The federal Patient Protection and Affordable Care Act (“ACA”) requires that nearly all individuals (who are above the threshold for filing income tax) must obtain health insurance for themselves and any of their dependent family members. The following plans will satisfy this individual responsibility requirement:
- Student Health Insurance plan offered based on student enrollment, which include:
- Urbana: UnitedHealthcare
- Chicago: Campus Care
- Springfield: Academic Health Plans
- State of Illinois health insurance plans offered through the Department of Central Management Services (“CMS”) based on University employment.
- RSL BasicCare Program, Essential Plan
The following types of health insurance coverage will also satisfy the individual responsibility requirement as long as the insurance qualifies as "minimum essential coverage" under ACA (contact the plan directly to find out if it qualifies):
- Health insurance provided by a parent/guardian, spouse, or other family member who claims you as a dependent
- Another employer-provided health insurance plan, if your primary employment is somewhere other than the University
- Private health insurance coverage purchased independent of employment
If you have questions about your student employment status, please contact your university student employment or human resources office.
If you have questions about the student health insurance plan, please contact the student insurance office at your university:
FAQs
Where can I read the Notice?
You can find the Insurance Marketplace Notice online.
I am a University of Illinois student. Why did I receive the Insurance Marketplace Notice?
You received the Notice because you are a new, student employee. The University is required by the ACA to provide all employees with information relating to the Health Insurance Marketplace (“Marketplace”). The Notice explains the option for the RSL BasicCare Program or to purchase coverage through the Health Insurance Marketplace.
Please note that the Notice discusses health plans offered to certain University employees through the State of Illinois Department of Central Management Services (“CMS”) (also referred to as the “State Employees’ Group Insurance program” or “SEGIP”). Student employees are not currently eligible for coverage through CMS.
Your student insurance plan or other coverage that you maintain through a parent, spouse, or other family member’s plan (including coverage as a dependent under a parent’s or spouse’s CMS plan) will satisfy your responsibility to maintain health insurance under ACA.
The Notice talks about health plans offered through the State of Illinois Department of Central Management Services (“CMS”) (or “State Employees’ Group Insurance Program” or “SEGIP”). Am I eligible for these plans as a student employee?
No, student employees are not currently eligible for SEGIP coverage through CMS, unless you are an eligible dependent of a state employee with coverage through CMS (i.e., if your parent or spouse works at the University).
Why does ACA require me to purchase health insurance coverage or pay a fee if I remain uninsured?
The rationale for requiring nearly all individuals to purchase coverage is that having a larger pool of individuals (both healthy and sick people) will reduce the overall cost of providing health care in this country. Other ACA requirements, such as prohibiting denial of coverage based on pre-existing conditions and removing annual and lifetime limits on coverage, provide increased protections to those who might otherwise not be able to obtain coverage. ACA attempts to create incentives for healthy individuals to obtain coverage and to guard against the adverse financial consequences of unexpected health care costs resulting from significant illness or injury.
If you choose not to obtain coverage for yourself and/or any dependents despite the individual responsibility requirement, you must pay a fee when filing your income taxes. The IRS administers the fee, which increases every year.
What if I already have insurance?
If you participate in a health plan offered through university student insurance, or you have coverage that meets the minimum essential coverage requirements through another employer, a parent, spouse or other family member, then you do not need to take any action as long as you and any dependents maintain health coverage.
Am I required to give up my current coverage?
No. If you have coverage that qualifies as minimum essential coverage under ACA, then you satisfy the individual responsibility requirement for yourself.
What if I don’t have coverage?
ACA requires nearly all individuals who are above the threshold for filing income tax to obtain minimum essential coverage for themselves and any of their dependent family members or pay a fee when filing income tax returns. If you are not eligible for CMS coverage or the RSL BasicCare Program based on your University employment or student status, and you do not otherwise have coverage through a spouse or other family member, then you should carefully review the Insurance Marketplace Notice and understand your option to purchase health insurance through the Marketplace.
If you were eligible for student insurance coverage through the University, but waived that coverage and now do not have any other health coverage through a parent, spouse or family member, you should contact your student insurance office to learn how and when to apply to reinstate coverage.
I waived student insurance through the University and now I am not covered under any other plan, such as a parent’s plan, Medicaid, or another employer’s plan. Can I reinstate student insurance now or wait until the next enrollment period?
Some student plans may permit you to enroll mid-semester or when experiencing a qualifying event. You should contact your campus student insurance office to learn how and when you can elect coverage or apply to reinstate coverage.
Urbana Students: If you were eligible for health insurance coverage through UnitedHealthcare, but waived coverage and do not have any other health coverage through a parent, spouse, or family member, then you can apply for reinstatement for upcoming semesters, or you may enroll if you experience a qualifying event, to satisfy your individual responsibility under ACA. If you remain eligible for UnitedHealthcare, you may have until August 2018 to fulfill your obligation under ACA. Contact the Student Insurance office or consult the website at https://www.uhcsr.com/Illinois for more information.
Chicago Students: If you were eligible for health insurance coverage through Campus Care, but waived coverage and do not have any other health coverage through a parent, spouse, or family member, then you can request reinstatement to satisfy your individual responsibility under ACA. If you remain eligible for Campus Care, you may have until September 2018 to fulfill your obligation under ACA. Contact Campus Care or consult the website at http://www.uic.edu/hsc/campuscare/feesdates.html for fees, deadlines, and enrollment forms.
Springfield Students: If you were eligible for health insurance coverage through Academic Health Plans, but waived coverage and do not have any other health coverage through a parent, spouse, or family member, then you can apply for reinstatement for upcoming semesters, or you may enroll within 31 days of experiencing a qualifying event, to satisfy your individual responsibility under ACA. If you remain eligible for Academic Health Plans, you may have until August 2018 to fulfill your obligation under ACA. Contact the Student Insurance office or consult the website at https://www.uis.edu/humanresources/studentinsurance/ for more information.
If you decide to remain uninsured, you and any uninsured dependents will be required to pay a fee when filing your income taxes. The IRS administers the fee, which increases every year.
What happens if I do not comply with ACA’s individual responsibility requirement?
If you do not have coverage in 2018, you must pay a fee when you file your income taxes. Final 2018 fee rates are not yet available; 2017 fees were $695 per adult ($347.50 per child) or 2.5% of yearly household income, whichever is higher. The maximum fee for a family is $2,085, or the amount of total yearly premium for the national average price of a Bronze plan sold through the Marketplace. These fees will increase annually.
I am already covered by a plan that meets the minimum essential coverage requirements. Do I have to do something with the Marketplace to prove I have insurance?
According to the Internal Revenue Service (IRS), you will not have to prove coverage (or pay any fees) until you file your 2018 federal income tax return in 2019. For more information, please visit the IRS website. For the tax filing thresholds for most taxpayers, see this chart. Please consult with your tax advisor regarding your tax filing status.
If I have the student health insurance plan, do I have to get something else too?
If you maintain coverage under a student health insurance plan, you have satisfied your individual responsibility under ACA for yourself. If you have dependent family members, you must also ensure that they have coverage that meets ACA minimum essential coverage requirements.
What are the deadlines for obtaining coverage for me and any dependent family members?
If you are not eligible for coverage through CMS or the University’s RSL BasicCare Program based on your University employment and you do not otherwise have health insurance coverage through another employer, a spouse, parent, or other family member, then you have the option to purchase health insurance through the Marketplace during the annual open enrollment period that typically begins each November. If you have life changes, like losing health coverage or having a baby/adopting a child, or qualify for Medicaid or CHIP, you may qualify for a special enrollment period.
Eligible for RSL BasicCare Program: If you were eligible for coverage under the RSL BasicCare Program but declined that coverage and do not have any other health coverage through a spouse or family member, you can elect coverage during the annual open enrollment period that typically occurs in November. If you experience a qualifying event, you may elect coverage earlier than the open enrollment period. Please not that the ACA individual responsibility requirement is NOT a qualifying event for RSL BasicCare Program.
Eligible for Student Insurance: If you are a student who plans to continue academic enrollment at the University, then you may have until August 2018 to elect health coverage under the student insurance plan. Contact your university student insurance office for information and deadlines.
Can my dependents be covered through the Marketplace if I am not getting insurance through the Marketplace?
Based on the currently available information, health insurance plans will be available through the Marketplace to provide insurance coverage for your dependent family members. Please contact the Marketplace at HealthCare.gov for coverage in any state or go directly to GetCoveredIllinois.gov for coverage in the State of Illinois for more information.
I am a former student who recently graduated and I am now covered under my parent’s or my new employer’s insurance. Do I need to get coverage through the Marketplace?
No, as long as your parent’s or new employer’s plan provides minimum essential coverage, you are meeting your individual responsibility requirement under ACA. You can contact that plan directly to find out if it meets the minimum essential coverage requirements.