Special Enrollment Period for Uninsured Paying 2014 Tax Penalties

Affordable Care Act

Special Enrollment Period for Uninsured Paying 2014 Tax Penalties

Published on March 06, 2015

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On February 20, 2015, the Centers for Medicare and Medicaid Services announced that it would create a new special enrollment period for consumers who paid the Affordable Care Act tax penalty (“shared responsibility payment”) for being uninsured in 2014, provided they’re currently uninsured for 2015.
The new special enrollment period runs from March 15 through April 30, 2015 for qualifying consumers in states that use Healthcare.gov instead of their own state exchange. To qualify, consumers must also attest that were unaware of Obamacare’s uninsured tax penalty until they field their tax returns for 2014.
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To help consumers understand whether they qualify for this special enrollment period, and how to take advantage of it, eHealth prepared answers to these frequently asked questions:

QUESTION: Has the health insurance enrollment period (or Obamacare enrollment period) been extended?

ANSWER: No, the federal government created a new special enrollment period for some people in states that did not build their own exchanges. The ACA’s official open enrollment period ended February 15, 2015.
This is a new, special enrollment period, and its only open to people who paid a tax penalty for being without health insurance in 2014, who are uninsured for 2015, and who only learned about the tax penalty while preparing their 2014 tax returns.

QUESTION: Does this special enrollment opportunity apply to everyone?

ANSWER: No. To qualify, you have to:

  1. Have filed your 2014 tax return and paid a tax penalty (the “shared responsibility payment”) for being uninsured in 2014
  2. Be currently uninsured for 2015;
  3. Attest that you first became aware of the tax penalty while completing your 2014 federal tax return.
  4. And, live in a state that did NOT build its own health insurance exchange.

QUESTION: Will this special enrollment opportunity apply in my state?

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A: The federal special enrollment period only applies in the 37 states using the federal health insurance exchange.  States that operate their own health insurance exchanges have generally established similar special enrollment periods, but details, such as dates and conditions, differ.
To learn more, review our map and contact eHealth or another licensed agent or your state’s Department of Insurance.
States where the new federal special enrollment period applies include: Alaska, Alabama, Arkansas, Arizona, Delaware, Florida, Georgia, Iowa, Illinois, Indiana, Kansas, Louisiana, Maine, Michigan, Missouri, Mississippi, Montana, North Carolina, North Dakota, Nebraska, New Hampshire, New Jersey, New Mexico, Nevada, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, West Virginia, and Wyoming.

Q: Where can I shop for coverage during the new special enrollment period?

A: If you qualify for the new special enrollment period from March 15 through April 30, you may or may not be able to shop for coverage, apply for subsidies, and complete your enrollment through qualifying private online marketplaces like eHealth.com, authorized local agents, or the government-run health insurance exchange, Healthcare.gov.

Q: If I qualify for the special enrollment period, will I be able to apply for government subsidies to reduce my monthly premiums?

A: Yes, if you qualify for the special enrollment period you may apply for a government subsidy and if you meet the income and other guidelines, you can qualify for a government subsidy.
A key factor in subsidy eligibility is income. To qualify for government subsidies, your household income can be no more than 400% of the federal poverty level (about $47,000 for a single person or $94,000 for a family of four in the continental US), although other factors apply as well.

Q: If I qualify for this special enrollment period and enroll in coverage, will that prevent me from having to pay the tax penalty for going uninsured in 2014 and 2015?

Revised Subsidy GraphicA: Not for 2014, but maybe for 2015.
To qualify for the special enrollment period you need to have paid a tax penalty for being uninsured (a “shared responsibility payment”) when you filed your 2014 federal income taxes.
If you are uninsured for longer than three months in 2015, you may also be subject to a pro-rated tax penalty when you file your 2015 income taxes. The tax will be based on how long you go without coverage.
Simply enrolling in a plan during the special enrollment period does not protect you from tax penalties you incurred in 2014, but it may help you avoid paying the tax penalty again for 2015.

Q: What if I haven’t yet filed my 2014 federal tax return yet?

A: The new enrollment period ends on April 30, 2015.
You need to file your 2014 taxes before you take advantage of this special enrollment period.  When you complete your 2014 federal tax return you should find out if you’re subject to the tax penalty for being uninsured.
Your income, how long you were uninsured and other factors will determine whether or not you pay the penalty.
If you do have to make a “shared responsibility payment” on your 2014 taxes and you’re still without coverage for 2015, you may qualify for the new special enrollment period.

Q: If I already have coverage for 2015 and I had to pay a penalty on my 2014 taxes, can I reshop during this open enrollment period?

A:  No, this is not an opportunity to reshop.
To qualify for this special enrollment period, you have to be uninsured.
If you have employer-sponsored health insurance or a major medicalindividual or family plan, you won’t qualify for this special enrollment period even if you paid the tax penalty for being uninsured in 2014.

Q: If I enroll in a health plan during this special enrollment period, when can my coverage begin?

A:  Typically, applications submitted between the 1st and 15th of each month go into effect on the first day of the following month.

  • Example: Submit your application on March 15 and, so long as you make your first payment, your coverage would be in effect on April 1.

Along those lines, if you apply for coverage between the 16th and the final day of a month, you’ll have to wait a full month for your coverage to go into effect.

  • Example: Submit your application between March 16 and March 31, and as long as you make your first payment, your coverage goes into effect on May 1. So you’re uninsured throughout April.

Each insurance company has its own enrollment policies and processing times, so your new plan’s start date may vary from these guidelines.
Now that you have been informed about special enrollment period, you can explore your options for major medical insurance plans by entering your zip code where indicated on the right side of this page. Or, you can sign up for our newsletter in the lower right side of this page, too.

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