CMS Announces Special Enrollment
Period for Tax Season
Eligible
consumers have from March 15 through April 30 to enroll in coverage
The Centers for Medicare &
Medicaid Services (CMS) announced today a special enrollment period (SEP) for
individuals and families who did not have health coverage in 2014 and are
subject to the fee or “shared responsibility payment” when they file their
2014 taxes in states which use the Federally-facilitated Marketplaces (FFM).
This special enrollment period will allow those individuals and families who
were unaware or didn’t understand the implications of this new requirement to
enroll in 2015 health insurance coverage through the FFM.
For those who were unaware or
didn’t understand the implications of the fee for not enrolling in coverage,
CMS will provide consumers with an opportunity to purchase health insurance
coverage from March 15 to April 30. If consumers do not purchase
coverage for 2015 during this special enrollment period, they may have to pay
a fee when they file their 2015 income taxes.
Those eligible for this special
enrollment period live in states with a Federally-facilitated Marketplace
and:
The special enrollment period
announced today will begin on March 15, 2015 and end at 11:59 pm E.S.T. on
April 30, 2015. If a consumer enrolls in coverage before the 15th of
the month, coverage will be effective on the first day of the following
month.
This year’s tax season is the
first time individuals and families will be asked to provide basic
information regarding their health coverage on their tax returns.
Individuals who could not afford coverage or met other conditions may be
eligible to receive an exemption for 2014. To help consumers who did not
have insurance last year determine if they qualify for an exemption, CMS also
launched a health
coverage tax exemption tool today on HealthCare.gov and
CuidadodeSalud.gov.
"We recognize that this is
the first tax filing season where consumers may have to pay a fee or claim an
exemption for not having health insurance coverage," said CMS Administrator
Marilyn Tavenner. “Our priority is to make sure consumers understand
the new requirement to enroll in health coverage and to provide those who
were not aware or did not understand the requirement with an opportunity to
enroll in affordable coverage this year.”
Most taxpayers, about three
quarters, will only need to check a box when they file their taxes to
indicate that they had health coverage in 2014 through their employer,
Medicare, Medicaid, veterans care or other qualified health coverage that
qualifies as “minimum essential coverage.” The remaining taxpayers -
about one-quarter - will take different steps. It is expected that 10 to
20 percent of taxpayers who were uninsured for all or part of 2014 will
qualify for an exemption from the requirement to have coverage. A much
smaller fraction of taxpayers, an estimated 2 to 4 percent, will pay a fee
because they made a choice to not obtain coverage and are not eligible for an
exemption.
Americans who do not qualify for
an exemption and went without health coverage in 2014 will have to pay a fee
– $95 per adult or 1 percent of their income, whichever is greater – when
they file their taxes this year. The fee increases to $325 per adult or
2% of income for 2015. Individuals taking advantage of this special
enrollment period will still owe a fee for the months they were uninsured and
did not receive an exemption in 2014 and 2015. This special enrollment
period is designed to allow such individuals the opportunity to get covered
for the remainder of the year and avoid additional fees for 2015.
The
Administration is committed to providing the information and tools tax filers
need to understand the new requirements. Part of this outreach effort
involves coordinating efforts with nonprofit organizations and tax preparers
who provide resources to consumers and offer on the ground support. If
consumers have questions about their taxes, need to download forms, or want
to learn more about the fee for not having insurance, they can find information
and resources at www.HealthCare.gov/Taxes
or www.IRS.gov.
Consumers can also call the Marketplace Call Center at 1-800-318-2596.
Consumers who need assistance filing their taxes can visit IRS.gov/VITA
or IRS.gov/freefile
Consumers seeking to take
advantage of the special enrollment period can find out if they are eligible
by visiting https://www.healthcare.gov/get-coverage
Consumers can find local help at: Localhelp.healthcare.gov or
call the Federally-facilitated Marketplace Call Center at 1-800-318-2596. TTY
users should call 1-855-889-4325. Assistance is available in 150 languages.
The call is free.
For more information about Health
Insurance Marketplaces, visit: www.healthcare.gov/marketplace
Additionally, here are helpful
links on Tax Roll-out:
Blog.CMS.gov blog
HealthCare.gov blog English:
Is your Form 1095-A correct? https://www.healthcare.gov/blog/is-your-form-1095a-correct/
Spanish version:
¿Está correcto su Formulario 1095-A? https://www.cuidadodesalud.gov/es/blog/is-your-form-1095a-correct/
Press Release:
Exemption Tool:
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Centers for
Medicare & Medicaid Services (CMS) has sent this update. To contact
Centers for Medicare & Medicaid Services (CMS) go to our contact
us page.
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