National Indian Health Board Annual Consumer Conference .

2y ago
23 Views
2 Downloads
3.13 MB
32 Pages
Last View : 2m ago
Last Download : 2m ago
Upload by : Eli Jorgenson
Transcription

National Indian Health BoardAnnual Consumer ConferenceSeptember 2014

Myra M. MunsonSonosky, Chambers, Sachse, Miller & Munson

The ACA requires that most Americans havehealth care coverageSpecial provisions for AI/AN people include: Special Enrollment Periods Zero and Limited Cost Sharing Exemption from the shared responsibility payment(requirement to have health care coverage) “The Individual Mandate”3

Individuals must have coverage or face a taxpenalty 2014: 95 per adult and 47.50 per child Up to 285 for a family Or 1% of family income, whichever is greater. Tax filer must pay penalty on all dependents. Married couples jointly responsible. Referred to as a “Fee” in most publications.4

If I have health coverage from . My employer provides insuranceI am enrolled in MedicareI am enrolled in MedicaidI am and/or my children are enrolled in CHIPI am enrolled in Veteran Benefits Veterans Health Care ProgramTRICAREVA Civilian Health and Medical Program (CHAMPVA)Spina bifida health care benefits program.then I have satisfied the “Individual Mandate”5

AI/AN people must file for this exemption ifyou don’t have health insurance Remember IHS is not considered “minimumessential” coverage You are encouraged to file even if you havehealth insurance The Indian Exemption is a lifetime exemption If you have Medicare or VA benefits you donot need the Indian Exemption Both are lifetime benefits6

Restrictive definition of “Indian”Tribal leaders continue to advocate for alegislative fixNew Hardship Exemption category issued bythe Secretary of HHS Final rule issued in June 2013 For individuals not enrolled in Tribes, but otherwiseeligible for IHS services This is not a statutory exemption7

For AI/ANs who are.For AI/ANs who are 1) Enrolled member offederally-recognized Tribe, orEligible to receive service from anI/T/U facility with no Tribal orcorporation enrollment2) Shareholder in Alaska NativeClaims Settlement Act (ANCSA)Corporation (regional or village)Indian Exemption (Lifetime)Hardship Exemption (Lifetime) Eligible to receive all specialprovisions for AI/AN’s Monthly enrollment option Zero Cost Sharing(At or below 300% FPL) Limited Cost Sharing NOT eligible to receive specialprovisions for AI/AN’s Must use open enrollmentperiod Not eligible for Cost SharingSpecial Provisions Exemption can applied forwith paper application or whenfiling taxes. Exemption can only be applied forwith the paper application.

Indian Exemption is awarded to:1. Enrolled Members of a federally recognized Tribe2. Alaska Native Claims Settlement Act (ANCSA)Corporation Shareholders (Regional or Village) Youcan apply for this exemption on the paperapplication or when you file taxes. Acceptablesupporting documents include: Tribal Enrollment card or letter ANCSA Shareholder Card or letter Including letter acknowledging child is a descendant. CDIB card if Tribal enrollment or ANCSA Shareholder status isnoted.

HardshipExemption is awarded to other individuals whoare eligible for services through an Indian health careprovider Youcan apply for this exemption ONLY with the paperapplication. Acceptable1.2.3.supporting documents include:U.S. Bureau of Indian Affairs (BIA) Form 4432 signed by BIA ortribal official.Certificate of Degree of Indian Blood (CDIB), signed by BIA ortribal official.IHS Eligibility Letter

Mechanics of Indian Specific Exemptions

If you don’t haveacceptable proof,you can get anIHS EligibilityLetter from yourlocal clinic.12

Document showing residency in an urbancenter (ex. utility bill or voter registration card)AND document establishing: Membership in a Tribe or descendency in 1st or2nd degree; Eskimo, Aleut, or other Alaska Native status; Considered by Sec. of Interior to be Indian for anypurpose; or Has been determined to be Indian throughregulations promulgated by the Secretary13

If you are a California Indian, a document from the Bureau ofIndian Affairs (BIA) or an Indian tribe, showing a person whois listed on the plans for distribution of the assets ofRancherias and reservations located within the state ofCalifornia under the Act of August 18, 1958, and anydescendant of such an Indian;or document showing trust interests in public domain,national forest, or reservation allotments in California;or document showing a person is a descendant of an Indianwho was residing in California on June 1, 1852, if suchdescendant is a member of the Indian community served bya local program of the Indian Health Service; and is regardedas an Indian by the community in which such descendantlives.14

If individual does not have supportingdocuments include Birth certificate Document listed under Step 5 for parent orgrandparent. If the document is from grandparent, a birthcertificate linking parent to grandparent mustalso be provided.15

A child under the age of 19 who is the natural child,adopted child, stepchild, foster child, legal ward, ororphan of an eligible Indian Must provide date of 19th birthday on application. Question 11 on Step 2 Spouse of an eligible Indian, if the Tribe passed a Tribalresolution that makes spouses eligible to receive servicesfrom the IHS Eligible unless marriage status changes Non-Indian women who are pregnant with the child of aneligible Indian Eligible until 6 weeks post partum. Must provide due date on application.16

Same form for either the Indian Exemption orthe Hardship Exemption. Which exemption you get depends on the type ofdocumentation you send in with your application. Paper Application: ribal-exemption.pdf Instructions are available: xemption-application-instructions.pdf Pages 11 & 1217

HOW TO FILL OUT THE EXEMPTION FORMS

Who can use this application? Although not included on the formlanguage, Indian Tribal member includesANCSA Shareholders (Regional orVillage)What do you need to apply? Tribal enrollment cards or ANCSAShareholder Cards are preferred.Certificate of Indian Blood (CIB) Card orIHS Eligibility letters are also acceptable.19

This first section is apoint of contact for theapplicant(s)

Complete this page for:1) Every adult in the taxhousehold-even if they are not AI/AN2) Every AI/AN child#5b Only list those tax dependentswho are AI/ANComplete a Step 2 page fordependent(s) who need anexemption#5c Each dependent must list whoclaims them as a dependent. This isusually his or her parent/guardian.

#7 If the “Yes” box is selected, therest of the form is left blank. #8-11 are only answered by thosewho are only eligible for IHS, eithershort or long term, and who are notmembers of a federally recognizedTribe or ANCSA Shareholders(regional or village)

Don’t forget a copy ofyour supportingdocumentationSee Step 5 for a list ofacceptable supportingdocuments23

Indian Exemption Documentation Documentation of enrollment ormembership in a federally recognizedTribe, Document issued by Alaska Nativevillage/tribe or an Alaska Native ClaimsSettlement Act (ANCSA) corporation(regional or village) Bureau of Indian Affairs Card (BIA) iftribe or ANCSA corporation (regional orvillage) is listed.Hardship Exemption Documentation Letter on IHS facility letterhead verifyingeligibility for services. Tribal document acknowledgingmembership, descent, participation inTribal community affairs, etc. Bureau of Indian Affairs (BIA) Card withno tribe or ANCSA Corporation (regionalor village) listed.

HOW TO FOLLOW UP ON YOUR EXEMPTIONAPPLICATION

Exemption Certificate Number (ECN) Issued One number for each family member who appliedKeep ECN in a safe place-Like a SocialSecurity Number Number remains valid for life (limited exceptions) Apply number(s) to income tax return27

Review the document sent back to you Errors have been reported Hardship Exemption issued instead of the Indian ExemptionNo certificate number issuedTwo different letters with two sets of numbersNot accepting NANA Shareholder Cards One of the regional ANCSA Corporations Some family members get a certificate number, some don’t

Theexemption processing center is calling people Calling to resolve inconsistencies Previously asked for Personal information People were concerned this was fraud Processors no longer asking for SS#’s or date of birth Cannot call back the processors In some cases, follow-up letters were sent to the applicant Healthcare.govcall center cannot provide info

Incorrect Exemption? Do not start the Appeal Process Unclear if they have a better understanding of the issue No response to exemption application? Do not resubmit exemption applications Could potentially cause further delays and problems at tax time CMS contact for help:Nancy Goetschius at CMS/CCIIO: nancy.goetschius@cms.hhs.gov Email Nancy Name(s), Date of Birth and City & State Do not include social security numbers Include information if family application or other details on problem(s) Or call Nancy at 410-786-0707

Legislative fix for the definition of “Indian” inthe ACARecommendation that the IRS issue theHardship Exemption for those eligible toreceive care at an IHS FacilityElectronic Verification for the registered usersof I/T/U facilitiesReprocessing of all Hardship exemptions thatwere issued31

Myra M. MunsonSonosky, Chambers, Sachse, Miller & Munson LLPmyra@sonoskyjuneau.comLiz MalerbaHealth Policy AnalystUnited South and Eastern Tribes, Inc. (USET)LMalerba@USETINC.ORGMonique MartinGovernment Relations SpecialistAlaska Native Tribal Health Consortium (ANTHC)mmartin@anthc.orgMelissa GowerHealth Care Consultantmgower59@gmail.com32

U.S. Bureau of Indian Affairs (BIA) Form 4432 signed by BIA or tribal official. 2. Certificate of Degree of Indian Blood (CDIB), signed by BIA or tribal official. 3. IHS Eligibility Letter. Mechanics of Indian Specific Exemp

Related Documents:

o Indian Journal of Biochemistry & Biophysics (IJBB) o Indian Journal of Biotechnology (IJBT) o Indian Journal of Chemistry, Sec A (IJC-A) o Indian Journal of Chemistry, Sec B (IJC-B) o Indian Journal of Chemical Technology (IJCT) o Indian Journal of Experimental Biology (IJEB) o Indian Journal of Engineering & Materials Sciences (IJEMS) .

32. Indian Journal of Anatomy & Surgery of Head, Neck & Brain 33. Indian journal of Applied Research 34. Indian Journal of Biochemistry & Biophysics 35. Indian Journal of Burns 36. Indian Journal of Cancer 37. Indian Journal of Cardiovascular Diseases in Women 38. Indian Journal of Chest Diseases and Allied Sciences 39.

glacier national park bridge roscoalde gras beartooth w arr i o r tt r a i l deer absarokee f h i g h w y fort peck indian reservation fort belknap indian reservatio n rocky boy’s indian reservation crow indian reservatio n northern cheyenne indian reservation blackfeet indian reservatio n 278 278 324 324 569 253 253 435 399 434 nye sula loma .

me "indian, indian, indian." And I said, Yes, I am. I am Indian. Indian, I am. 16 Third Grade My traditional Native American art career began and ended with my very 17 first portrait: Stick Indian Taking a Piss in My Backyard. As I circulated the original print around the classr

(i) Indian Administrative Service. (ii) Indian Foreign Service. (iii) Indian Police Service. (iv) Indian P & T Accounts & Finance Service, Group A ï. (v) Indian Audit and Accounts Service, Group A ï. (vi) Indian Revenue Service (Customs and Central Excise), Group A ï.

Indian Institute of Technology Roorkee Roorkee IITR* Indian Institute of Technology Mandi Mandi IITMandi Indian Institute of Technology Ropar Ropar IITRPR South Zone Indian Institute of Technology Madras Chennai IITM* Indian Institute of Technology Hyderabad Hyderabad IITH Indian Institute of Technology Palakkad Palakkad IITPKD

Indian child's grandparent, aunt or uncle, brother or sister, brother-in-law or sister-in-law, niece or nephew, first or second cousin, or stepparent. Extended family members include non-Indian relatives. An Indian Child is an unmarried person under 18 who is either a member of an Indian tribe(s) or eligible for membership in an Indian

ASTM D2996 – “Standard Specification for Filament-Wound ‘Fiberglass’ (Glass-Fiber-Reinforced Thermosetting-Resin) Pipe” ASTM D2517 – “Standard Specification for Reinforced Epoxy Resin Gas Pressure Pipe and Fittings” 3 Design Overview The patented LinePipe design consists of an inner thermoplastic pressure barrier layer that is bonded to and reinforced by high-strength .