"(A) IN GENERAL.-Any applicable individual for any month if the applicable individual's required contribution (determined on an annual basis) for coverage for the month exceeds 8 percent of such individual's household income for the taxable year described in section 1412(b)(1)(B) of the Patient Protection and Affordable Care Act. For purposes of applying this subparagraph, the taxpayer's household income shall be increased by any exclusion from gross income for any portion of the required contribution made through a salary reduction arrangement. "(B) REQUIRED CONTRIBUTION. For purposes of this Definition. paragraph, the term 'required contribution' means "(i) in the case of an individual eligible to purchase minimum essential coverage consisting of coverage through an eligible-employer-sponsored plan, the portion of the annual premium which would be paid by the individual (without regard to whether paid through salary reduction or otherwise) for self-only coverage, or "(ii) in the case of an individual eligible only to purchase minimum essential coverage described in subsection (f)(1)(C), the annual premium for the lowest cost bronze plan available in the individual market through the Exchange in the State in the rating area in which the individual resides (without regard to whether the individual purchased a qualified health plan through the Exchange), reduced by the amount of the credit allowable under section 36B for the taxable year (determined as if the individual was covered by a qualified health plan offered through the Exchange for the entire taxable year). "(C) SPECIAL RULES FOR INDIVIDUALS RELATED TO EMPLOYEES. For purposes of subparagraph (B)(i), if an applicable individual is eligible for minimum essential coverage through an employer by reason of a relationship to an employee, the determination shall be made by reference to the affordability of the coverage to the employee. "(D) INDEXING.-In the case of plan years beginning Applicability. in any calendar year after 2014, subparagraph (A) shall Determination. be applied by substituting for '8 percent' the percentage the Secretary of Health and Human Services determines reflects the excess of the rate of premium growth between the preceding calendar year and 2013 over the rate of income growth for such period. "(2) TAXPAYERS WITH INCOME UNDER 100 PERCENT OF POVERTY LINE.-Any applicable individual for any month during a calendar year if the individual's household income for the taxable year described in section 1412(b)(1)(B) of the Patient Protection and Affordable Care Act is less than 100 percent of the poverty line for the size of the family involved (determined in the same manner as under subsection (b)(4)). “(3) MEMBERS OF INDIAN TRIBES.-Any applicable individual for any month during which the individual is a member of an Indian tribe (as defined in section 45A(c)(6)). "(4) MONTHS DURING SHORT COVERAGE GAPS.— "(A) IN GENERAL.-Any month the last day of which occurred during a period in which the applicable individual Applicability. Definition. was not covered by minimum essential coverage for a continuous period of less than 3 months. "(B) SPECIAL RULES.-For purposes of applying this paragraph "(i) the length of a continuous period shall be determined without regard to the calendar years in which months in such period occur, "(ii) if a continuous period is greater than the period allowed under subparagraph (A), no exception shall be provided under this paragraph for any month in the period, and "(iii) if there is more than 1 continuous period described in subparagraph (A) covering months in a calendar year, the exception provided by this paragraph shall only apply to months in the first of such periods. The Secretary shall prescribe rules for the collection of the penalty imposed by this section in cases where continuous periods include months in more than 1 taxable year. "(5) HARDSHIPS.-Any applicable individual who for any month is determined by the Secretary of Health and Human Services under section 1311(d)(4)(H) to have suffered a hardship with respect to the capability to obtain coverage under a qualified health plan. "(f) MINIMUM ESSENTIAL COVERAGE.-For purposes of this section "(1) IN GENERAL.-The term 'minimum essential coverage' means any of the following: "(A) GOVERNMENT SPONSORED PROGRAMS.-Coverage under "(i) the Medicare program under part A of title XVIII of the Social Security Act, "(ii) the Medicaid program under title XIX of the Social Security Act, "(iii) the CHIP program under title XXI of the Social Security Act, "(iv) the TRICARE for Life program, "(v) the veteran's health care program under chapter 17 of title 38, United States Code, or "(vi) a health plan under section 2504(e) of title 22, United States Code (relating to Peace Corps volunteers). "(B) EMPLOYER-SPONSORED PLAN.-Coverage under an eligible employer-sponsored plan. "(C) PLANS IN THE INDIVIDUAL MARKET.-Coverage under a health plan offered in the individual market within a State. "(D) GRANDFATHERED HEALTH PLAN.-Coverage under a grandfathered health plan. "(E) OTHER COVERAGE.-Such other health benefits coverage, such as a State health benefits risk pool, as the Secretary of Health and Human Services, in coordination with the Secretary, recognizes for purposes of this subsection. “(2) ELIGIBLE EMPLOYER-SPONSORED PLAN.-The term 'eligible employer-sponsored plan' means, with respect to any employee, a group health plan or group health insurance coverage offered by an employer to the employee which is "(A) a governmental plan (within the meaning of section 2791(d)(8) of the Public Health Service Act), or "(B) any other plan or coverage offered in the small or large group market within a State. Such term shall include a grandfathered health plan described in paragraph (1)(D) offered in a group market. "(3) EXCEPTED BENEFITS NOT TREATED AS MINIMUM ESSENTIAL COVERAGE.-The term 'minimum essential coverage' shall not include health insurance coverage which consists of coverage of excepted benefits "(A) described in paragraph (1) of subsection (c) of section 2791 of the Public Health Service Act; or "(B) described in paragraph (2), (3), or (4) of such subsection if the benefits are provided under a separate policy, certificate, or contract of insurance. "(4) INDIVIDUALS RESIDING OUTSIDE UNITED STATES OR RESIDENTS OF TERRITORIES.—Any applicable individual shall be treated as having minimum essential coverage for any month "(A) if such month occurs during any period described in subparagraph (A) or (B) of section 911(d)(1) which is applicable to the individual, or “(B) if such individual is a bona fide resident of any possession of the United States (as determined under section 937(a)) for such month. "(5) INSURANCE-RELATED TERMS.-Any term used in this section which is also used in title I of the Patient Protection and Affordable Care Act shall have the same meaning as when used in such title. "(g) ADMINISTRATION AND PROCEDURE.— “(1) IN GENERAL.-The penalty provided by this section shall be paid upon notice and demand by the Secretary, and except as provided in paragraph (2), shall be assessed and collected in the same manner as an assessable penalty under subchapter B of chapter 68. “(2) SPECIAL RULES.-Notwithstanding any other provision of law "(A) WAIVER OF CRIMINAL PENALTIES.-In the case of any failure by a taxpayer to timely pay any penalty imposed by this section, such taxpayer shall not be subject to any criminal prosecution or penalty with respect to such failure. "(B) LIMITATIONS ON LIENS AND LEVIES.-The Secretary shall not "(i) file notice of lien with respect to any property of a taxpayer by reason of any failure to pay the penalty imposed by this section, or "(ii) levy on any such property with respect to such failure.". (c) CLERICAL AMENDMENT.-The table of chapters for subtitle D of the Internal Revenue Code of 1986 is amended by inserting after the item relating to chapter 47 the following new item: "CHAPTER 48-MAINTENANCE OF MINIMUM ESSENTIAL COVERAGE.". (d) EFFECTIVE DATE.-The amendments made by this section 26 USC 5000A shall apply to taxable years ending after December 31, 2013. note. 26 USC 6055. SEC. 1502. REPORTING OF HEALTH INSURANCE COVERAGE. (a) IN GENERAL.-Part III of subchapter A of chapter 61 of the Internal Revenue Code of 1986 is amended by inserting after subpart C the following new subpart: "Subpart D-Information Regarding Health "Sec. 6055. Reporting of health insurance coverage. "SEC. 6055. REPORTING OF HEALTH INSURANCE COVERAGE. "(a) IN GENERAL.-Every person who provides minimum essential coverage to an individual during a calendar year shall, at such time as the Secretary may prescribe, make a return described in subsection (b). "(b) FORM AND MANNER OF RETURN. "(1) IN GENERAL.-A return is described in this subsection if such return and "(A) is in such form as the Secretary may prescribe, "(B) contains "(i) the name, address and TIN of the primary insured and the name and TIN of each other individual obtaining coverage under the policy, "(ii) the dates during which such individual was covered under minimum essential coverage during the calendar year, "(iii) in the case of minimum essential coverage which consists of health insurance coverage, information concerning— "(I) whether or not the coverage is a qualified health plan offered through an Exchange established under section 1311 of the Patient Protection and Affordable Care Act, and "(II) in the case of a qualified health plan, the amount (if any) of any advance payment under section 1412 of the Patient Protection and Affordable Care Act of any cost-sharing reduction under section 1402 of such Act or of any premium tax credit under section 36B with respect to such coverage, and "(iv) such other information as the Secretary may require. "(2) INFORMATION RELATING TO EMPLOYER-PROVIDED COVERAGE.-If minimum essential coverage provided to an individual under subsection (a) consists of health insurance coverage of a health insurance issuer provided through a group health plan of an employer, a return described in this subsection shall include "(A) the name, address, and employer identification number of the employer maintaining the plan, "(B) the portion of the premium (if any) required to be paid by the employer, and "(C) if the health insurance coverage is a qualified health plan in the small group market offered through an Exchange, such other information as the Secretary may require for administration of the credit under section 45R (relating to credit for employee health insurance expenses "(c) STATEMENTS TO BE FURNISHED TO INDIVIDUALS WITH RESPECT TO WHOM INFORMATION IS REPORTED.— “(1) IN GENERAL.-Every person required to make a return under subsection (a) shall furnish to each individual whose name is required to be set forth in such return a written statement showing "(A) the name and address of the person required to make such return and the phone number of the information contact for such person, and "(B) the information required to be shown on the return with respect to such individual. "(2) TIME FOR FURNISHING STATEMENTS.-The written statement required under paragraph (1) shall be furnished on or before January 31 of the year following the calendar year for which the return under subsection (a) was required to be made. "(d) COVERAGE PROVIDED BY GOVERNMENTAL UNITS.—In the case of coverage provided by any governmental unit or any agency or instrumentality thereof, the officer or employee who enters into the agreement to provide such coverage (or the person appropriately designated for purposes of this section) shall make the returns and statements required by this section. "(e) MINIMUM ESSENTIAL COVERAGE. For purposes of this section, the term 'minimum essential coverage' has the meaning given such term by section 5000A(f).”. (b) ASSESSABLE PENALTIES.— (1) Subparagraph (B) of section 6724(d)(1) of the Internal Revenue Code of 1986 (relating to definitions) is amended by 26 USC 6724. striking "or" at the end of clause (xxii), by striking "and" at the end of clause (xxiii) and inserting "or", and by inserting after clause (xxiii) the following new clause: "(xxiv) section 6055 (relating to returns relating to information regarding health insurance coverage), and". (2) Paragraph (2) of section 6724(d) of such Code is amended by striking "or" at the end of subparagraph (EE), by striking the period at the end of subparagraph (FF) and inserting or" and by inserting after subparagraph (FF) the following new subparagraph: 66 "(GG) section 6055(c) (relating to statements relating to information regarding health insurance coverage).". (c) NOTIFICATION OF NONENROLLMENT.-Not later than June 30 of each year, the Secretary of the Treasury, acting through the Internal Revenue Service and in consultation with the Secretary of Health and Human Services, shall send a notification to each individual who files an individual income tax return and who is not enrolled in minimum essential coverage (as defined in section 5000A of the Internal Revenue Code of 1986). Such notification shall contain information on the services available through the Exchange operating in the State in which such individual resides. (d) CONFORMING AMENDMENT.—The table of subparts for part III of subchapter A of chapter 61 of such Code is amended by inserting after the item relating to subpart C the following new item: Deadline. |