed our non-dependent wouldn't qualify for *any* premium tax credit, since both years he made under 100% of the federal poverty line (66% in 2022 and 35% in 2023).

Yet, when I experimented with allocating 100% to our non-dependent son anyway, much to my surprise TurboTax determined he *did* qualify for a premium tax credit, and a much *larger* one than my husband and I were qualifying for, even though the program was simultaneously properly recognizing (on line 5 of each of the 8962 forms) that he made *less than* 100% of the poverty line each year.

In looking for answers as to why, I stumbled upon this explanation regarding exceptions to 100% poverty level rule on page 8 of the 2023 instructions for Form 8962, which stated:
"You may qualify for the PTC if your household income is less than 100% of the federal poverty line and you meet all of the following requirements.
• No one can claim you as a dependent for the year.
• You or an individual in your tax family enrolled in a qualified health plan through a Marketplace.
• The Marketplace estimated at the time of enrollment that your household income would be at least 100% of the federal poverty line for your family size for 2023.
• APTC was paid for the coverage of 1 or more months during 2023.
• You otherwise qualify as an applicable taxpayer (except for the federal poverty line percentage)."

In our case, it's not clear to me that all of the above exception criteria are necessarily true, nor did TurboTax ask us about all of them - so I'm really confused about why the program concluded our non-dependent son qualified for *any* PTC. Can someone explain why that might be?

Part of my confusion relates to how exactly to interpret the Form 8962 instructions exception criteria. If the "you" is meant to apply to my husband, as the person who applied, then the 1st bullet would make no sense. If the "you" is meant to apply to our non-dependent son, then the 1st, 4th and 5th bullets would be true; however the 2nd bullet wouldn't end up being true because our non-dependent son ended up with no one in his "tax family" other than himself and he didn't personally apply for the health care plan, and the 3rd bullet would be entirely inapplicable if not false, since our non-dependent son didn't personally enroll, and, if he had, the Marketplace wouldn't have estimated his expected income to be over 100% of the poverty line (although it did rightly estimate my husband's to be when he applied).

Thanks in advance for any insight anyone can offer about why the program is behaving in this way and whether it would in fact be safe to allocate 100% of our 2022 and 2023 policies to our non-dependent son, on the assumption that his large PTC claims for both years would be considered justified and accurate.

[AmeliesUncle]

I understand the confusion and it could be "gray area" (assuming YOU meet that criteria, even if your son doesn't).  But if I remember correctly, the way I read the law it is allowed.

At any rate, this has been around since 2014 and I have never heard of the IRS denying doing it that way.  In other words, so far it has been okay with the IRS.

I would allocate 100% to your son and get the larger credit.  In the unlikely event the IRS changes its viewpoint of the matter and were to challenge you on it, you could just amend and allocate 100% to yourself (which is what you originally were going to do anyway).

[tibbons2]

Hi @AmeliesUncle,

Thanks so much for your input! I really appreciate it. I'm inclined to agree with you on how to interpret the exception's second and third bullets, i.e., though the eyes of the policy applicant. However, I do wish TurboTax asked questions to be *sure* the exception applied, yet under no circumstances does it seem to do so.

For example, I experimented to see what would happen if I said on our son's draft return that the policy was *purely* his (i.e., not shared/allocated), and the program *still* automatically awarded him PTC without first asking questions to determine whether or not the criteria for the exception were met. 

By contrast, a CPA friend's software assumed the criteria were *not* met, whether the CPA inputted the policy as shared/allocated or not. He had to proactively click a check box to confirm that the exception applied before the software would say our son qualified for PTC.

I am wondering if this issue has been or could be reported to TurboTax? I tried calling a few times but it seemed folks had a hard time understanding what I was describing. In any event, I'd also be interested in hearing any further thoughts you or anyone else has on this. Thanks! 🙂

[AmeliesUncle · Accepted solution]

---

@tibbons2 wrote:

without first asking questions to determine whether or not the criteria for the exception were met. 

I am wondering if this issue has been or could be reported to TurboTax? I tried calling a few times but it seemed folks had a hard time understanding what I was describing. 🙂

---

If a person receives the Advance credit, the Marketplace accepted them as an eligible person.  There is no need to TurboTax to re-verify what the Marketplace has already done.

It does check if a person is a dependent or not.  For ANY of the Premium Tax Credit, I don't THINK it asks if a person was eligible for other insurance (although I could be wrong about that, or it could be in the fine print somewhere).

Even if there was an error (which I don't think there is), I promise you that you will never get a hold of anybody that knows about it at Intuit.  Personally, I don't think there *IS* anybody at Intuit that knows about it.  They don't actually program it to the law; they just program it to the IRS Instructions and Publications.