ACA Healthcare Coverage Exemptions

Let’s flip the script for a post and talk about the individuals who are now, according to the ACA, responsible for obtaining health insurance that meets minimum essential coverage (MEC). If you’re a full-time employee with an ACA-compliant company, you shouldn’t have to worry too much since the coverage your employer offers will meet this criteria.

If you’re one of the many Americans who hasn’t received an offer of coverage from your employer, it’s likely they weren’t required to make an offer to you, and you’re therefore responsible for seeking out and purchasing a plan of your own. This can be done through a Marketplace, the private insurance sector, and through governmental programs. If you don’t obtain adequate coverage, you may be required to make an individual shared responsibility payment.

You may be able to get out of this payment if you qualify for an exemption from the requirement to have coverage. Generally, you apply for this exemption if, throughout the year:

• you didn’t have access to affordable coverage,
• you only went without coverage during a one-time gap of less than three consecutive months, or
• you qualify for one of any of these exemptions, including a hardship exemption.

There are certain exemptions that can only be granted by the Marketplace (and are claimed on Form 8965), while others can only be granted on your tax return. A select few exemptions can be applied for through either means, so it’s important to research the exemption for which you may be eligible.

Applicable Large Employers, CPAs, and any other ACA filers who still need to transmit their 1094 and 1095 forms to the IRS by the June 30th deadline can do so quickly and easily with ExpressIRSForms! Create an account to get started, and if you have any questions, give our customer support center a call at (704) 684-4751 or send us an email to support@ExpressIRSForms.com.