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Updated Individual Health Insurance Mandate Fact Sheet Now Available from the IRS

June 10, 2014 at 8:06 pm

Guidance on Reporting Minimum Essential Coverage & Making a Payment

Effective January 1, 2014, the “individual mandate” provision under Health Care Reform requires every individual to have minimum essential health coverage for each month, qualify for an exemption, or make a payment when filing his or her federal income tax return. The IRS has released an updated fact sheet which details these requirements and includes additional resources to help individuals comply.

Reporting Coverage or Exemptions
Individuals will not need to report minimum essential coverage or exemptions, or make any payment, until they file their 2014 federal income tax returns in 2015. Information will be made available later about how to report coverage or an exemption (or make a payment) on the 2014 income tax return.

Making a Payment
For 2014, the annual payment amount is the greater of:

  •  1% of the individual’s household income that is above the tax return filing threshold for his or her filing status, or
  • The family’s flat dollar amount, which is $95 per adult and $47.50 per child, limited to a family maximum of $285.

The payment is capped at the cost of the national average premium for a bronze level health plan available through the Health Insurance Marketplace (Exchange) in 2014. Basic examples of the payment calculation and the federal tax filing requirement thresholds are also available.

More detailed information on the individual mandate is available in IRS Questions and Answers.

 

 

Categories: Group Benefit Administration.

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