AFFORDABLE CARE ACT (ACA) Approaching the ACA For each person in the tax household:

1

Did the taxpayer, spouse, or any dependent have qualifying health plan coverage purchased through the Marketplace? If YES: In ACA Pg 1 Worksheet, select “Yes” for the first question and complete Form 8962.

2

Was the taxpayer, spouse, or any dependent eligible for an exemption for any month without coverage? If YES: In ACA Pg1 Worksheet, select “Yes” for the second question and complete Form 8965.

Did this person have coverage or an exemption in each month of the year?

3

If YES: In ACA Pg1 Worksheet, select “Had minimum essential coverage and/or is applying for or was granted an exemption for the entire year” for that person. (See software image on next page) If every person on the return had minimum essential coverage for each month of the year, TaxWise will check the box on Form 1040, line 61.

Did this person have minimum essential coverage or an exemption for part of the year?

4

If YES: In ACA Pg 1 Worksheet, select “Had minimum essential coverage and/or is applying for or was granted an exemption for part of the year.” Place a check in the box for each month the individual had no coverage AND no exemption. A shared responsibility payment will be calculated for each checked month.

Did this person have no coverage AND no exemption for the entire year?

5

If YES: In ACA Pg1 Worksheet, select “Did not have minimum essential coverage and is not claiming an exemption for any part of the year.” A shared responsibility payment will be calculated for that person for each month of the year.

!

Remember • Each person in the tax household should be screened individually to determine in which months the person had coverage, is eligible for an exemption, or is subject to a shared responsibility payment. • A tax return claiming zero personal exemptions (a dependent filing his or her own return) should not complete the ACA Pg 1 Worksheet. The dependent’s coverage exemption or premium tax credit will be reported on the return of the taxpayer who properly claims his or her dependency exemption.

ACA-1

TaxWise ACA PG 1 Worksheet TaxWise Tip ACA Worksheet must be completed unless the return is being filed by a dependent.

Used to indicate that the individual had coverage or an exemption on Form 8965 for some months of the year, but not the entire year.

Used to indicate a shared responsibility payment will be due for all 12 months. • Do not select for a person who was born or died during the year. The coverage requirement applies only to FULL months alive. • The coverage requirement for an adopted child applies only to the FULL months after the adoption occurs. • Do not select if a person had either coverage or an exemption for any month.

ACA-2

Used to indicate that the individual had coverage or is eligible for an exemption on Form 8965 for each month of the year.

Select if anyone on the return was granted an exemption from the Marketplace, or is eligible for an exemption. Also complete Form 8965.

Caution! These are the shared responsibility payment months. Only check the months when the person had no coverage AND no exemption.

Check to indicate if anyone on the return had coverage through the Marketplace for at least one month. Also complete Form 8962 using Form 1095-A.

TaxWise ACA PG 2 Worksheet (cont.)

TaxWise will complete these boxes (based on date of birth) to indicate people under age 18, which affects the shared responsibility payment computation.

Caution: Enter dependent’s MAGI only if the dependent has a tax filing requirement. Do not enter the MAGI of taxpayer or spouse as it is already included. See page ACA-8 for dependents’ filing threshold chart.

Caution: This is the Shared Responsibility Payment. If everyone on the tax return has MEC or qualifies for an exemption for every month the amount on this line should be 0.

ACA-3

ÏÆ»Éż¿Ä¿ÃËÃÉÉ»ÄÊ¿·ÂÅ̻ȷ½» ¿Ä¿ÃËûÉÉ»ÄÊ¿·Â¹Å̻ȷ½»û·Äɾ»·Âʾ¹·È»¹Å̻ȷ½»Ëĺ»È·ÄÏżʾ»¼ÅÂÂÅͿĽÆÈŽȷÃÉƔ ʺŻÉÄÅÊƑ¾Åͻ̻ÈƑ¿Ä¹Â˺»¹ÅÌ»ÈƖ ·½»¹ÅÄÉ¿ÉʿĽÉÅ»ÂÏż»Î¹»ÆÊ»º¸»Ä»¼¿ÊÉƔι»ÆÊ»º¸»Ä»¼¿ÊɿĹÂ˺»ÉʷĺƖ·ÂÅĻ̿ɿÅķĺº»ÄÊ·ÂÆ·ÄÉƺ»Î¹»ÆÊÆ»º¿·ÊÈ¿¹º»Äʷ¹ÅÌƖ »È·½»ƻƑÍÅÈÁ»ÈÉͱ¹ÅÃÆ»ÄÉ·Ê¿ÅĹÅ̻ȷ½»Ƒ·Äº¹Å̻ȷ½»¿ÿʻºÊÅ·ÉÆ»¹¿¼¿»ºº¿É»·É»ÅÈ¿ÂÂÄ»ÉÉƔ ÃÆÂÅÏ»ÈƖÉÆÅÄÉÅÈ»º¹Å̻ȷ½»Ɠ

ÈÅËƾ»·Âʾ¿ÄÉËȷĹ»¹Å̻ȷ½»¼ÅÈ»ÃÆÂÅÏ»»ÉËĺ»ÈƳ

½ÅÌ»ÈÄûÄÊ·ÂÆ·ÄƑÉ˹¾·Éʾ» »º»È·ÂÃÆÂÅÏ»»É»·Âʾ»Ä»¼¿ÊÆÈŽȷà Æ·ÄÅȹÅ̻ȷ½»ż¼»È»º¿Äʾ»É÷ÂÂÅÈ·Ƚ»½ÈÅËÆ÷ÈÁ»ÊͿʾ¿Ä·ÉÊ·Ê» ½È·Äº¼·Ê¾»È»º¾»·ÂʾÆ·Äż¼»È»º¿Ä·½ÈÅËÆ÷ÈÁ»Ê

ɻ¼Ɩ¿ÄÉËÈ»º¾»·ÂʾƷļÅÈ»ÃÆÂÅÏ»»É ¹Å̻ȷ½» »Ê¿È»»¹Å̻ȷ½»

Å̻ȷ½»Ëĺ»È·Ä»ÎÆ·ÊÈ¿·Ê»¾»·ÂʾƷļÅÈ»ÃÆÂÅÏ»»É ĺ¿Ì¿ºË·Â¾»·Âʾ¹Å̻ȷ½»Ɠ

»·Âʾ¿ÄÉËȷĹ»ÏÅËÆËȹ¾·É»º¿È»¹ÊÂϼÈÅ÷ĿÄÉËȷĹ»¹ÅÃÆ·ÄÏ »·Âʾ¿ÄÉËȷĹ»ÏÅËÆËȹ¾·É»ʾÈÅ˽¾ʾ»·ÈÁ»ÊÆ·¹» »·Âʾ¿ÄÉËȷĹ»ÆÈÅÌ¿º»ºʾÈÅ˽¾·ÉÊ˺»Äʾ»·ÂʾÆÂ·Ä ·Ê·ÉÊÈÅƾ¿¹Æ·ÄÉ

Å̻ȷ½»Ëĺ»È·Ä»ÎÆ·ÊÈ¿·Ê»¾»·ÂʾƷļÅÈÄÅÄƖ»ÃÆÂÅÏ»»ÉÉ˹¾·ÉÉÊ˺»ÄÊɷĺÿÉÉ¿ÅÄ·È¿»É Å̻ȷ½»Ëĺ»È½ÅÌ»ÈÄûÄÊƖÉÆÅÄÉÅÈ»ºÆÈŽȷÃÉƓ »º¿¹·È»·ÈʹÅ̻ȷ½»

»º¿¹·È»ºÌ·ÄÊ·½»Æ·ÄÉ ÅÉÊ»º¿¹·¿º¹Å̻ȷ½»dž

¾¿ÂºÈ»ÄͱÉ»·Âʾ ÄÉËȷĹ»ÈŽȷÃƺ ƻ¹Å̻ȷ½» ÅÉÊÊÏÆ»Éż ¹Å̻ȷ½»

ÅÃÆÈ»¾»ÄÉ¿Ì»¾»·Âʾ¹·È»ÆÈŽȷÃÉż¼»È»º¸Ïʾ»»Æ·ÈÊûÄÊż»Ê»È·Äɼ¼·¿ÈÉ »·Âʾ¹Å̻ȷ½»ÆÈÅÌ¿º»ºÊÅ»·¹»ÅÈÆÉÌÅÂËÄÊ»»ÈÉ

»Æ·ÈÊûÄÊż»¼»ÄÉ»ÅÄ·ÆÆÈÅÆÈ¿·Ê»º Ëĺ»·Âʾ»Ä»¼¿ÊÉÈŽȷà »¼Ë½»»»º¿¹·ÂÉÉ¿ÉʷĹ»

Å̻ȷ½»ʾÈÅ˽¾··É¿¹»·ÂʾÈŽȷÃƺƻÉʷĺ·Èº¾»·ÂʾÆÂ·Ä ʾ»È¹Å̻ȷ½»Ɠ

»ÈÊ·¿Ä¼ÅÈ»¿½Ä¹Å̻ȷ½»

»ÈÊ·¿Ä¹Å̻ȷ½»¼ÅȸËÉ¿Ä»ÉÉÅÍÄ»ÈÉ

Å̻ȷ½»È»¹Å½Ä¿Ð»º¸Ï·ÉÿĿÃËûÉÉ»ÄÊ¿·Â¹Å̻ȷ½»Ɣdždž dž»º¿¹·¿ºÆÈŽȷÃÉʾ·ÊÆÈÅÌ¿º»¿ÿʻº¸»Ä»¼¿Êɽ»Ä»È·ÂÂϺÅÄͱÊÇ˷¿¼Ï·ÉÿĿÃËûÉÉ»ÄÊ¿·Â¹Å̻ȷ½»ƒ¾Åͻ̻ÈƑÍ¿ÂÂÆÈÅÌ¿º»·¾·ÈºÉ¾¿Æ»Î»ÃÆÊ¿ÅÄÊſĺ¿Ì¿ºË·ÂÉ Ϳʾ¹»ÈÊ·¿ÄÊÏÆ»Éż¿ÿʻºƖ¸»Ä»¼¿Ê»º¿¹·¿º¹Å̻ȷ½»Ɣ dždž·ÄÉÈ»¹Å½Ä¿Ð»º·ÉÿĿÃËûÉÉ»ÄÊ¿·Â¹Å̻ȷ½»·È»¿ÉÊ»º·ÊƓÍÍÍƔ¹ÃÉƔ½ÅÌƭ ƭÈŽȷÃÉƖ·ÄºƖ Ä¿Ê¿·Ê¿Ì»Éƭ»·ÂʾƖ ÄÉËȷĹ»Ɩ·ÈÁ»ÊƖ»¼ÅÈÃÉƭÿĿÃËÃƖ»ÉÉ»ÄÊ¿·ÂƖ ¹Å̻ȷ½»Ɣ¾ÊÃÂƑɹÈźÅÍķĺ¹Â¿¹ÁÅÄʾ»¿ÄÁ¼ÅÈʾ»¿ÉÊż·ÆÆÈÅÌ»ºÆ·ÄÉƔ

No proof of coverage is needed. Oral statement from the taxpayer is acceptable, unless normal due diligence leads you to believe the taxpayer’s statement is incorrect.

ACA-4

Exemptions: Overview Exemptions: Overview Exemptions: Where do I start? STEP

STEP

STEP

STEP

Does anyone in the tax household already have an exemption in hand from the Marketplace? Marketplace exemptions require an application. If a person applied for an exemption through the Marketplace (or if they were granted an exemption automatically because they were denied Medicaid coverage in a state that did not expand . Medicaid), they should have received an Exemption Certificate Number (ECN) from the Marketplace. It is a 6 or 7 digit alphanumeric code. Is household or gross income under the filing threshold? If YES, check box 7a or 7b on Form 8965, Part II. Everyone on the tax return is exempt from the coverage requirement, and there is no need to consider additional exemptions. (See page ACA-7 for more information.) If the family does not qualify for an exemption under Step 2, does any individual qualify for an exemption that can be claimed directly on the tax return? If YES, enter the exemption code on Form 8965, Part III. (See page ACA-9 for more information.) For any uninsured individual that does not qualify under Step 2 or 3, does any individual in the tax household qualify for an exemption from the Marketplace? If YES, direct the person to the Marketplace for additional help. Enter “pending” on Form 8965, Part I, if the Marketplace has not processed the application for exemption before the return is filed. A tax return with a “pending” exemption can still be e-filed. The IRS will follow-up with a taxpayer directly on all Pending submissions if the Marketplace does not approve the exemption.

Form 8965 in TaxWise Part I: Enter information in Part I only if the individual has an exemption from the Marketplace or is applying for one. Enter “pending“ if the Marketplace has not processed the application for exemption before the return is filed.

Part II and Part III: Most exemptions will be entered in Parts II and III. TaxWise Tip Form 8965, Part III: Multiple exemptions cannot be indicated on a single line. If a person is eligible for multiple exemptions covering different months, enter his or her name on multiple lines.

ACA-5

ÏÆ»ÉżÅ̻ȷ½»λÃÆÊ¿ÅÄÉ ¾¿É¹¾·ÈÊɾÅÍÉ·ÂÂżʾ»¹Å̻ȷ½»»Î»ÃÆÊ¿ÅÄÉ·Ì·¿Â·¸Â»¼ÅÈʹʷʸʼƑ¿Ä¹Â˺¿Ä½¿Ä¼ÅÈ÷ʿÅÄ·¸ÅËÊ;»È»ʾ»¹Å̻ȷ½»»Î»ÃÆÊ¿ÅÄɹ·Ä ¸»Ÿʷ¿Ä»º·Äºʾ»¹Åº»¼ÅÈʾ»¹Å̻ȷ½»»Î»ÃÆÊ¿ÅÄʾ·Ê¿ÉÊŸ»ËÉ»ºÅÄ ÅÈÃʿˀʽʼ;»ÄÏÅ˹·¿Ãʾ»»Î»ÃÆÊ¿ÅÄƔ ¼ÏÅËȹÅ̻ȷ½» »Î»ÃÆÊ¿ÅÄͷɽȷÄÊ»º¸Ïʾ»·ÈÁ»ÊÆ·¹»ƑÏÅËÍ¿ÂÂÄ»»ºÊÅ»ÄÊ»Èʾ»λÃÆÊ¿ÅÄ»ÈÊ¿¼¿¹·Ê»Ëø»ÈƺƻÆÈÅÌ¿º»º¸Ïʾ»·ÈÁ»ÊƖ Æ·¹»ƺÉ»»ʾ»¿ÄÉÊÈ˹ʿÅÄɼÅÈ·ÈÊ ƻƔ Å̻ȷ½»λÃÆÊ¿ÅÄ

È·ÄÊ»º¸Ï ·ÈÁ»ÊÆ·¹»

ĹÅû¸»ÂÅÍʾ»¼¿Â¿Ä½ʾȻɾźƳÅËȽÈÅÉɿĹÅûÅÈÏÅËȾÅËÉ»¾Åº¿Ä¹ÅûÍ·É »ÉÉʾ·ÄÏÅËÈ·ÆÆ¿¹·¸Â»ÿĿÃËÃʾȻɾź¼Åȼ¿Â¿Ä½·Ê·ÎÈ»ÊËÈÄƔ Å̻ȷ½»¹ÅÄÉ¿º»È»ºËÄ·¼¼ÅȺ·¸Â»Ƴ¾»ÿĿÃË÷ÃÅËÄÊÏÅËÍÅ˺¾·Ì»Æ·¿º¼ÅÈ ÆȻÿËÃÉ¿ÉÃÅÈ»ʾ·ÄʿƔʷʼ̈żÏÅËȾÅËÉ»¾Åº¿Ä¹ÅûƔ

¾ÅÈʹÅ̻ȷ½»½·ÆƳÅËÍ»ÄÊͿʾÅËʹÅ̻ȷ½»¼ÅÈ»ÉÉʾ·Äʺ¹ÅÄÉ»¹ËÊ¿Ì»ÃÅÄʾÉ ºËȿĽʾ»Ï»·ÈƔ

¿Ê¿Ð»ÄÉ¿̿Ľ·¸ÈÅ·º·Äº¹»ÈÊ·¿ÄÄÅĹ¿Ê¿Ð»ÄÉƳÅËͻȻƓ ƔƔ¹¿Ê¿Ð»ÄÅÈȻɿº»ÄÊ;ÅÉÆ»ÄÊ·Ê»·ÉÊʺʺʷ¼Ëº·ÏÉÅËÊÉ¿º»żʾ»ƔƔºËȿĽ·ʸʹƯ ÃÅÄʾƻȿźƒ ƔƔ¹¿Ê¿Ð»Ä;ÅÍ·É·¸ÅÄ·¼¿º»Ȼɿº»ÄÊż·¼ÅÈ»¿½Ä¹ÅËÄÊÈÏÅÈƔƔÊ»ÈÈ¿ÊÅÈσ Ȼɿº»Äʷ¿»Ä;ÅÍ·É·¹¿Ê¿Ð»Äż·¼ÅÈ»¿½Ä¹ÅËÄÊÈÏͿʾ;¿¹¾ʾ»ƔƔ¾·É·Ä ¿Ä¹ÅûÊ·ÎÊÈ»·ÊÏͿʾ·ÄÅĺ¿É¹È¿Ã¿Ä·Ê¿ÅĹ·ËÉ»Ƒ·ÄºÏÅËͻȻ·¸ÅÄ·¼¿º»Ȼɿº»ÄÊż· ¼ÅÈ»¿½Ä¹ÅËÄÊÈϼÅÈʾ»Ê·ÎÏ»·Èƒ ÅÊ·ͼËÂÂÏÆȻɻÄÊ¿Äʾ»Ɣ·ÄºÄÅÊ·ƔƔ¹¿Ê¿Ð»ÄÅÈƔƔÄ·Ê¿ÅÄ·ÂƔ ÅÈÃÅÈ» ¿Ä¼ÅÈ÷ʿÅÄ·¸ÅËÊ;Å¿ÉÊÈ»·Ê»º·É·ͼËÂÂÏÆȻɻÄʼÅÈÆËÈÆÅɻɿʾ¿É¹Å̻ȷ½»»Î»ÃÆÊ¿ÅÄƑ ̿ɿʾ»·Âʾ¹·È»Ɣ½Å̃ÅÈ ÄÅÄȻɿº»Äʷ¿»ÄƑ¿Ä¹Â˺¿Ä½ƺʸƻ·ºË·ÂƖÉÊ·ÊËɷ¿»Ä¿Äʾ»¼¿ÈÉÊÏ»·ÈżȻɿº»Ä¹Ï·Äºƺʹƻ ·ÄÅÄȻɿº»Äʷ¿»ÄÅȺ˷ÂƖÉÊ·ÊËÉÄÅÄȻɿº»Äʷ¿»Ä;Ż»¹ÊÉÊż¿Â»·ÀÅ¿ÄÊÈ»ÊËÈÄͿʾ· ÉÆÅËÉ»Ɣ ÅȺ»¼¿Ä¿Ê¿ÅÄÉżȻɿº»Äʷ¿»Ä·ÄºÄÅÄȻɿº»Äʷ¿»ÄƑÉ»» ·ÎÅÆ¿¹ʿʼʸ·Ê ÍÍÍƔ¿ÈÉƔ½ÅÌƭÊ·ÎÊÅÆ¿¹Éƭʹ˃ˀʼƔ¾ÊÃÂƔ

»Ã¸»ÈÉż·¾»·Âʾ¹·È»ɾ·È¿Ä½ÿĿÉÊÈÏƳÅËͻȻ·ûø»Èż·¾»·Âʾ¹·È» ɾ·È¿Ä½ÿĿÉÊÈÏƔ

»Ã¸»ÈÉż ĺ¿·ÄÊÈ¿¸»ÉƳÅËͻȻ»¿Ê¾»È·ûø»Èż· »º»È·ÂÂÏƖÈ»¹Å½Ä¿Ð»º ĺ¿·Ä ÊÈ¿¸»Ƒ¿Ä¹Â˺¿Ä½·Ä·ÉÁ··Ê¿Ì»·¿ÃÉ»ÊÊ»ûÄʹÊƺƻÅÈÆÅÈ·Ê¿Åľ·È»¾Åº»È ƺÈ»½¿ÅÄ·ÂÅÈ̿·½»ƻƑÅÈÏÅËͻȻÅʾ»ÈÍ¿É»»Â¿½¿¸Â»¼ÅÈÉ»ÈÌ¿¹»ÉʾÈÅ˽¾·Ä ĺ¿·Ä¾»·Âʾ¹·È» ÆÈÅÌ¿º»ÈÅÈʾ» ĺ¿·Ä»·Âʾ»ÈÌ¿¹»Ɣ

Ĺ·È¹»È·Ê¿ÅÄƳÅËͻȻ¿Ä·À·¿ÂƑÆÈ¿ÉÅÄƑÅÈɿÿ·Èƻķ¿ÄÉÊ¿ÊËÊ¿ÅÄÅȹÅÈÈ»¹Ê¿Åķ¼·¹¿Â¿ÊÏ ·¼Ê»Èʾ»º¿ÉÆÅÉ¿Ê¿ÅÄż¹¾·È½»ÉƔ

½½È»½·Ê»ɻ¼ƖÅÄÂϹÅ̻ȷ½»¹ÅÄÉ¿º»È»ºËÄ·¼¼ÅȺ·¸Â»ƳÍÅÅÈÃÅÈ»¼·Ã¿ÂÏûø»ÈÉͱ ·½½È»½·Ê»¹ÅÉÊżɻ¼ƖÅÄÂÏ»ÃÆÂÅÏ»ÈƖÉÆÅÄÉÅÈ»º¹Å̻ȷ½»Í·ÉÃÅÈ»ʾ·ÄʿƔʷʼ̈ż ¾ÅËÉ»¾Åº¿Ä¹ÅûƑ·ÉÍ·Éʾ»¹ÅÉÊż·ÄÏ·Ì·¿Â·¸Â»»ÃÆÂÅÏ»ÈƖÉÆÅÄÉÅÈ»º¹Å̻ȷ½»¼ÅÈʾ» »ÄÊ¿È»¼·Ã¿ÂÏƔ »É¿º»ÄÊż·ÉÊ·Ê»ʾ·Êº¿ºÄÅÊ»ÎƷĺ»º¿¹·¿ºƳÅËȾÅËÉ»¾Åº¿Ä¹Åûͷɸ»ÂÅÍ ʸʺʿ̈żʾ»¼»º»È·ÂÆÅÌ»ÈÊÏ¿Ļ¼ÅÈÏÅËȼ·Ã¿ÂÏɿл·Äº·Ê·ÄÏʿû¿ÄʹʷʸʼÏÅËȻɿº»º¿Ä· ÉÊ·Ê»ʾ·Êº¿ºÄͱÊÆ·ÈÊ¿¹¿Æ·Ê»¿Äʾ»»º¿¹·¿º»ÎÆ·ÄÉ¿ÅÄËĺ»Èʾ»¼¼ÅȺ·¸Â»·È»¹ÊƔ

»Ã¸»ÈżÊ·Î¾ÅËÉ»¾Åº¸ÅÈÄƑ·ºÅÆÊ»ºƑÅȺ¿»ºƳËȿĽʹʷʸʼ·¹¾¿ÂºÍ·É·ºº»ºÊÅÏÅËÈ Ê·Î¾ÅËÉ»¾Åº¸Ï¸¿ÈʾÅÈ·ºÅÆÊ¿ÅÄƑÅÈ·ûø»ÈżÏÅËÈʷξÅËÉ»¾Åºº¿»ººËȿĽʾ»Ï»·È ·ÄºÏÅ˹·Äͱʹ¾»¹Áʾ»¼ËÂÂƖÏ»·È¹Å̻ȷ½»¹¾»¹Á¸ÅÎÅÄÏÅËÈÊ·ÎÈ»ÊËÈÄƔ »Ã¸»ÈÉż¹»ÈÊ·¿ÄȻ¿½¿ÅËÉÉ»¹ÊÉƳÅË·È»·ûø»Èż·È»¹Å½Ä¿Ð»ºȻ¿½¿ÅËÉÉ»¹ÊƔ

»Ê»ÈÿĻº¿Ä»Â¿½¿¸Â»¼ÅÈ»º¿¹·¿º¿Ä·ÉÊ·Ê»ʾ·Êº¿ºÄͱÊ»ÎƷĺ»º¿¹·¿º¹Å̻ȷ½»Ƴ ÅËͻȻº»Ê»ÈÿĻº¿Ä»Â¿½¿¸Â»¼ÅÈ»º¿¹·¿ºÉÅ»Âϸ»¹·ËÉ»ʾ»ÉÊ·Ê»¿Ä;¿¹¾ÏÅËȻɿº»º º¿ºÄͱÊÆ·ÈÊ¿¹¿Æ·Ê»¿Ä»º¿¹·¿º»ÎÆ·ÄÉ¿ÅÄËĺ»Èʾ»¼¼ÅȺ·¸Â»·È»¹ÊƔ

·¿Ã»ºÅÄ Ê·ÎÈ»ÊËÈÄ

ź»¼ÅÈ λÃÆÊ¿ÅÄ Åź» »»·ÈÊ  



 



 »»º »»·ÈÊ »»º »»·ÈÊ

»Ä»È·Â¾·ÈºÉ¾¿ÆƳÅË»Îƻȿ»Ä¹»º·¾·ÈºÉ¾¿Æʾ·ÊÆȻ̻ÄÊ»ºÏÅ˼ÈÅßʷ¿Ä¿Ä½ ¹Å̻ȷ½»Ëĺ»È·Ç˷¿¼¿»º¾»·ÂʾÆ·ÄƔ

»»º »»·ÈÊ

Ä·¸Â»ÊÅȻĻͻοÉʿĽ¹Å̻ȷ½»ƳÅËͻȻÄÅÊ¿¼¿»ºʾ·ÊÏÅËȾ»·Âʾ¿ÄÉËȷĹ»ÆÅ¿¹Ï Í·ÉÄÅÊȻĻͷ¸Â»·ÄºÏÅ˹ÅÄÉ¿º»È»ºʾ»Åʾ»ÈÆ·ÄÉ·Ì·¿Â·¸Â»ËÄ·¼¼ÅȺ·¸Â»Ɣ

»»º »»·ÈÊ

Å̻ȷ½»¹ÅÄÉ¿º»È»ºËÄ·¼¼ÅȺ·¸Â»¸·É»ºÅÄÆÈÅÀ»¹Ê»º¿Ä¹ÅûƳÅ˺¿ºÄͱʾ·Ì» ·¹¹»ÉÉÊŹÅ̻ȷ½»ʾ·Ê¿É¹ÅÄÉ¿º»È»º·¼¼ÅȺ·¸Â»¸·É»ºÅÄÏÅËÈÆÈÅÀ»¹Ê»º¾ÅËÉ»¾Åº¿Ä¹ÅûƔ »ÈÊ·¿Ä»º¿¹·¿ºÆÈŽȷÃÉʾ·Ê·È»ÄÅÊÿĿÃËûÉÉ»ÄÊ¿·Â¹Å̻ȷ½»ƳÅËͻȻƺʸƻ »ÄÈÅ»º¿Ä»º¿¹·¿º¹Å̻ȷ½»ÆÈÅÌ¿º»ºÊÅ·ÆÈ»½Ä·ÄÊÍÅ÷Äʾ·Ê¿ÉÄÅÊÈ»¹Å½Ä¿Ð»º·É ÿĿÃËûÉÉ»ÄÊ¿·Â¹Å̻ȷ½»ƒƺʹƻ»ÄÈÅ»º¿Ä»º¿¹·¿º¹Å̻ȷ½»ÆÈÅÌ¿º»ºÊÅ·ûº¿¹·ÂÂÏ Ä»»ºÏ¿Äº¿Ì¿ºË·Âƺ·ÂÉÅÁÄÅÍÄ·ÉƻĺƖºÅÍÄ»º¿¹·¿ºÅȾ·È»ƖżƖÅÉÊ»º¿¹·¿ºƻʾ·Ê¿ÉÄÅÊ È»¹Å½Ä¿Ð»º·ÉÿĿÃËûÉÉ»ÄÊ¿·Â¹Å̻ȷ½»ƒÅÈƺʺƻ»ÄÈÅ»º¿Ä»º¿¹·¿ºƑ·ÄºÈ»¹»¿Ì»º ÿĿÃËûÉÉ»ÄÊ¿·Â¹Å̻ȷ½»¼ÅÈÅÄ»ÅÈÃÅÈ»ÃÅÄʾÉżʾ»Ï»·È¸Ïû»Ê¿Ä½·ÉƻĺƖºÅÍÄƑ ¸ËÊÄÅÊ¿ÄÅʾ»ÈÃÅÄʾɸ»¹·ËÉ»ʾ»ÉƻĺƖºÅÍľ·ºÄÅʸ»»ÄûÊƔ

»»º »»·ÈÊ

»»º »»·ÈÊ

Hardship Exemptions Granted by the Marketplace 1. 2. 3. 4. 5. 6. 7. 8.

ACA-6

Homelessness Eviction in the last 6 months or facing eviction or foreclosure Utility shut-off notice Domestic violence Recent death of a close family member Disaster that resulted in significant property damage Bankruptcy in the last 6 months Significant debt from medical expense in the last 24 months

9. High expense caring for ill, disabled or aging relative 10. Failure of another party to comply with a medical support order for a dependent child who is determined ineligible for Medicaid or CHIP 11. Through an appeals process, determined eligible for a Marketplace QHP, PTC, or CSR but was not enrolled 12. Determined ineligible for Medicaid because the state did not expand coverage 13. Individual health insurance plan was cancelled and you believe Marketplace plans are considered unaffordable 14. Other hardship in obtaining coverage

Affordable Care Act Exemptions – TY2015 Quick Reference Guide – Page 1 Description

Household income below filing threshold (F8965 L 7a) Gross income below filing threshold (F8965 L 7b) Short coverage gap (