"Your Health Insurance Specialists"
Health Shop ® 7823 W 38th Ave, Wheat Ridge, CO 80033 Phone (303) 425-4466 Fax (303) 420-8988
- 2016 - 2017 Greater of $695.00 per Adult, $347.50 per child ($2085.00 Maximum for family) or 2.5% of taxable household income.
- Members of Certain Faiths- Members of certain faiths will be free from tax penalties. You must certify you are a member of a recognized religious sect.
Copyright 2013: Health Shop | Insurance Agency Denver | All rights reserved.
- Income Restraints- Tax penalty exemptions may be granted for people when the lowest cost plan option exceeds 8% of of annual income.
- Hardships- If the US Department of Health and Human Services determines someone has suffered a qualified hardship, they may be exempt.
- Taxpayers with income below the filing threshold;
- Members of Indian tribes;
- Individuals who experience short coverage gaps;
- Incarcerated individuals;
- Individuals who are not lawfully present;
Large Business Group Employer Penalties (Employers with 50 or more Full Time Equivalents)
If minimum essential coverage(MEC) is not offered OR is offered to less than 95% of all FT employees and their child dependents AND one FT employee receives premium tax credits under an exchange, the employer must pay:
- 2015 - $2,080 / year for each full time employee, excluding the first 30 employees
- 2016 - Adjusts to $2,080 year for each full time employee, excluding the first 30 employees
If MEC is offered offered to 95% of all full time employees and their child dependents, but if coverage is not "deemed affordable" "or does not provide minimum essential value at lease one FT employee receives premium tax credits under an exchange, the employer must pay:
- 2015 - $3,120 / year per FT employee
- 2016 - Adjusts to $3,240 / year per FT employee
Pending further guidance, there are nine categories that may be exempt from the shared responsibility payment:
On March 23, 2012, the Patient Protection and Affordable Care Act, ACA, was signed into law. Beginning January 1, 2014 all US citizens and legal residents are required to have a qualified health plan with minimal essential coverage or pay a penalty tax. The ACA calls for a federal marketplace for individuals and small group employers to purchase qualified health plans. States have the option to create their own exchange or marketplace, Colorado has developed "Connect for Health Colorado" for our state's exchange. The small Business Health Options Program (SHOP) is Colorado's marketplace for small group employers.
How does the new tax credit work?
Individuals who receive these subsidies / advanced tax credits must remember to update financial information throughout the year as well as changes in family size. Tax credit qualification amounts may be adjusted, meaning you may qualify for more of a tax credit or your tax credit may be reduced. If not adjusted during the year you may end up with a sizable tax bill to the IRS at tax time. Example of items to update:
*Please note: Subsidies: Pending further regulatory guidance, an individual qualifying for a subsidy or tax credit "must" purchase an individual plan through the exchange.
Start by answering these 3 questions:
•Does your employer offer health insurance? •Do you receive Medicare / Medicaid? •Do you or your family make more in a year than chart shown.
If you answered “No” to all three questions, you may qualify for the new tax credit.
Do I qualify for the tax credit / subsidy?
The new tax credit can be quite confusing.
We can help you through the process. Just give us a call and we can get you started today!
Eligibility for Health Care Tax Credits
- Household income must be between 100% to 400% of the Federal Poverty Level
- Individuals must enroll in a "qualified" health plan through the Insurance Exchange
- Individuals must not be incarcerated and must be legally present in the United States
- Individuals must not be eligible for other qualifying coverage such as Medicare or Medicaid
- Individuals must not be eligible for an affordable, qualified employer sponsored plan
Important Note - Reporting Life Changes / Income Changes
- Loss of employment, demotion
- No longer claim a dependent
Determine Tax Credit Qualification
1. Determine Size of Your Household - Include
- Children who live with you, even if they file tax returns
- Dependents listed on your tax return even if they don't live with you
- Spouse or unmarried partner
- Anyone under 21 who lives with you and you take care of
2. Estimate Household Income
Include income from you, your spouse and any dependents required to file a tax return. (Including Dependent Children)
- Net Income from self employment/business
Family Size Annual Household Income
- Other taxable Income. prizes, awards etc.
The tax credit is designed to help lower the amount you pay for health insurance. The premium tax credits are based on household size and annual income. Generally the tax credit will be claimed when filing your annual tax return. This credit will be applied against taxes owed or will be refunded if no taxes are owed. However, if you qualify, you may choose to take the tax credit in the form of advanced premium payments to help pay monthly for health premiums.
Distribution of Health Exchange Notice to Employees - Employers need to comply with the new requirement to provide current employees and each new hire, regardless of enrollment status, part time or full time, a written notice with information about a Health Insurance Exchanges. If you would like assistance obtaining these notices call us at 303.425.4466 or email us your request.
90 Day Wait Period Limitation- Health Care Reform requires new hires must be enrolled on an employer sponsored health plan "no later" than their 91st day of employment. In general wait periods will need adjusted to a 60 Day Wait Period in order to ensure new hires have benefit coverage by the 91st day of employment.
30 Hours a Week Minimum Eligibility for Health Coverage- Health Care Reform now requires employers with 50 or more FTE employees to consider employees working 30 hours or more per week be considered full time and are eligible for an employer sponsored health plan.
The substantial changes under the new law are the elimination of declination of health coverage due to a pre-existing medical condition and the availability of tax credit / subsidies to individuals who qualify. The tax credit is based on a sliding scale so that the individual's premium contribution will be limited to a percentage of income for specified income levels. If an individual does qualify for a tax credit you must be diligent to update any changes in income or you may have an unexpected tax consequence when reconciled at the end of the tax year.
Health Reform & Employers
Health Reform Subsidies & Tax Credits
Employers have new employee enrollment requirements as well as additional Notice Requirements.
Our brokers can help you find the answers you need to know.
We help you understand how Health Reform affects you and your healthcare.
- The amount for a household is capped at $2,085. The fee called the “individual shared responsibility payment” on healthcare.gov will remain the same, with adjustments for inflation.
- If you lack coverage for only part of the year, the fee is prorated. For example, if an individual is without health insurance for six months you will be assessed 50 percent of the fee.
Health First Co
APTC & CSR
$47,521 and above
$64,081 and above
$80,641 and above
$97,201 and above
$113,761 and above
$130,321 and above
400% and above