1. Taxes and the ACA 2015-2016 ACA NAME ENROLL VA TITLE EMAIL Work AddressT: Work Number

2. What You Need to Know for Tax Season Everyone must have: Minimum Essential Coverage or Exemption or Pay an Individual Shared Responsibility Fee

3. What is Minimum Essential Coverage? Minimum Essential Coverage Includes: Medicare, parts A & C, Medicare Advantage Medicaid Chip Employer plan or Cobra Any Marketplace plan Certain individual plans bought outside the marketplace Tricare Most Veterans Healthcare programs Peace Corps Volunteer Self-funded health coverage offered to Students by universities for plans/policy years that begin on or before December 31, 2014 What does NOT count as minimum essential coverage? Coverage for only vision/dental Workers’ compensation Coverage only for specific disease or condition Plans that only offer discounts on medical service

4. Exemptions: Exemptions that Must Be Claimed at the Marketplace  Members of Certain Religious Sects  General Hardship  Coverage considered unaffordable based on projected income  Determined ineligible for Medicaid in a state that did not expand Medicaid coverage  Unable to renew existing coverage  AmeriCorps coverage WHEN YOU FILL OUT A MARKETPLACE EXEMPTION, YOU WILL RECEIVE A MARKETPLACE EXEMPTION CERTIFICATE NUMBER, PLEASE KEEP THAT NUMBER FOR YOUR TAXES

5. What is a General Hardship?  You were homeless  You were evicted in the last four months or you were facing eviction or foreclosure  You received a shut off notice from a utility company  You recently experienced domestic violence  You recently experienced death of a close family member  You expect to claim a child as a tax dependent who’s been denied coverage in Medicaid/FAMIS, and another person is required by court to give medical support to the child, you don’t have to pay the penalty for the child.  Individual insurance plan was cancelled and believed Marketplace plan was unaffordable  You experienced a fire, flood, or other natural or human disaster that caused substantial damage to your property  You filed bankruptcy in the last 6 months  You had a medical expense that you couldn’t pay in the last 24 months that resulted in substantial debt  You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member  As a result of an appeal, you are eligible for QHP, lower costs on monthly premiums, or cost sharing reduction for the time period you weren’t enrolled  Ineligible for Medicaid because state didn’t expand Medicaid  Experience another hardship in obtaining health insurance

6. Exemptions that Must be Claimed on Tax Return Exemptions Exempt Code Coverage is considered unaffordableA Short coverage gap (less than 3 consecutive months, can only be used once in the yearB Citizen living abroad or certain non-citizens (undocumented immigrants)C Aggregate self-only coverage considered unaffordable (if it exceeds 8% of household income) G Gap coverage at beginning of year (if they were enrolled in a plan by May 1, 2014 or March 1, 2015) G Resident of state that did not expand Medicaid and your income falls below 138% FPL G Income Below Filing Threshold - 2014 tax year, $10,150, single - 2014 tax year, $20,300, married - 2014 tax year, $13,050, head of household

7. Exemptions that May be Claimed at the Marketplace or on a Tax Form Members of a health care sharing ministry (Exempt Code D) Members of an Indian Tribe (Exempt Code E) Incarceration (Exempt Code F)

8. Tax Forms Overview If you did not meet filing threshold and you did not have insurance then no action is required If you have a marketplace account then you must file a tax return and use form 8962 If you have minimum essential coverage and filing then check box on 1040 If you are filing and do not have minimum essential coverage then you will need form 8965 or pay a fee

9. Tax Time: Claiming an Exemption  You will need to attach form 8965 to your tax return form (1040, 1040A, or 1040EZ)  Part I of form 8965 deals with the Marketplace-Granted Coverage Exemptions for Individuals  If you have a Marketplace-Granted Coverage exemption, you will need the Exemption Certificate Number you received when you applied for the Marketplace exemption

10. Form 8965 Continued  Part II is used for individuals who are filing a tax return, but their income is below the filing threshold - 2014 tax year, $10,150, single - 2014 tax year, $20,300, married - 2014 tax year, $13,050, head of household  Part III is the place to fill out a tax return exemption, you must fill out what exemption type applies to what months and to what individuals.

11. Insurance Outside the Marketplace I h ave insurance… NOW WHAT???  Just check the box on your tax return saying you had coverage for the 2015 tax year!

12. I Have Marketplace Insurance, Now What? Marketplace Insurance  First, you will be receiving a 1095a in the mail, a 1095a is like a W2.  Next, make sure everything on your 1095a is correct, if it is NOT correct contact your local Certified Assister or call 800-318-2596. Do NOT contact your insurance.  Then you will use the 1095a to fill out your Form 8962.

13. Marketplace Insurance, Reconciliation  If Form 8962 shows that you paid to much for health insurance, the federal government will return that money at the end of the year with the refund.  However, if Form 8962 shows that you took too much of a tax credit, then you will have to pay some or all of that tax credit back. There are caps on how much you have to pay back depending on if you make below 400% of the federal poverty level Federal Poverty LevelSingleMarried Less than 200%$300$600 200%- 300%$750$1,500 300%- 400%$1,250$2,500

14. 2015 Federal Poverty Level (FPL) Source: 2014 Federal Poverty Guidelines, U.S. Dept. of Health and Human Services Family Size Family’s Annual Income Levels 100% FPL133% FPL 150% FPL 200% FPL 250% FPL 400% FPL 1$11,770$15,654$17,655$23,540$29,425$47,080 2$15,930$21,187$23,995$31,860$39,825$63,720 3$20,090$26,720$30,135$40,180$50,225$80,360 4$24,250$32,253$36,375$48,500$60,625$97,000 5$28,410$37,785$42,615$56,820$77,025$113,640

15. Reconciliation and Falling Below the Federal Poverty Level  For individuals who fall below the federal poverty level they will not have to pay back their advanced premium tax credit if:  They are enrolled in a Qualified Health Plan,  The marketplace estimated at the time of enrollment their income to be between 100%- 400% FPL  Advance Tax Credits were made for one or more months  The Taxpayer otherwise qualifies as an applicable taxpayer

16. Reconciliation Rules for Individuals Receiving a Premium Tax Credit  You must file a tax return, even if your income falls below filing threshold AND  If you are married you must file jointly unless  You meet Head of Household filing status or  You are a victim of domestic violence or  You are a victim of spousal abandonment

17. Filing Single When Married  Domestic Abuse  Living apart  Unable to file jointly because taxpayer is a victim of domestic violence  Indicates the above criteria on their tax return  Head of Household  You file a separate tax return  You paid more than half the cost for keeping up your home for the tax year  Your spouse did not live in your home for the last 6 months  Your home is the main home of your child, step child, or foster child for more than half the year  You must be able to claim an exemption for the child (special rules for custody agreements) Abandonment The taxpayer is abandoned by his or her spouse Unable to locate spouse after reasonable diligence Must certify that they meet these requirements

18. No Health Insurance & No Exemption: What is the Fee?  2014: The Greater of  1% of your household income above the federal tax return filing threshold (capped at the national average for a bronze plan) or  $95 per adult and $47.50 per child (capped at $285)  The national average bronze plan is $208 a month, therefore the cap is $2,448 for a single individual.  2015: The Greater of  2% of your household income above the federal tax return filing threshold (capped at the national average for a bronze plan) or  $325 per adult and $162.50 per child (capped at $285)

19. THANK YOU! Name (000)000-0000 ENROLL Virginia! is a nonprofit, nonpartisan entity that assists individuals and small businesses to obtain health insurance including commercial health coverage through the federally facilitated health insurance marketplace, to qualify for applicable tax subsidies, and to comply with the U.S. Patient Protection and Affordable Care Act and avoid penalties for failure to do so. The program is paid for by a federal grant (Funding Opportunity Number CA-NAV-13-001 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services) and administered by the Virginia Poverty Law Center. The contents provided here are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.