PENALTY -  Individual Shared Responsibility Payment

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.")

Premium Tax Credit

• You owe the fee for any month you, your spouse, or your tax dependents don’t have qualifying health coverage (sometimes called "minimum essential coverage"). See all insurance types that qualify.


• You pay the fee when you file your federal tax return for the year you don’t have coverage.


• In some cases, you may qualify for a health coverage exemption from the requirement to have insurance. If you qualify, you won’t have to pay the fee. Learn about health coverage exemptions.

Learn more about the individual shared responsibility payment from the Internal Revenue Service.

The fee for not having qualifying health insurance in 2017

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 filing threshold ($10,300 for individuals, $20,600 for couples filing jointly in 2015, the most recent year available) 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. Learn about the “short gap” exemption.
•You pay the fee when you file your federal tax return for the year you don’t have coverage.

Source: HealthCare.gov

Here's an example of an individual making $25,000 a year:


Summary of $25,000 estimated annual income:

Current Tax year
Total estimated annual income: $25,000.00
Filing threshold amount for your filing status: $10,350.00
Total flat dollar amount for your family size: $695.00
Total excess income amount: $366.25
Total of the monthly penalty amounts (the larger of the flat dollar amount or excess income amount): $695.00
National average bronze plan premium for your family size: $2,676.00
Estimated shared responsibility payment (the lesser of the total monthly penalty amounts or the national average bronze plan premium): $695.00

Your Estimated Shared Responsibility Payment
Based on the information you provided and any changes during the year, your estimated shared responsibility payment is: $695.00.

Months            Non-exempt family members               Monthly penalty amount
Jan - Dec                             1                                                           $57.92

The penalty for not having health insurance if I'm unemployed

Other exemptions are based on low income too. Learn more about exemptions and how to claim them.

Add the following when applying for the Premium Tax Credit on Healthcare.gov

Agent: Susan Speciale
National Producer#: 1635661
FFM Agent ID: cms-agent@susan082513