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Self-Employed

Open Enrollment For 2014 Health Coverage for Individuals Is Over

If you’re a self-employed individual with no employees, you are eligible to purchase coverage through the new individual health insurance Marketplace.  Enrollment in the Marketplace closed on March 31, 2014.  You may still have options to get 2014 coverage in the Marketplace in special cases, including:

  • Marriage, birth, or adoption
  • A move outside your service area
  • Loss of health coverage
  • Applying for Medicaid or CHIP
  • See full list

Key Provisions Under the Affordable Care Act for Self-Employed Individuals

Implementation of the Affordable Care Act occurs in stages, with many of the reforms and requirements taking effect in 2014. Some of the provisions that may impact self-employed individuals include:

  • Individual Shared Responsibility (Also Known as Individual Mandate)

Starting in 2014, the Individual Shared Responsibility provision of the Affordable Care Act means that each individual must have basic health insurance coverage (known as minimum essential coverage), qualify for an exemption, or  pay a fee when filing a federal income tax return. Individuals will not have to pay the fee (also known as an individual shared responsibility payment or individual mandate) if coverage is unaffordable, if they spend less than three consecutive months without coverage, or if they qualify for an exemption for several other reasons, including hardship and religious beliefs. The fee in 2014 is calculated one of two ways. You’ll pay whichever of these amounts is higher:

•1% of your yearly household income. (Only the amount of income above the tax filing threshold, $10,150 for an individual, is used to calculate the payment.) The maximum payment is the national average yearly premium for a bronze plan.

•$95 per person for the year ($47.50 per child under 18). The maximum payment per family using this method is $285.

For more information about the Individual Shared Responsibility requirements and exemptions that may apply, refer to this Fact Sheet from the U.S. Department of Treasury as well as these Q&As from IRS. 

  • Individual Health Insurance Marketplace

Coverage through the new Health Insurance Marketplace for individuals and small businesses began on January 1, 2014. The individual Marketplace offers self-employed and other consumers a choice of four levels of benefit packages that differ by the percentage of costs the health plan covers. You may qualify for advanceable, refundable tax credits – known as Premium Tax Credits - and subsidies on a sliding scale, based on income.  Increased access to quality, affordable health care will make it easier for potential entrepreneurs to go out on their own instead of staying at larger firms simply because of "job lock". 

2014 Open Enrollment in the individual Marketplace is now closed. You may still qualify for 2014 coverage in special cases. Visit Healthcare.gov to learn more. If you're a small business owner with at least one employee, you can purchase coverage year-round for your employees through the small employer side of the Marketplace known as SHOP.

  • Coverage through Medicaid Expansion

Each state operates a Medicaid program that provides health coverage for lower-income people, families and children, the elderly, and people with disabilities. The eligibility rules for Medicaid are different for each state, but most states currently offer coverage for adults with children at some income level.  In addition, under the Affordable Care Act, states have the option to expand Medicaid eligibility to include adults ages 19 – 64 with incomes up to 133% of the Federal Poverty Level (about $15,000 per year for an individual, $31,000/year for a family of four).  To learn more about your state Medicaid program and other options available to you, visit Healthcare.gov.

  • Additional Medicare Assessment

An Additional Medicare Tax of .9 % went into effect in 2013 and applies to wages, compensation, and self-employment income above a threshold amount received in taxable years beginning after Dec. 31, 2012.  An individual is liable for Additional Medicare Tax if the individual’s wages, compensation, or self-employment income (together with that of his or her spouse if filing a joint return) exceed the threshold amount for the individual’s filing status - $200,000 for single filers and $250,000 for married joint filers. For more information, refer to these FAQs from IRS.

  • Net Investment Income Assessment

Beginning January 1, 2013, a 3.8% tax will be assessed on net investment income such as taxable capital gains, dividends, rents, royalties, and interest for taxpayers with Modified Adjusted Gross Income (MAGI) over $200,000 for single filers and $250,000 for married joint filers.  Common types of income that are not investment income are wages, unemployment compensation, operating income from a non-passive business, Social Security Benefits, alimony, tax-exempt interest, and self-employment income.

Find Plan Information In Your Area

Find and compare Marketplace health plans in your area by using this interactive tool at Healthcare.gov.

Timeline of Provisions 

The Affordable Care Act timeline provided by the U.S. Department of Health and Human Services includes the next steps you can take to implement the provisions.

 

 

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