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Smart Benefits: Hardship Exemptions from Individual Mandate Published

Monday, December 08, 2014

 

The Internal Revenue Service recently issued Notice 2014-76, which includes information on getting a hardship exemption from the individual mandate for health insurance coverage. 

The mandate, created by the Affordable Care Act, requires individuals to have minimum essential health coverage for themselves and their dependents or include an individual shared responsibility payment with their federal income tax return – unless they qualify for an exemption,

An individual is exempt from the requirements for a month if he or she has a hardship exemption certification issued by the health insurance exchange certifying that they have suffered a hardship affecting their ability to obtain minimum essential coverage that month.

Individuals can also claim an exemption without obtaining a certification from the exchange if they are eligible to claim one of the following hardship exceptions on their Federal income tax return:

1.) Two or more members of a family whose combined cost of employer-sponsored coverage is considered unaffordable

2.) Gross income below the applicable return filing threshold

3.) Individuals who obtained minimum essential coverage during the 2014 open enrollment period

4.) Certain individuals who applied for CHIP coverage during the open enrollment period for 2014

5.) Individuals eligible for services through an Indian Health Care Provider

6.) Certain individuals residing in a state that did not expand Medicaid eligibility under section 2001(a) of the Affordable Care Act

More details on each of these exemptions can be found in the IRS publication here.

Amy Gallagher has over 21 years of healthcare industry experience guiding employers and employees. As Vice President at Cornerstone Group, she advises large employers on all aspects of healthcare reform, benefit solutions, cost-containment strategies and results-driven wellness programs. Amy speaks regularly on a variety of healthcare-related topics, and is often quoted by national publications on the subject matter. Locally, Amy is a member of SHRM-RI, the Rhode Island Business Group on Health, and the Rhode Island Business Healthcare Advisory Council.

 

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