Feds explain individual mandate exemptionsNews added by Benefits Pro on May 14, 2014

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By Allison Bell

Consumers who can’t afford to buy major medical coverage, or simply don’t want to, can apply for individual mandate exemptions.

Officials at the Centers for Medicare & Medicaid Services explain the Patient Protection and Affordable Care Act individual mandate exemption process in a guide aimed at “in person assisters” – people who help consumers sign up for public exchange plan coverage and use it.

PPACA requires most with incomes over a certain level to have “minimum essential coverage” or else pay a penalty for each month they don’t.

In practice, for 2014, most of those affected who earn enough to be subject to the penalty will pay an amount equal to 1 percent of income, ranging from a minimum of $95 per adult and $47.50 per child for the full year, according to the Tax Policy Center.

The 2014 annual maximum penalty will be $3,600 (the national average cost of bronze-level exchange coverage) per affected adult and $1,900 per affected child.

PPACA caps the penalty for large families.

PPACA also indexes the penalty amounts for inflation.

In 2016, the annual minimum will rise to $695 per adult and $347.50 per child. The maximum will rise to $4,045 per adult and $2,135 per child.

In 2014, a single, uninsured, childless adult with an income of $60,000 might owe a penalty of $499. A single, childless adult with an income of $375,000 might owe the $3,600 maximum.

In the guide, CMS officials list the many types of exemptions, such as for members of federally recognized Indian tribes; people who have short gaps in coverage; and those who can’t find coverage that meets federal affordability standards.

Originally published on BenefitsPro.com
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