Affordable Care Act (ACA) FAQs

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  • Are U.S. citizens living outside the U.S. affected by the ACA? 
    • If you reside outside the U.S. for 330 days or more per calendar year, you are exempt from ACA rules. If you are covered by an expatriate group plan purchased in the U.S. by your employer, you meet ACA requirements. If you do not fall into either of these categories, certain rules apply (see below).
  • Are non-U.S. citizens living inside the U.S. affected by the ACA?
    • ACA rules apply if you are a permanent legal resident (green card holder) or a resident alien as defined by the IRS. Please note that certain regulations surrounding the individual mandate are determined at a state level. To see whether or not your state is offering individuals the option of keeping their current non ACA coverage beyond March 31, 2014, view this map.
  • Does travel outside the U.S. affect a U.S. resident’s obligations under the ACA?
    • No. Short-term travel outside the U.S. has no bearing on a U.S. resident’s obligations under the ACA.
  • Are non-U.S. citizens traveling inside the U.S. affected by the ACA?
    • No. Unless you are a permanent legal resident or a resident alien, you are typically exempt from ACA requirements.
  • What ACA rules apply?
      • If you are subject to ACA rules, you are expected to meet the Individual Mandate each calendar year, or you will be subject to tax penalties when you file your Federal tax return.

     

  • Do plans that meet the Individual Mandate function well outside the U.S.?
    • Plans available today on https://www.healthcare.gov, online exchanges operated by certain states, as well as websites operated by health insurers and health insurance brokers are not designed for accessing care outside the U.S. and thus expose the policy holder to significant financial risk. Click here to see examples of how patients outside the U.S. directly bear substantial costs for medical emergencies, preventive care or routine illnesses when they purchase a plan that meets the Individual Mandate.
  • Do tax penalties outweigh the savings I may realize by purchasing a plan that does meet the Individual Mandate?
      • Not necessarily. It depends on your income level, your choice of health plan and the medical expenses you incur.

     

  • Can I keep my current GeoBlue coverage without penalty in 2014?
    • Recent modifications to the Affordable Care Act make it possible to renew a plan that does not meet the Individual Mandate without incurring a tax penalty depending on your state of residence. Please contact us at 855-481-6647 to discuss.
  • How is the shared responsibility payment calculated?
    • The penalty in 2014 is calculated in one of 2 ways. You’ll pay whichever of these amounts is higher:

• 1% of your yearly income above the filing threshold. The 1% share responsibility payment cannot exceed the national average expense of a bronze level plan which the Congressional Budget Office estimates is between $4,500 – $5,000 per individual. (See filing thresholds in financial examples below)
• $95 per person if the household income is under $20,000 ($47.50 per child under 18). The maximum penalty per family using this method is $285.

Financial Examples Individual Income: $50,000 Taxable income = $39,850 (individual income ($50,000) – taxable threshold for individual ($10,150)) Shared responsibility payment = $398.50 annually, $33.21 monthly (taxable income X 1%)

Family Income: $100,000 Taxable income = $80,000 (individual income ($100,000) – taxable threshold for couple/family ($20,000)) Shared responsibility payment = $800 annually, $66.67 monthly (taxable income X 1%)

The information above is provided for general instructional purposes only and is not intended to be legal guidance, opinion, or serve as a substitute for advice from licensed, legal and/or tax professionals; the law and tax regulations change frequently and may vary depending on jurisdiction. All risk of loss or damage based upon this information is solely that of the User, and Company (WIS) disclaims any and all liability thereof.