§ 44-30-101. Requirements concerning qualifying health insurance coverage.
(a) Definitions. For purposes of this section:
(1) “Applicable individual” has the same meaning as set forth in 26 U.S.C. § 5000A(d).
(2) “Minimum essential coverage” has the same meaning as set forth in 26 U.S.C. § 5000A(f).
(3) “Shared responsibility payment penalty” means the penalty imposed pursuant to subsection (c) of this section.
(4) “Taxpayer” means any resident individual, as defined in § 44-30-5.
(b) Requirement to maintain minimum essential coverage. Every applicable individual must maintain minimum essential coverage for each month beginning after December 31, 2019.
(c) Shared responsibility payment penalty imposed for failing to maintain minimum essential coverage. As of January 1, 2020, every applicable individual required to file a personal income tax return pursuant to § 44-30-51, shall indicate on the return, in a manner to be prescribed by the tax administrator, whether and for what period of time during the relevant tax year the individual and his or her spouse and dependents who are applicable individuals were covered by minimum essential coverage. If a return submitted pursuant to this subsection fails to indicate that coverage was in force or indicates that any applicable individuals did not have coverage in force, a shared responsibility payment penalty shall hereby be assessed as a tax on the return.
(d) Shared responsibility payment penalty calculation. Except as provided in subsection (e), the shared responsibility payment penalty imposed shall be equal to a taxpayer’s federal shared responsibility payment for the taxable year under section 5000A of the Internal Revenue Code of 1986, as amended, and as in effect on the 15th day of December 2017.
(e) Exceptions.
(1) Penalty cap. The amount of the shared responsibility payment penalty imposed under this section shall be determined, if applicable, using the statewide average premium for bronze-level plans offered through the Rhode Island health benefits exchange rather than the national average premium for bronze-level plans.
(2) Hardship exemption determinations. Determinations as to hardship exemptions shall be made by the exchange under § 42-157-11.
(3) Religious conscience exemption determinations. Determinations as to religious conscience exemptions shall be made by the exchange under § 42-157-11.
(4) Taxpayers with gross income below state filing threshold. No penalty shall be imposed under this section with respect to any applicable individual for any month during a calendar year if the taxpayer’s household income for the taxable year as described in section 1412(b)(1)(B) of the Patient Protection and Affordable Care Act is less than the amount of gross income requiring the taxpayer to file a return as set forth in § 44-30-51.
(5) Out of state residents. No penalty shall be imposed by this section with respect to any applicable individual for any month during which the individual is a bona fide resident of another state.
(6) Individual on Medicaid. No penalty shall be imposed by this section with respect to any applicable individual who is enrolled in the Medicaid program through December 31, 2023.
(f) Health insurance market integrity fund. The tax administrator is authorized to withhold from any state tax refund due to the taxpayer an amount equal to the calculated shared responsibility payment penalty and shall place those amounts in the health insurance market integrity fund created pursuant to § 42-157.1-5.
(g) Deficiency. If, upon examination of a taxpayer’s return, the tax administrator determines there is a deficiency because any refund due to the taxpayer is insufficient to satisfy the shared responsibility penalty or because there was no refund due, the tax administrator may notify the taxpayer of the deficiency in accordance with § 44-30-81 and interest shall accrue on the deficiency as set forth in § 44-30-84. All monies collected on the deficiency shall be placed in the health insurance market integrity fund created pursuant to § 42-157.1-5.
(h) Application of federal law. The shared responsibility payment penalty shall be assessed and collected as set forth in this chapter and, where applicable, consistent with regulations promulgated by the federal government, the exchange, and/or the tax administrator. Any federal regulation implementing section 5000A of the Internal Revenue Code of 1986, as amended, and in effect on the 15th day of December 2017, shall apply as though incorporated into the Rhode Island code of regulations. Federal guidance interpreting these federal regulations shall similarly apply. Except as provided in subsections (j) and (k) of this section, all references to federal law shall be construed as references to federal law as in effect on December 15, 2017, including applicable regulations and administrative guidance that were in effect as of that date.
(i) Unavailability of federal premium tax credits. For any taxable year in which federal premium tax credits available pursuant to 26 U.S.C. § 36B become unavailable due to the federal government repealing that section or failing to fund the premium tax credits, the shared responsibility payment penalty under this section shall not be enforced.
(j) Imposition of federal shared responsibility payment. For any taxable year in which a federal penalty under section 5000A of the Internal Revenue Code of 1986 is imposed on a taxpayer in an amount comparable to the shared responsibility payment penalty assessed under this section, the state penalty shall not be enforced.
(k) Agency coordination. Where applicable, the tax administrator shall implement this section in consultation with the office of the health insurance commissioner, the office of management and budget, the executive office of health and human services, and the Rhode Island health benefits exchange.
History of Section.
P.L. 2019, ch. 88, art. 11, § 5; P.L. 2023, ch. 79, art. 4, § 4, effective June 16,
2023.