NJ Health Insurance Mandate (2022)

This chart shows all of the coverage exemptions available, including descriptions of each and the associated code that will be used to claim the exemption on Schedule NJ-HCC of Form NJ-1040.

Income Related Coverage Exemption Type Exemption Code Marketplace Affordability A-1

Coverage is considered unaffordable if the premiums for the lowest cost Bronze-Level plan available to you through the Marketplace in the tax year are more than 8.05% of your household income. To estimate your household income, see income worksheet.

The total cost to you must be more than 8.05%, accounting for any tax credit you would qualify for if you enrolled in that plan.

If you can claim this exemption, it may apply to the dependent(s) you claim on your tax return who didn’t have coverage in the year.

Job-Based Affordability A-2

When considering whether to file this exemption, know that job-based health insurance is considered unaffordable in different ways, depending on how the coverage is offered:

    • For the employee: The annual premium for the lowest costself-onlyplan (a plan that covers only you and not other members of your family) is more than 8.05% of household income
    • For the employee’s family: The annual premium for the lowest cost family plan is more than 8.05% of household income
    • If you can claim this exemption, it may apply to everybody on your tax return who doesn’t have coverage in the tax year. This will depend on the cost of the coverage and to whom it’s offered.
Poverty Line Exemption A-3

You qualify for this exemption if your household income is at or below 138 percent of the federal poverty level. You will be requested to complete a Household Income worksheet and provide a Family Member Count. If your household income and family size are within these limits, you may file for this exemption:

For each additional person in families of more than eight, add $6,265 to $61,356.18 to determine the Federal Poverty Level.

Health Coverage Related Coverage Exemption Type Exemption Code Short Gap in Coverage B-1
  • In any tax year, you may apply for a Short-Gap exemption if you had a lapse in coverage of less than three months.
  • New Jersey considers you covered during a month if you had coverage for even one day during that month. So if you are without insurance for two consecutive months, you must have insurance by the last day of the third month to qualify for a Short-Gap exemption.
  • If you have a gap that is three months or longer, you cannot claim this exemption for any month. The Shared Responsibility Payment will be due for every month you were without coverage.
  • If you had two or more such gaps in coverage during a year, you can claim this exemption only for the months of the first coverage gap. Example: You didn't have coverage any day in May or any day in November or December. You can claim the exemption only for May.
  • f your coverage gap crosses calendar years, the months without coverage of the second tax year aren't counted for the exemption for the first tax year. But the uncovered months from the first year are counted for the exemption for the second tax year. Example: You don't have qualifying coverage in November 2020, December 2020, and January 2021. You're not eligible for the 2021 short gap exemption for January because you didn't have coverage for three consecutive months - from November 2020 through January 2021.

If you qualify, you can claim this exemption for the dependent(s) you claim on your tax return.

Group Membership Coverage Exemption Type Exemption Code Religious Sect C-1

To claim this exemption, you must be a member of a religious sect or division that:

  • Has been in existence since December 31, 1950 and is recognized by the Social Security Administration as conscientiously opposed to accepting any insurance benefits (including Social Security and Medicare). Or
  • Relies solely on a religious method of healing, and for whom the acceptance of medical health services would be inconsistent with the religious beliefs of the individual.

If you get this exemption, you won’t have to reapply for an exemption unless you turn 21 or leave your religious sect.

Health Care Sharing Ministry C-2

A health care sharing ministry is a tax-exempt organization whose members:

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  • Share a common set of ethical or religious beliefs, and
  • Share medical expenses in accordance with those beliefs, even after a member develops a medical condition.

The health care sharing ministry must have been in existence and sharing medical expenses continuously since December 31, 1999.

Federally Recognized Tribe C-3

  • Any Indian or Alaska Native tribe, Alaska Native Claims Settlement Act (ANCSA) Corporation (regional or village), band, nation, pueblo, village, rancheria, or community that the United States Department of the Interior acknowledges to exist as an Indian tribe.
  • People Eligible for Indian Health Services C-4

    You qualify for this exemption if you're:

    • A member of a federally recognized Indian tribe;
    • An Alaska Native Claims Settlement Act (ANCSA) Corporation Shareholder (regional or village);
    • Otherwise eligible for services from an Indian health care provider or through the Indian Health Service.

    You qualify for the exemption for any month you had any of these statuses for at least 1 day, or for the full year if you had the status all year.

    You can claim this exemption for yourself or any dependent(s) you claim on your tax return who qualify.

    Incarcerated Coverage Exemption Type Exemption Code Incarcerated D-1

  • For these purposes, incarcerated means serving a term in prison or jail.
  • Incarceration doesn’t include being on probation, parole, or home confinement.
  • You’re not considered incarcerated if you’re being held but not convicted of a crime.
  • You can claim this exemption for any month you are incarcerated for at least 1 day.
  • U.S. Citizen Living Abroad and Certain Non-U.S. Citizens Coverage Exemption Type Exemption Code U.S. Citizen Abroad/Non-U.S. Citizen E-1

    You’re a U.S. citizen who either:

    • Spent at least 330 full days outside of the U.S. during a 12-month period, or
    • Was a bona fide resident of a foreign country (or countries) for a full tax year.

    You’re a resident alien who both:

    • Was a citizen or national of a foreign country with which the U.S. has an income tax treaty with a nondiscrimination clause including (1) a dual-state alien in the first year of U.S. residence or (2) a nonresident alien or dual-status who elects to file a joint return with a U.S. spouse, and
    • Was a bona fide resident of a foreign country for the next tax year. File for this exemption only if you are required to file a New Jersey resident tax return.
    Hardships Coverage Exemption Type Exemption Code Child Medically Supported by Another Party F-1

    You need to retain for your records copies of these documents:

    • A court order that covers the months you want to claim this exemption, and
    • A denial notice that shows the child was denied coverage through either Medicaid or the Children’s Health Insurance Program (CHIP) in the tax year.

    This exemption applies only to the child, not you. You and other members of your household who don’t have coverage but don’t qualify for this exemption must qualify for a different exemption or pay the Shared Responsibility Payment.

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    Homeless F-2

    This exemption applies to everyone listed on your tax return. No specific documentation is required, but the State may require corroboration on a case-by-case basis.

    Evicted or Facing Eviction/Foreclosure F-3
  • The eviction or foreclosure must have occurred in the last 3 years.
  • You’ll need to retain for your records an eviction or foreclosure notice when you apply for this exemption.
  • An eviction or foreclosure hardship could apply to you and the dependent(s) you claim on your tax return.

    Utility Shut-Off F-4

  • The utility shut-off must have occurred in the last 3 years.
  • You’ll need to retain for your records a copy of a notice from an electric, gas, or water utility company that says a service was or will be shut off.
  • Domestic Violence F-5

    To qualify for this exemption:
    You must have experienced domestic violence.
    A domestic violence exemption could apply to your entire household. No specific documentation is required, but the State may require corroboration on a case-by-case basis.

    Death of Close Family Member F-6

    To qualify for this exemption:

    • The death of the close family member must have occurred in the last 3 years.
    • You must retain for your records one of these forms of documentation:
      • Death certificate
      • Death notice from a newspaper
      • Funeral service program
      • Document showing funeral expenses
      • Coroner’s report
      • Military notification of death
      • Other official notice of death

    A death of a close family member hardship could apply to you and the dependent(s) you claim on your tax return.

    Fire, Flood, or Other Disaster F-7

    To qualify for this exemption:

    • You must have experienced the disaster within the last 3 years.
    • You need to retain for your records copies of a police record, fire record, insurance claim, or other document from a government agency, private entity, or news source about the event.

    An exemption due to a disaster could apply to you and the dependent(s) you claim on your tax return.

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    Filed for Bankruptcy F-8

    To qualify for this exemption:

    • You must have filed for bankruptcy in the last 3 years.
    • You must retain for your records copies of official bankruptcy filing documents from a court of law.

    A bankruptcy hardship could apply to you and the dependent(s) you claim on your tax return.

    Unpaid Medical Expenses F-9

  • You need to retain copies of medical expenses you were unable to pay.
  • Increased Expenses Caring for a Family Member F-10

    To qualify for this exemption:

    • You must have experienced an increase in expenses for caring for a family member in the last 3 years.
    • You need to retain for your records copies of bills or receipts for services related to care. You can send copies of medical bills, statements for home care services, or transportation receipts.

    This hardship could apply to you and the dependent(s) you claim on your tax return.

    Uncovered Waiting for a Successful Appeal F-11

    To qualify for this exemption:

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    • You need to retain for your records a copy of the appeal decision showing that in the months you didn’t have coverage you were eligible for at least one of these:
      • Enrollment in a qualified health plan (QHP) through the Marketplace
      • Advance payments of the premium tax credit to lower costs on your monthly premiums
      • Cost-sharing reductions that lower your out-of-pocket costs
    You Had Another Hardship (Not Listed) F-12

    FAQs

    Is there a penalty for not having health insurance in 2022 in NJ? ›

    There is no penalty for not having ACA mandated coverage in 2022 unless you live in a state like New Jersey or Massachusetts where it is mandated by the state.

    Is it mandatory to have health insurance in NJ? ›

    The New Jersey Health Insurance Market Preservation Act requires most state residents to maintain health coverage. You and your tax household must have minimum essential health coverage, qualify for an exemption, or remit a Shared Responsibility Payment when you file your New Jersey Income Tax return.

    How can I avoid health insurance fines in NJ? ›

    If you have Medicaid or Medicare, or have health insurance through your job, or purchase health insurance through the Health Insurance Marketplace created by the ACA, or purchase comprehensive insurance directly from an insurance company, you meet the MEC requirement and will not have to pay the penalty.

    Does NJ tax you for not having health insurance? ›

    Failure to have health coverage or qualify for an exemption may result in the assessment of a Shared Responsibility Payment (SRP) on your New Jersey Income Tax return. Individuals who are not required to file a New Jersey Income Tax return are automatically exempt from the SRP.

    Is the individual mandate gone? ›

    The individual mandate itself still exists (and qualifying for an exemption from the mandate still allows a person to buy a catastrophic health plan even if they're 30 or older). But there is no longer a federal penalty for non-compliance.

    Does Pennsylvania have a penalty for not having health insurance? ›

    The fee for not having health insurance (sometimes called the "Shared Responsibility Payment" or "mandate”) ended in 2018. This means you no longer pay a tax penalty for not having health coverage. If you don't have health coverage, you don't need an exemption to avoid paying a tax penalty.

    What type of insurance is mandatory in New Jersey? ›

    New Jersey law requires all drivers to carry auto insurance that includes both liability and personal injury protection (PIP) coverages. Uninsured motorist and collision and comprehensive coverages aren't required in New Jersey but can be added to your policy.

    Is it required to have health insurance? ›

    Yes, it is mandatory for companies to provide health insurance in India post the Covid-19 lockdown in 2020. In April 2020, the Indian government made it mandatory for all employers to provide mediclaim policy for employees in India.

    Are employers required to provide health insurance 2021? ›

    From a legal standpoint, there is no federal law that says companies must offer health insurance to their employees.

    What is the ACA penalty for 2022? ›

    A penalty of $2,750 (for 2022) per full-time employee minus the first 30 will be incurred if the employer fails to offer minimum essential coverage to 95 percent of its full-time employees and their dependents, and any full-time employee obtains coverage on the exchange.

    What happens if you don't pay the shared responsibility payment? ›

    The law prohibits the IRS from using liens or levies to collect any individual shared responsibility payment. However, if you owe a shared responsibility payment, the IRS may offset that liability against any tax refund that may be due to you.

    Do I have to file 3853? ›

    Not required to file a tax return.

    Only one form FTB 3853 should be filed for each applicable household. If you can be claimed as a dependent by another taxpayer, you do not need to file form FTB 3853 and do not owe an Individual Shared Responsibility Penalty.

    Do NJ employers have to offer health insurance? ›

    In general: Employers in New Jersey with 50 or more employees must provide “minimum essential” health care coverage for employees who work 30 or more hours per week or must pay an annual penalty; Businesses in the Garden State with two to 50 employees are not required to offer health care coverage to their employees.

    Is the premium tax credit waived for 2021? ›

    The American Rescue Plan Act of 2021 (ARPA), enacted on March 11, 2021, suspended the requirement to repay excess advance payments of the premium tax credit (excess APTC, which is the amount by which your advance credit payments for the year exceed your premium tax credit for the year) for tax year 2020.

    How long can you go exempt without being penalized? ›

    The IRS gives no maximum time that you can be on an exempt status. You must balance the potential tax bill with the zero interest loan you give the IRS if you withhold too much and end the year with a large refund.

    When was individual mandate removed? ›

    On December 22, 2017, President Donald Trump signed the Tax Cuts and Jobs Act of 2017, which eliminated the federal tax penalty for violating the individual mandate, starting in 2019.

    What is the point of the individual mandate? ›

    The goal of the individual mandate was to encourage young and healthy people to get or stay insured, which would help spread out the cost of sicker people who would enroll and use more services because of the ACA's rule changes.

    Does Florida have a health insurance mandate? ›

    Since 2014, the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) has required most individuals to maintain health insurance coverage or potentially to pay a penalty for noncompliance.

    Is health insurance mandatory in USA? ›

    Key Takeaways. Health insurance coverage is no longer mandatory at the federal level, as of Jan. 1, 2019. Some states still require you to have health insurance coverage to avoid a tax penalty.

    How many points do you get for not having insurance? ›

    Penalties for driving without insurance

    You could receive a fixed penalty of £300 and six penalty points on your licence if you are caught driving a vehicle that you are not insured to drive. If the case goes to court you could get an unlimited fine and be disqualified from driving.

    What is the minimum insurance requirement in New Jersey? ›

    In order to legally drive your car in New Jersey, you have a carry a state-mandated minimum amount of insurance, which includes: $15,000 per person for injury or death. $30,000 per accident for all injuries.

    Is PIP coverage mandatory in New Jersey? ›

    It is mandatory for all drivers in New Jersey. Its purpose is to pay for medical expenses or other costs for the driver or their passengers following an accident. It is awarded regardless of who is at fault in the accident. The minimum required is $15,000, but you can purchase up to $250,000 of PIP.

    How much PIP insurance do I need in NJ? ›

    The minimum amount of PIP coverage you need in New Jersey is $15,000, but you can purchase up to $250,000. If you have lower limits and suffer a severe brain or spinal injury, your limits may automatically jump up to $250,000 until you are stabilized.

    Is insurance mandatory for all employees? ›

    Is Company Health Insurance Compulsory in India? Yes, medical insurance policy for employees is compulsory in India post the nation-wide COVID-19 lockdown in 2020.

    Is it mandatory for an employer to offer health insurance? ›

    The government has made it mandatory for all employers which resume functioning as the lockdown gets over, to provide medical insurance to their employees.

    Why should health insurance be mandatory? ›

    Health insurance protects you from unexpected, high medical costs. You pay less for covered in-network health care, even before you meet your deductible. You get free preventive care, like vaccines, screenings, and some check-ups, even before you meet your deductible.

    How many hours do you need for employment insurance? ›

    Usually, you need between 420-700 hours during your qualifying period. From September 26, 2021 to September 24, 2022, you only need to have worked 420 hours during your qualifying period, regardless of the unemployment rate in your area.

    How many hours is considered full-time? ›

    Full-time employees usually work an average of 38 hours each week. They're usually employed on a permanent basis or on a fixed term contract.

    Are employers allowed to offer different benefits to different employees? ›

    Technically, there are no federal laws that require an employer to provide benefit plans with the same coverage to their employees. In fact, employers can offer different benefits to different employees, as long as they treat "similarly situated individuals" equally.

    What triggers an ACA penalty? ›

    Trigger. The penalty is triggered if one employee purchases coverage on the Marketplace and receives a federal premium subsidy. 250 employees purchase coverage on the Marketplace and are eligible for a subsidy. Penalty.

    Will ACA reporting be required in 2022? ›

    Self-funded employers and health insurance carriers in California must furnish healthcare information to their employees and their dependents by January 31, 2022.

    What if you underestimate your income for Obamacare? ›

    You'll make additional payments on your taxes if you underestimated your income, but still fall within range. Fortunately, subsidy clawback limits apply in 2022 if you got extra subsidies. in 2021 However, your liability is capped between 100% and 400% of the FPL.

    How do you avoid shared responsibility payments? ›

    Offer at least minimum essential coverage to full-time employees and dependents and document those offers of coverage. To avoid insufficient offer penalties, offer affordable coverage that is at least minimum value.

    Does IRS require health insurance? ›

    Almost all taxpayers must report health care coverage, claim a coverage exemption or report a shared responsibility payment. The IRS will not accept tax returns that do not reflect at least one of these options if filed electronically.

    Why do I owe shared responsibility? ›

    For any month during the year that you or any of your family members don't have minimum essential coverage and don't qualify for a coverage exemption, you are required to make an individual shared responsibility payment when you file your tax return. The payment is reported on Form 1040.

    When did shared responsibility payment end? ›

    Enacted in December 2017, the Tax Cuts and Jobs Act (TCJA) reduced the shared responsibility payment to zero for tax year 2019 and all subsequent years. For January 1, 2019 and beyond, taxpayers are still required by law to have minimum essential coverage or qualify for a coverage exemption.

    What is individual shared responsibility penalty? ›

    The Individual Shared Responsibility Penalty is imposed on any applicable individual for any month in which they fail to enroll and maintain minimum essential healthcare coverage.

    What is the amount of the individual shared responsibility in 2021? ›

    The California Individual Shared Responsibility Penalty (ISRP) is either a flat penalty per household member or 2.5% of gross household income that exceeds California's filing threshold, whichever is higher.

    What is the penalty in NJ for not having health insurance? ›

    New Jersey's mandate, which mirrors the federal requirement, includes an annual penalty of 2.5 percent of a household's income or a per-person charge — whichever is higher. The maximum penalty based on a per-person charge will be $2,085.

    How many hours do you have to work to get health insurance in NJ? ›

    Coverage tip 2: While full time is defined as 25 hours per week for eligibility, if the employer has only one employee, that employee would have to work at least 30 hours per week in order for the employer to qualify as a small employer.

    How much is NJ State health insurance? ›

    How much does health insurance cost in New Jersey? New Jersey residents can expect to pay an average of $451 per person* for a major medical individual health insurance plan.

    How can I avoid paying back my premium tax credit? ›

    The easiest way to avoid having to repay a credit is to update the marketplace when you have any life changes. Life changes influence your estimated household income, your family size, and your credit amount. So, the sooner you can update the marketplace, the better. This ensures you receive the correct amount.

    How do I know if I have to pay back premium tax credit? ›

    If at the end of the year you've taken more premium tax credit in advance than you're due based on your final income, you'll have to pay back the excess when you file your federal tax return. If you've taken less than you qualify for, you'll get the difference back.

    Do I have to pay back the premium tax credit in 2022? ›

    For Tax Year 2020, under Section 9662, taxpayers were not required to repay any excess advanced premium tax credits (APTC). For Tax Years 2021 and 2022, under Section 9661, taxpayers have increased premium tax credits for all income brackets and reduced premiums that they will be required to pay.

    What happens if I go exempt for 3 months? ›

    By “going exempt” for the last 3 months, they can squeeze out some extra dollars to help pay for gifts and other things for the year's end. Of course, “going exempt” means that it will affect his tax filing and what he may or may not owe.

    What happens if I claim exempt for 6 months? ›

    When you file exempt with your employer for federal tax withholding, you do not make any tax payments during the year. Without paying tax, you do not qualify for a tax refund unless you qualify to claim a refundable tax credit, like the Earned Income Tax Credit.

    What happens if you go tax exempt all year? ›

    What Does Exempt Mean? Generally, the IRS will issue a tax refund when you pay more tax than what is actually owed in that specific tax year. When you file exempt with your employer, however, this means that you will not make any tax payments whatsoever throughout the tax year.

    What is the ACA penalty for 2022? ›

    A penalty of $2,750 (for 2022) per full-time employee minus the first 30 will be incurred if the employer fails to offer minimum essential coverage to 95 percent of its full-time employees and their dependents, and any full-time employee obtains coverage on the exchange.

    What type of insurance is mandatory in New Jersey? ›

    New Jersey law requires all drivers to carry auto insurance that includes both liability and personal injury protection (PIP) coverages. Uninsured motorist and collision and comprehensive coverages aren't required in New Jersey but can be added to your policy.

    Is it required to have health insurance? ›

    Yes, it is mandatory for companies to provide health insurance in India post the Covid-19 lockdown in 2020. In April 2020, the Indian government made it mandatory for all employers to provide mediclaim policy for employees in India.

    What is a hardship exemption NJ? ›

    An exemption that's needed when applying for Catastrophic coverage for people 30 and older who faced a "hardship" that prevented them from getting insurance. Hardship exemptions are one type of exemption that someone can claim to qualify for Catastrophic coverage, along with affordability exemptions.

    What triggers an ACA penalty? ›

    Trigger. The penalty is triggered if one employee purchases coverage on the Marketplace and receives a federal premium subsidy. 250 employees purchase coverage on the Marketplace and are eligible for a subsidy. Penalty.

    Will ACA reporting be required in 2022? ›

    Self-funded employers and health insurance carriers in California must furnish healthcare information to their employees and their dependents by January 31, 2022.

    Is the ACA employer mandate still in effect? ›

    The short answer is: The ACA remained in full force for 2019, especially as it relates to US employers, and for now, remains in effect for 2020 and beyond. Even the individual mandate (requiring individuals to have ACA-compliant health coverage or else pay a penalty) remained in force for 2019 – a surprise to many.

    What is the minimum insurance requirement in New Jersey? ›

    In order to legally drive your car in New Jersey, you have a carry a state-mandated minimum amount of insurance, which includes: $15,000 per person for injury or death. $30,000 per accident for all injuries.

    Is PIP coverage mandatory in New Jersey? ›

    It is mandatory for all drivers in New Jersey. Its purpose is to pay for medical expenses or other costs for the driver or their passengers following an accident. It is awarded regardless of who is at fault in the accident. The minimum required is $15,000, but you can purchase up to $250,000 of PIP.

    How much PIP insurance do I need in NJ? ›

    The minimum amount of PIP coverage you need in New Jersey is $15,000, but you can purchase up to $250,000. If you have lower limits and suffer a severe brain or spinal injury, your limits may automatically jump up to $250,000 until you are stabilized.

    Is insurance mandatory for all employees? ›

    Is Company Health Insurance Compulsory in India? Yes, medical insurance policy for employees is compulsory in India post the nation-wide COVID-19 lockdown in 2020.

    How much health insurance is required? ›

    First, your health cover should be at least 50% of your annual income. And second, the insurance cover should at least cover the cost of a coronary artery bypass graft in a hospital of your choice. Most personal finance experts recommend a minimum health cover of Rs 5 lakh.

    Why should health insurance be mandatory? ›

    Health insurance protects you from unexpected, high medical costs. You pay less for covered in-network health care, even before you meet your deductible. You get free preventive care, like vaccines, screenings, and some check-ups, even before you meet your deductible.

    What is a medical hardship? ›

    Medical hardship is defined as an incapacity resulting from injury or illness that has occurred under certain specific conditions.

    Who is exempt from Obamacare? ›

    If you're seeking an exemption because you can't afford coverage, you're a member of a federally recognized tribe, you're incarcerated, or you participate in a recognized health care sharing ministry, you have two options: The exemptions can be claimed when you complete your federal tax return.

    Do I have to file 3853? ›

    Not required to file a tax return.

    Only one form FTB 3853 should be filed for each applicable household. If you can be claimed as a dependent by another taxpayer, you do not need to file form FTB 3853 and do not owe an Individual Shared Responsibility Penalty.

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