ASW Benefit Consultants
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Penalties and Subsidies

Do I have to buy health insurance? What are the penalties for not having health coverage?

There will be penalties for individuals who choose not to get affordable insurance. These penalties are part of the federal law and will be collected by the Internal Revenue Service as part of individual tax filing for 2014. There are no penalties for small employers (fewer than 50 full-time-equivalent employees), but starting in 2015 large employers may be subject to a penalty if they do not offer affordable coverage to their employees.

In 2014, an individual who does not maintain minimum health coverage will face a penalty of $95 or 1 percent of income, whichever is greater. In 2014, a family will be charged a penalty of $95 per uncovered adult and $47.50 per uncovered child (up to $285 for a family) or 1 percent of the family’s income, whichever is greater.

For 2015, the penalty increases to $325 per adult and $162.50 per child (up to $975 for a family) or 2 percent of family income, whichever is greater.

For 2016, the penalty is $695 per adult and $374.50 per child (up to $2,085 for a family) or 2.5 percent of family income, whichever is greater.

How much will it cost me to purchase health insurance through Covered California, and will I be eligible for financial assistance?

Health insurance premium costs through Covered California will be based on age, where you live (ZIP code), household size and income, and the health plan and benefit level you select.  Click here for income guidelines.

What kind of help is available to reduce the cost of insurance?

Starting in 2014, individuals seeking health coverage will be helped to afford coverage in three ways:

  • Premium assistance: Premium assistance is available to reduce the cost of health coverage for individuals and families who meet certain income requirements and do not have health insurance from an employer or a government program. When you enroll in a health plan through Covered California, premium assistance can be immediately applied to the insurance premium, which reduces the amount you pay.
  • Cost-sharing subsidies: Cost-sharing subsidies reduce the amount of out-of-pocket health care expenses an individual or family has to pay. These expenses might include the copayments for health care services or other costs.
  • Medi-Cal assistance: Starting in 2014, the state of California is planning to expand the Medicaid program (called Medi-Cal in California) to cover people under age 65, including people with disabilities, or those with income of less than $15,856 for a single individual and $32,499 for a family of four. The coverage is free for those who qualify and is part of the provisions of the Affordable Care Act.

(source:  Covered California)

Next Step?

Contact us and let us help you get a quote, find out if you qualify for financial assistance, apply for insurance and avoid penalties.  

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