DIABETES EXEMPTION ENDS. On February 21, the FMCSA formally announced the immediate end of its exemption process for the medical certification of insulin-dependent truck and bus drivers. The agency said diabetic drivers who possess a medical card will need to renew when their cards expire, and those seeking a medical card in the future will be certified to drive only if they get okayed by an agency-certified medical examiner. FMCSA withdraws its September 3, 2003 notice concerning exemptions for certain individuals with insulin-treated diabetes mellitus. The exemption process will remain in effect for drivers with epilepsy and seizure disorders, as well as for hearing and vision disorders.
The revised diabetes standard allows certified examiners, in consultation with a driver’s treating doctor, to determine whether to approve an insulin-treated individual for a medical certificate to drive a commercial motor vehicle in interstate commerce for up to twelve months. Obtaining certification under the new standard should be much less burdensome in terms of time and resources than the previous lengthy process of applying for and maintaining an exemption. Therefore, the FMCSA has determined that an exemption program for diabetes is no longer necessary.
The new rule eliminates a two- or three-month delay for the estimated 4,700 diabetic drivers with medical cards to navigate a burdensome process requesting an exemption from the FMCSA after being automatically disqualified for having the condition. While waiting for the exemption, diabetic drivers were not allowed to drive, often resulting in loss of income. Under the old rule, about 76% of drivers that applied received an exemption.
Despite dropping the exemption process, a diabetic driver still must convince his treating doctor and medical examiner that his or her diabetes is under control. Not only are diabetic drivers required to keep blood glucose self-monitoring records for at least the preceding three months, they must detail how many times per day they test their blood glucose, reveal if they have experienced any severe hypoglycemic episodes in the past three months, and if they have taken a Hemoglobin A1C measurement intermittently over the past twelve months.
Although the final rule outlining the requirements for diabetic exemptions technically ended the program in September, FMCSA said they were still clearing out drivers requesting exemptions. Many drivers are not aware of their diabetes disorder, and many who suspect they have the condition do not get treatment. As a group, the number of truck drivers in the U.S. with diabetes is about 50% above the national average – about one of every seven, primarily due to sedentary lifestyles and poor eating choices.
NO MORE PENALTIES. Thanks to the latest tax reform, beginning in 2019, the penalty for not having health insurance (which the government calls the “individual shared responsibility payment”) will no longer apply. The elimination of this penalty as of 2019 does not impact the health care subsidy for low-income families, which is known as the premium tax credit, and which is available for policies acquired through a government insurance marketplace. This elimination also does not affect the penalties assessed on employers that do not offer affordable insurance to employees and that have 50 or more full-time employees. However, the penalty still applies for individual taxpayers who did not have the minimum essential health coverage for 2018 and is the greater of the sum of the family’s flat dollar amounts or 2.5% of the amount by which the household’s income exceeds the income-tax-filing threshold.
For 2018, the flat dollar amounts are $695 per year ($57.92 per month) for each adult and $347.50 per year ($28.96 per month) for each child under the age of 18. The maximum family penalty using this method is $2,085 per year ($173.75 per month). As an example, say that a family of four (2 adults and 2 kids) has a household income that exceeds the filing threshold by $100,000. This family would have a maximum penalty equal to the greater of the flat dollar amount ($695+$695+$347.50+$347.50=$2,085) or 2.5% of the income amount (2.5%×$100,000=$2,500). Thus, the maximum penalty would be $2,500. However, the penalties are applied separately per month, and they do not apply in a given month if certain exceptions are met.
There are a number of exceptions to the penalty, as listed below. For details related to qualifying for any of these exceptions, please give your CPA a call. Some of the penalty exceptions apply to the entire year, and some only apply to a specific month in the year. If penalty relief applies to a specific month, it also applies to the months just preceding and following that month. Following are the various exceptions and the code number the government has assigned to that exception.
Income below the tax-filing threshold (no code). Coverage considered unaffordable (A). Short coverage gap (B). Certain U.S. citizens or resident aliens living abroad (C). Member of a health care ministry (D). Member of an Indian tribe (E). Incarcerated (F). Aggregate self-only coverage unaffordable (G). Resident of a state that did not expand Medicaid (G). Member of household born or adopted during the year (H). Member of household died during the year (H). Member of certain religious sects (ECN). Ineligible for Medicaid based on a state decision not to expand Medicaid (ECN). Coverage considered unaffordable based on income (ECN). ECN stands for “Exception Certification Number” which must be applied for and provided through the government marketplace.
In addition to the general exceptions listed above, hardship exemptions are also available, including: being homeless; evicted or facing eviction because of foreclosure; received a shut-off notice from a utility company; experienced domestic violence; death of a family member; fire, flood or other disaster that caused substantial damage; bankruptcy; unpaid medical expenses causing substantial debt; expenses to care for an ill, disabled or aging family member; claiming a child who was denied Medicaid; financial or domestic circumstances, including an unexpected natural or human-caused event, causing unexpected expenses, which prevented obtaining coverage; and the expense of purchasing a qualified health plan would have caused the taxpayer to experience serious deprivation of food, shelter, clothing or other necessities.
To claim a hardship exemption, an individual must obtain an ECN through the normal application process, or for 2018, they may self-certify the hardship (retain documentation that demonstrates qualification for the exemption in case it is later challenged by the IRS). A person is eligible for a hardship exemption for at least the month before, the month(s) during and the month after the specific event or circumstance that created the hardship.