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INDIVIDUAL MANDATE TO MAINTAIN MINIMUM HEALTH COVERAGE

The individual mandate under the Affordable Care Act is scheduled to take effect on January 1, 2014. The mandate for large businesses to provide health insurance and report coverage has been delayed until January 1, 2015. On August 28, 2013 the IRS issued final regulations for the individual mandate.


For 2014, individuals who cho...ose not to enroll in a health insurance program will have to pay a penalty of $95 per adult per year ($47.50 per child), or 1 percent of income whichever is greater. The penalty increases in 2015 and again in 2016 at which point a cost of living formula will be developed.


The regulations define what is considered an eligible plan for individual health insurance. The new regulations clarify that the following plans would qualify under the Affordable Care Act: medical coverage offered by an organization acting on behalf of the employer; union-sponsored health plan; plans offered through a PEO (professional employer organization); the Defense Department's Non appropriated Fund Health Benefits Program, and; a self-insured group health plan. 


The final regs also define "coverage for a month" to be defined as: for any calendar month, an individual has minimum essential coverage if the individual is enrolled in and entitled to receive benefits under a program or plan that is minimum essential coverage for at least one day during the month.

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