Under the Affordable Care Act, the federal government, state governments, insurers, employers and individuals each are given roles in reforming and improving the availability, quality and affordability of health insurance coverage in the United States. Starting January 1, 2014, the individual shared responsibility provision calls for each individual to have minimum essential health coverage (known as “minimum essential coverage”) for each month, qualify for an exemption, or make a payment when filing his or her federal income tax return.
Many individuals in the United States have health coverage today that is already recognized as minimum essential coverage and will not need to do anything more than continue the coverage that they have.
Minimum essential coverage designated by statute or regulations includes the following:
Employer-sponsored coverage (including Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage and retiree coverage)
Coverage purchased in the individual market, including a qualified health plan offered by the Health Insurance Marketplace (also known as an Affordable Insurance Exchange)
The Centers for Medicare & Medicaid Services (CMS) is accepting applications from organizations seeking minimum essential coverage recognition for their health plans or policies. If your organization provides coverage in any of the minimum essential coverage categories above, your organization does not need to apply to CMS for minimum essential coverage recognition. Applicants who are not part of the categories identified above and would like to have their plan or policy recognized as minimum essential coverage, should use the process outlined in sub-regulatory guidance issued by the Center for Consumer Information and Insurance Oversight (CCIIO).