Individual and Family Health Plan Information

Percentage of income

In 2015 the penalty is 2 percent of your adjusted gross income, and it will increase to 2.5 percent in 2016. The penalty is capped at the average cost of a Bronze plan.  Wealthy households will be happy to know that they will pay a penalty only on that portion of their adjusted gross income “above and beyond their filing threshold.” 

The flat-dollar penalty is $325 in 2015 and $695 in 2016 plus half that amount for each uninsured child under age 18. Your total household penalty is capped at three times the adult rate, no matter how many children you have. In 2015 that’s $975 and $2085 in 2016.

You won’t pay a penalty if:

  • you are covered by your employer
  • you are covered by the government
    (
    Medicaid, Medicare, CHIP, TRICARE or the VA)
  • you already have purchased coverage that – at a minimum – meets the requirements for a Bronze plan under the ACA
  • your income is low enough that your share of premiums (after federal subsidies and employer contributions) would total more than 8 percent of your income (this is increasing to 8.05 percent for 2015)
  • your income is below the income tax filing threshold.
  • You had a short gap in coverage during the year, that lasted no more than three months (if you’re uninsured for more than three months, the penalty is prorated)
  • you qualify for a religious exclusion
  • you are a member of a Native American tribe
  • you are an undocumented immigrant
  • you are in prison