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ACA Marketplace 2016 Open Enrollment and 2015 Individual Shared Responsibility Payment (Penalty)

October 22, 2015


Below are reminders for when the 2016 open enrollment period will be for obtaining health insurance through the Federal or a State Marketplace, and what the individual shared responsibility (penalty) will be for not having insurance for all or part of 2015.

2016 Affordable Care Act Marketplace Open Enrollment Period
The time period for individuals to either renew or obtain health insurance through a Federal or State Marketplace for 2016 will begin on November 1, 2015 and end on January 31, 2016.

Individuals who had health insurance through a Marketplace for 2015 will be automatically enrolled and should have already received a letter from the Federal or State Marketplace.

2015 Individual Shared Responsibility Payment (Penalty)
Just as in 2014, all individuals must have health insurance coverage for all of 2015. If an individual (and/or their family members) does not have health insurance for all or part of 2015 and they do not qualify for a health coverage exemption, they will owe an additional tax (penalty or individual shared responsibility payment).

It is important to note that most individuals who do not have health insurance will qualify for an exemption, so before determining what their penalty will be, tax preparers should determine if the individual qualifies for one of the health coverage exemptions.

For more information on health coverage exemptions and how to apply for them, see the Health Care Exemptions section of How the Affordable Care Act Will Affect Individuals on the CrossLink website.

If an individual does owe a penalty (which has risen substantially from 2014) for 2015, it will be calculated as the greater of: 

  • 2% of the individual’s income that exceeds their 2015 filing threshold (personal exemptions plus standard deduction for their filing status)

Or

  • A flat dollar amount that is assessed for the taxpayer, spouse, and dependents as follows:
    • $325 for taxpayer, spouse, and dependents over age 18
    • $162.50 for each dependent under age 18
    • The maximum family flat dollar amount for 2015 is $975

If an individual did not have health insurance for part of the year, the penalty is pro-rated for the number of months they did not have coverage during 2015.

For more information see the following on the IRS website:

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