Need Health Insurance? LaRusa Can Help!

Starting January 2014, United States citizens and legal residents must obtain minimum essential health care coverage for themselves and their dependents, or have an exemption from coverage or pay a penalty when filing their tax return. We have helped many of our clients obtain affordable health insurance and avoid IRS penalties. We are licensed health insurance agents and represent many health insurance companies throughout Tampa Bay.  We combine unique expertise as both licensed tax preparers and health insurance agents so we can help you and your family obtain the maximum premium tax credits to help offset the cost of health insurance premiums. The premium tax credit can help make purchasing health insurance coverage more affordable for people with moderate incomes. A sliding scale based on family size will be used to determine the amount of the credit. Don’t hesitate to call us if you need assistance navigating the complexities of the Affordable Care Act. We’re here for you!

Eight basic concepts you need to know about the Affordable Care Act:

  1. Requires all U.S. citizens to obtain health insurance or pay a tax penalty.
  2. Offers subsidies for low-income people to afford health insurance.
  3. Prohibits insurers from declining coverage.
  4. Mostly prohibits insurers from charging substantially more based on health or age.
  5. Creates online, government-run health insurance exchanges for people and small business.
  6. Increases tax credits for small businesses to offset health insurance costs.
  7. Mandates minimum benefits offered, including hospitalization, maternity leave and prescription drugs.
  8. Requires all large businesses to offer health insurance or pay a penalty.

If you can afford health insurance but choose not to buy it, you must pay a fee called the individual shared responsibility payment. (The fee is sometimes called the “penalty,” “fine,” or “individual mandate.”)  The fee is calculated 2 different ways – as a percentage of your household income, and per person. You’ll pay whichever is higher.

Percentage of income
  • 2.5% of household income
  • Maximum: Total yearly premium for the national average price of a Bronze plan sold through the Marketplace
Per person
  • $695 per adult
  • $347.50 per child under 18
  • Maximum: $2,085
Paying the fee
  • Using the percentage method, only the part of your household income that’s above the yearly tax fiiling requirements is counted.
  • Using the per-person method, you pay only for people in your household who don’t have insurance coverage.
  • If you have coverage for part of the year, the fee is 1/12 of the annual amount for each month you (or your tax dependents) don’t have coverage. If you’re uncovered only 1 or 2 months, you don’t have to pay the fee at all.
  • You pay the fee when you file your federal tax return for the year you don’t have coverage.
Estimating your fee

Use this IRS tool to estimate your individual responsibility payment.