Minimum Essential Coverage includues the following:
- Employer -sponsored coverage, including COBRA & retiree benefits
- Coverage purchased on individiual market
- Medicare Advantage
- Children’s Health Insurance Program (CHIP)
- Certain Veteran health plans
*does not include specialized coverage, such as the following stand-alone coveages, vision care, dental care, workers compensation plans, disability plans, or coverage only for specifice disease or condition.
These Marketplaces offer coverage to consumers who do not have coverage through an employer plan.
Public Individual Marketplaces are the only place a consumer can access any available premium credits or cost sharing subsidies
Formally refered to as an “EXCHANGE”, a “MARKETPLACE” is a new way to purchase health coverage. An online “store” where consumers can compare comprehensive insurance options based on price and benefits specific to a consumers need. Marketplaces are typically ran by State or Federal Government.
Employee monthly contribution for employee only coverage must be less than 9.5% of said employees prior years W2 earnings (box 1 of tax form W2)
A short coverage gap period is a period less than three consecutive month. Coverage gap waiver is only allowed once during a calendar year.
Should the gap period extend between two calendar years (example, November to Febuary) there is no tax/penalty/shared responsibility due unless a full three month consecutive period is spent in one calendar year.
A Public Marketplace is ran by a government entity.
A Private Marketplace is ran by a private company, similiar to how many access coverage now.
Dependent child under age 18: 1/2 the flat dollar amount
NOTE: Since provision goes into effect in 2014, Individuals will NOT have to have to submit coverage or exemption information or pay any penalties until they file their 2014 tax return in 2015.