THE Affordable Care Act’s Individual Mandate The Affordable Care Act’s individual mandate requires that most Americans have and maintain qualifying health care coverage (known as “minimum essential coverage”) for each month, or pay a penalty. The individual mandate went into effect at the beginning of January 2014 and continues each year. The penalty for not having coverage will be paid when you file your federal income tax return. The penalty applies for each full month you or a family member doesn’t have minimum essential coverage (or an exemption). What is minimum essential coverage? Minimum essential coverage includes the following: • Employer-sponsored coverage, including self-insured plans, COBRA coverage and retiree coverage • Coverage purchased in the individual market, including a qualified health plan offered by the Health Insurance Marketplace (for example, HealthSource RI, MA Health Connector or Access Health CT) • Medicare Part A coverage and Medicare Advantage plans • Most Medicaid coverage • Children’s Health Insurance Program (CHIP) coverage • Certain types of veterans health coverage administered by the Veterans Administration (VA) • Most types of TRICARE coverage How much is the penalty? *Using the percentage method, only the part of your household income that’s above the yearly tax filing threshold. For 2015, that threshold is $10,300 if filing single; $20,600 if married filing jointly. **Using the flat dollar amount method, you pay only for people in your household who didn’t have insurance coverage. ***Under either method, your payment amount is capped at the cost of the national average premium for a bronze level health plan available through the Marketplace. For 2015, the annual national average premium for a bronze level health plan available through the Marketplace is $2,484 per year for an individual and $12,240 per year for a family with five or more members. www.hilgroupne.com.