Eligible consumers have from March 15 through April 30 to enroll in coverage
The Centers for Medicare & Medicaid Services (CMS) announced on February 23 a special enrollment period (SEP) for individuals and families who did not have health coverage in 2014 and are subject to the fee or “shared responsibility payment” when they file their 2014 taxes in states which use the Federally-facilitated Marketplaces (FFM). This special enrollment period will allow those individuals and families who were unaware or didn’t understand the implications of this new requirement to enroll in 2015 health insurance coverage through the FFM.
How this affects consumers
-You can now apply for coverage between March 15-April 30 if you were subject to a penalty for not having coverage in 2014 AND you only found out about the new law as a result of filing your taxes.
-You must live in a state that has a Federally-facilitated Marketplace, like Georgia.
-You must not have been enrolled in coverage through the Marketplace for 2015.
-You must also pay the appropriate fee based on your income and household size for not having coverage in 2014.
(see “Understanding ACA Penalties and Exemptions”).
The special enrollment period will begin on March 15, 2015 and end at 11:59 pm E.S.T. on April 30, 2015. If a consumer enrolls in coverage before the 15th of the month, coverage will be effective on the first day of the following month.
This year’s tax season is the first time individuals and families will be asked to provide basic information regarding their health coverage on their tax returns. Individuals who could not afford coverage or met other conditions may be eligible to receive an exemption for 2014. To help consumers who did not have insurance last year determine if they qualify for an exemption, CMS also launched a health coverage tax exemption tool today on HealthCare.gov and CuidadodeSalud.gov.
You can find the tool here: https://www.healthcare.gov/exemptions-tool/#/
Penalties & Exemptions
Most taxpayers (approx 75%) will only need to check a box when they file their taxes to indicate that they had health coverage in 2014 through their employer, Medicare, Medicaid, veterans care or other qualified health coverage that qualifies as “minimum essential coverage.” The remaining taxpayers will take different steps. It is expected that 10 to 20 percent of taxpayers who were uninsured for all or part of 2014 will qualify for an exemption from the requirement to have coverage. A much smaller fraction of taxpayers, an estimated 2 to 4 percent, will pay a fee because they made a choice to not obtain coverage and are not eligible for an exemption.
Americans who do not qualify for an exemption and went without health coverage in 2014 will have to pay a fee – $95 per adult or 1 percent of their income, whichever is greater – when they file their taxes this year. The fee increases to $325 per adult or 2% of income for 2015. Individuals taking advantage of this special enrollment period will still owe a fee for the months they were uninsured and did not receive an exemption in 2014 and 2015. This special enrollment period is designed to allow such individuals the opportunity to get covered for the remainder of the year and avoid additional fees for 2015.
Source: Accountants Intuit
Getting Assistance
For assistance with tax filing you can visit our comprehensive map of free & reliable AARP & IRS VITA tax preparation sites across Georgia, all of which have trained preparers who understand the new ACA/IRS tax filing guidelines: https://georgiawatch.org/taxmap/
Consumers can also call the Marketplace Call Center at 1-800-318-2596.
Consumers seeking to take advantage of the special enrollment period can find out if they are eligible by visiting https://www.healthcare.gov/get-coverage Consumers can find local help at: Localhelp.healthcare.gov or call the Federally-facilitated Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855-889-4325. Assistance is available in 150 languages. The call is free.
