Blue Cross and Blue Shield of Illinois

  November 1, 2013 

Legislative Update
Affordable Care Act Question of the Week: Minimum Essential Coverage

The “Question of the Week” answers frequently asked questions regarding the Affordable Care Act. Beginning Jan. 1, 2014, most U.S. citizens and legal residents will be required to have a minimum level of health care coverage.

Q. How much is the penalty if a person does not get coverage in 2014?

A. Beginning in 2014, most people who choose to go without coverage will pay a tax penalty, unless they are part of an exempt group or qualify for an exception.

The shared responsibility penalty is the lesser of:

  1. The sum of the monthly penalty amounts for each individual in the shared responsibility family; or
  2. The sum of the monthly national average Bronze plan premiums for the shared responsibility family.

In 2014, the penalty is $95 per adult and $47.50 per child (with the penalty for a family capping at $285), or 1 percent of income, whichever is greater. However, neither of these penalties may exceed the cost of the national average of the lowest Bronze metallic plan on the exchange. These penalties will increase each year.

Note that some people are exempt from the Individual Shared Responsibility tax penalty because of financial hardship, religious beliefs, incarceration, or if they have special coverage as established by another law, such as American Indians.

This communication is intended for informational purposes only. It is not intended to provide, does not constitute, and cannot be relied upon as legal, tax or compliance advice. The information contained in this communication is subject to change based on future regulation and guidance.

 


.

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company,
an Independent Licensee of the Blue Cross and Blue Shield Association.