News & Updates
December 22, 2016
The U.S. Department of Health and Human Services (HHS) has released a final rule which establishes the required contribution percentage under the individual mandate for 2018 and codifies certain special enrollment periods.
The Affordable Care Act's "individual mandate" provision requires every individual to have minimum essential coverage for each month, qualify for an exemption, or make a penalty payment when filing his or her federal income tax return. One such exemption applies when the amount that an individual would be required to pay for minimum essential coverage (the required contribution) exceeds a particular percentage of his or her actual household income for a taxable year (the required contribution percentage).
Under the final rule, the required contribution percentage under the individual mandate for 2018 is 8.05%, a decrease from 8.16% for 2017.
In addition, HHS codified special enrollment periods for the following consumers who apply for coverage on the Health Insurance Marketplace (among others):
While these special enrollment periods have previously been available to consumers, the agency sought codification in order to ensure the rules are clear and to limit potential abuse. Click here to read the final rule in its entirety.
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