Superintendent of Insurance Notifies Maine Residents about Special Enrollment Period for Individual Health Insurance

Insurance Superintendent Eric Cioppa is notifying Maine residents that if they have not done so already, they may have another opportunity to purchase insurance on the Individual Health Insurance Market for 2015. A Special Enrollment Period (SEP) will occur between March 15 and April 30.

"Under federal law, some people will be required to pay a penalty when they file their taxes this year, if they did not having qualifying health coverage in 2014, and did not have a hardship exemption from the federal government," Superintendent Cioppa said. 

The federal government recently announced that those who are still without insurance and who were not aware of the financial tax penalty, may purchase insurance for the remaining months of 2015. This will allow them to avoid the full penalty at tax time next year, when the penalty will be significantly higher.

-- Penalties for individuals who did not have qualifying coverage in 2014, or a hardship exemption,
face a penalty of $95 per adult and $47.50 per child under age 18, up to $285 per household, or 1% of household income - whichever is higher.

-- The penalty increases for 2015 to $395 per adult and $197.50 per child under age 18, up to $885 per household, or 2% of household income - whichever is higher. For more details about qualifying coverage, exemptions, and the "individual shared responsibility payment," visit www.irs.gov/Affordable-Care-Act/Individuals-and-Families. The site also provides a calculator to determine the maximum amount individuals and familiar must pay when applying the percentage (which has a cap), versus the flat per person amount.

Those eligible for this SEP are individuals/families who:

-- Currently are not enrolled in coverage through the Individual Health Insurance Marketplace for 2015.

-- Attest when they filed their 2014 tax return that they paid the penalty for not having health coverage in 2014.

-- Attest that they first became aware of, or understood the implications of, the "individual shared responsibility payment," or tax penalty, after the end of open enrollment (February 15, 2015) in connection with preparing their 2014 taxes. 

This year's tax season is the first time consumers are asked to provide basic information about their health coverage on their federal tax returns. Individuals who could not afford coverage or meet other conditions may be eligible to receive an exemption from the individual shared responsibility payment for 2014. 

More information about the SEP or other special enrollment possibilities, and more details about the tax penalties, are available at www.healthcare.gov/get-coverage or by calling the Federally Facilitated Marketplace at 1-800-318-2596 (or TTY 1-855-889-4325). 

Maine residents who have questions about any type of insurance can contact the Bureau of Insurance at 1-800-300-5000 (in-state only) or at insurance.pfr@maine.gov. Information about Maine's Individual Insurance Marketplace can be found on the Bureau's home page at www.maine.gov/pfr/insurance.