Paying the Penalty for Not Having Health Coverage: How It’s Calculated

by | Dec 15, 2015 | Uncategorized

office-620822_1920In case you weren’t aware, December 15th, 2015–that’s today–is the deadline for purchasing health coverage through the Health Insurance Marketplace that will start January 1, 2016. There are plans and pricing to fit most budgets, with 7 out of 10 reportedly paying premiums less than $75 per month, after credits and other financial assistance.

This deadline is important since having health insurance, as long as you can afford it, is required by law. As a result, those who opt not to purchase any coverage for 2016 will face a penalty or fine when they pay their federal income taxes at the end of next year.

If that’s you, you may be wondering exactly what kind of fee you may be looking at, as a result of refusing to purchase health insurance. Here’s the lowdown on how the fee is calculated, as well as a few other important facts you need to know.

  1. There are 2 ways the fee can be calculated. If you’re uninsured for more than 3 months, despite having access to affordable coverage, you’ll pay the higher of the two. Either a set amount for each person in your family who doesn’t have coverage or a percentage of your annual income, depending on your situation. You can use this tool to estimate your fee based on your personal situation.
  2. Next year’s fee will be higher. The current penalties for 2015 are the greater of 2{d044ab8acbff62f209a116f8142e303cb886f535b0fcf58cb82cde7cb327d3c9} of your household income or $325/person. For 2016, those will increase to 2.5{d044ab8acbff62f209a116f8142e303cb886f535b0fcf58cb82cde7cb327d3c9} and $695, respectively.
  3. Every month counts. Once you hit the 3-month mark without qualifying coverage, you’ll pay 1/12 of the fee that applies to your situation, until you reach the maximum fee listed above.
  4. Some exemptions apply. People below certain income levels and those who meet other specified criteria may qualify for an exemption from any fees that would otherwise apply.
  5. The final deadline to apply for coverage is January 31. While today is the deadline for coverage to be effective on January 1, you still have until the 31st to sign up altogether. Although special enrollment periods have previous been offered around tax time, that won’t happen in 2016.

For more information on fees and requirements, visit healthcare.gov or contact us today.