Pay Or Play
These are the penalties if a consumer does not purchase a qualified individual health plan or participate in your employers group health plan.
- 2014 – The annual penalty will be $95 per adult and $47.50 per child, up to a family maximum of $285 or 1 percent of family income, whichever is greater.
- 2015 – The penalty will be $325 per adult and $162.50 per child, up to a family maximum of $975 or 2 percent of family income, whichever is greater.
- 2016 – The penalty will be $695 per adult and $347.50 per child, up to a family maximum of $2,085 or 2.5 percent of family income, whichever is greater.
The penalty will accumulated for the months you don’t carry coverage in that given year. However, a person may be without coverage for up to three months without triggering the penalty.
Example of the penalty:
Family of 4 with income of $100,000 in 2014. Family maximum penalty is $285 or $1,000 (1%) of income, which ever is greater. Therefore the penalty would be $1000 is the family did not buy coverage in 2014.
The mandate is designed to apply to people who make enough money to buy private health insurance but choose not to be insured either on their employer’s plan, in the individual market, or through the insurance exchanges that must be set up in each state under the law. It does not apply to Americans age 65 and up who are covered by Medicare.
People who will not have to buy insurance
- between jobs and without insurance for up to three months
- have religious objections
- are an undocumented immigrant
- are in jail
- are a member of an Indian tribe
- financial hardship
The penalty will not apply if:
- You have group health coverage through your job.
- You have a government-sponsored health plan, like Medicare, Medicaid, CHIP or TRICARE.
- You buy an individual health insurance plan through the Marketplace, directly from an insurance company, or through an insurance broker
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