What is the fee for not having health insurance in 2016?

The fee is calculated two different ways – as a percentage of your household income, and per person.  You pay whichever is higher.

  • Percentage of income

2.5% of household income, the maximum is the total yearly premium for the national average price of a Bronze plan sold through the marketplace.

  • Per Person

$695 per adult

$347.50 per child under 18

Maximum is $2,085

You pay the fee when you file your federal tax return for the year.  If you had coverage for part of the year, the fee is 1/12 of the annual amount for each month you didn’t have coverage.  If you were uncovered only 1 or 2 months, you don’t have to pay the fee at all.  Talk to you accountant if you have any further questions.


When is the next open enrollment?

Open enrollment for 2017 effective dates is November 1, 2016 through January 31, 2017.  You must apply by December 15, 2016 if you want coverage to start on January 1, 2017.

Do I qualify for a special enrollment?

Changes that qualify for a special enrollment period:

  • Loss of qualifying health coverage, i.e. you lose job-based group health insurance coverage, your individual plan is being cancelled and is no longer offered by the insurance company, you lose eligibility for Medicaid, Medicare, or CHIP.
  • You get married, divorced or legally separated.  Divorce without losing coverage doesn’t quality you for a special enrollment.
  • You have a baby or adopt a child.
  • You move to a new home in a new ZIP code IN A DIFFERENT COUNTY.
  • There are a few, rare other circumstances that may qualify you for a special enrollment.