Covered California and ACA related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the ACA and Covered California knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

Exempt from Individual Mandate?

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Question: I understand most of the exemptions from the Individual mandates but need clarification on these. Individuals who cannot afford coverage (i.e. required contribution exceeds 8% of household income,) Individual in a hardship situation, and individual with income below the tax filing threshold threshold.

Answer: Here is the list of exemptions from the individual mandate:

  • coverage is unaffordable (excedes 9.5% of household income;
  • they do not meet the filing threshold for purposes of income tax filing;
  • they are Native Americans;
  • they have a short lapse in coverage (less than three months since they had minimum essential coverage);
  • they have suffered a hardship;
  • they are a dependent; or
  • they reside outside of the United States.



I am offered medical insurance by my employer, but I have not had to enroll in it in the past since I am covered by my wife’s health insurance with Kaiser Permanente.

Can I stay on Kaiser Permanente health insurance coverage through my wife’s employer?

Thank you, Roger Stephens

Do I have to have insurance if I am not working, not filing 2013 taxes and a full-time student?

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