Do You Have Minimum Essential Coverage?
Under the Affordable Care Act, individuals and families are generally required to have minimum essential coverage in order to avoid year-end penalties or shared responsibility payments. This coverage can be obtained in several ways, including through the Health Insurance Marketplace, direct purchase from a healthcare provider, and receiving health care coverage from an employer sponsored plan. For tax reporting purposes, a simple check mark in the applicable box signifies that you and all of your family members had qualifying health care. Please note that any U.S. citizens who are residents of a foreign nation or a resident of a U.S. territory are not necessarily excluded from this requirement.
Many are confused by what exactly “minimum essential coverage” entails, and further, whether their insurance qualify as such. Find out if your health care counts as minimum essential coverage with the checklist below, and to find health care coverage visit here.
Is your health coverage employee-sponsored?
If you’ve answered YES, then your coverage qualifies as minimum essential coverage if it is any of the following:
· A governmental group health plan. Find your Federal Employee Benefits Program (FEHB) visit here.
· A small or large group market plan offered through individual states.
· A group market health care plan grandfathered in post-ACA.
Is your coverage self-insured through a group health plan?
If YES, then two health plans primarily qualify:
· Coverage through COBRA
· Coverage through a retiree plan
Are you an individual with your own health care coverage?
Answering YES to this question means you’ve either purchased your own coverage or it was factored into school tuition. These include:
· Purchasing health insurance directly from an insurance provider
· Purchasing health insurance from the Health Insurance Marketplace
· Health insurance obtained through a student health care plan
Is your health care sponsored by a government program?
If you’ve answered YES to receiving government-sponsored health care, the following agencies qualify:
· Refugee Medical Assistance
· Medicare Part A coverage
· Department of Veterans Affairs comprehensive health care
· Medicare Advantage plans
· Most Medicaid
· Most forms of TRICARE
· Children’s Health Insurance Program (CHIP)
· Department of Defense Non-appropriated Fund Health Benefits (NAF)
For more information on qualifying coverage, please visit here and here.
We’re committed to helping companies reduce risk, avoid penalties, and achieve 100% ACA compliance. For questions about the ACA contact us here.
