skip navigation
Search Help
Navigation Help

Tax Map Index
ABCDEFGHI
JKLMNOPQR
STUVWXYZ#

International
Tax Topic Index

Affordable Care Act
Tax Topic Index

Exempt Organization
Tax Topic Index

FAQs
Forms
Publications
Tax Topics
Worksheets

Comments
About Tax Map

IRS.gov Website
Instructions for Form 8965
taxmap/instr/i8965-008.htm#TXMP6567e06b

Shared Responsibility Payment

rule
taxmap/instr/i8965-008.htm#en_us_publink100032420

To Figure Your Shared Responsibility Payment(p14)

rule
taxmap/instr/i8965-008.htm#TXMP308776c9

 Step 1   All Filers

1.  Can someone claim you as a dependent?
Yes. Stop.  You do not owe a shared responsibility payment. Do not check the box on line 6a of Form 1040 or Form 1040A. If you file Form 1040EZ, check the box on line 5.
No.  Continue...
2.  Did you, your spouse (if filing jointly), and everyone you claimed or could have claimed as a dependent have qualifying health coverage for every month of 2015*?
Yes. Stop.  You do not owe a shared responsibility payment. Check the Full-year coverage checkbox on Form 1040, line 61; Form 1040A, line 38; or Form 1040EZ, line 11.
No.  Continue...
*You can check the Full-year coverage box if you had or adopted a child during the year, or a member of your tax household died during the year, as long as that person had qualifying health care coverage for every month he or she was a member of your tax household.
3.  Do you, your spouse (if filing jointly), or anyone else you claimed or could have claimed as a dependent have qualifying health coverage or qualify for a coverage exemption for any month in 2015?
Yes. Stop.   Claim any coverage exemption you qualify for on Form 8965. Skip questions 4 and 5; go to Worksheet A.
No.  Continue...
4.  Did you elect not to claim a dependent you could have claimed?
Yes. Stop.   Skip question 5; go to Worksheet A.
No.  Continue...
5.  Did you, your spouse (if filing jointly), or any of your dependents turn 18 during 2015?
Yes.  Go to  Worksheet A.
No.  Go to Step 2.
taxmap/instr/i8965-008.htm#TXMP460bc36e

 Step 2   Flat Dollar Amount

1.  Multiply $325 for each person for whom you claimed an exemption on line 6d of Forms 1040 or 1040A who was at least 18 years old.* Multiply $325 by each person for whom you did not check a box on Form 1040EZ, line 5, who is at least 18 years old.
 1
*For purposes of figuring the shared responsibility payment, an individual is considered under age 18 for an entire month if he or she didn't turn 18 before the first day of the month. An individual turns 18 on the anniversary of the day the individual was born.
2.  Multiply $162.50 for each person for whom you claimed an exemption on line 6d of Forms 1040 or 1040A who was under age 18. Multiply $162.50 by each person for whom you did not check a box on Form 1040EZ, line 5, who is under age 18.
 2
3.  Add lines 1 and 2.
 3
4.  Enter the smaller of line 3 or $975 here and on line 1 of the Shared Responsibility Payment Worksheet. Go to Step 3.
 4
taxmap/instr/i8965-008.htm#TXMP769dea99

 Step 3   Household Income

1.  Enter the amount from Form 1040, line 38; Form 1040A, line 21; or Form 1040EZ, line 4.
 1
2.  Did you receive any tax-exempt interest?
Yes.  Enter the amount from Form 1040, line 8b; Form 1040A, line 8b; or the amount entered in the space to the left of Form 1040EZ, line 2.
No.  Continue...
 2
3.  Did you attach Form 2555 or Form 2555-EZ?
Yes.  Enter the amount from Form 2555, lines 45 and 50; or Form 2555-EZ, line 18.
No.  Continue...
 3
4.  Did you claim any dependents?
Yes.  Continue...
No. Stop.  Add lines 1 through 3. This is your household income. Enter the result on Step 4, line 1.
5.  Were any of the dependents you claimed required to file a return?
Yes.  Complete questions 1 through 3 for each dependent with a filing requirement for whom you did not attach Form 8814. Enter the total here.
No. Stop.  Add lines 1 through 3. This is your household income. Enter the result on Step 4, line 1.
 5
6.  Did you attach Form 8814?
Yes.  Continue...
No. Stop.  Add lines 1, 2, 3, and 5. This is your household income. Enter the result on Step 4, line 1.
7.  Is Form 8814, line 4 more than $1,050?
Yes.  Add the amount from Form 8814, line 1b and the smaller of Form 8814, line 4 or 5.
No.  Continue...Enter -0- below.
 7
8.  Add lines 1, 2, 3, 5, and 7. This is your household income. Enter the result on Step 4, line 1.
 8
taxmap/instr/i8965-008.htm#TXMP574bfda4

 Step 4   Percentage Income Amount

1.  Enter your household income from Step 3.
 1
2.  Were you or your spouse (if filing jointly) born before January 2, 1951?
Yes.  Skip question 3. Find your filing threshold on the Filing Thresholds For Most People chart and enter it both here and on line 4.
No.  Go to question 3.
 2
3.  Enter the amount listed below for your filing status.
  Single—$10,300
  Head of household—$13,250
  Married filing jointly—$20,600
  Married filing separately—$4,000
  Qualifying widow(er) with dependent child—$16,600
 3
4.  Enter the amount from line 2 or 3.
 4
5.  Subtract line 4 from line 1.
 5
6.  Is the amount on line 5 zero or less?
Yes. Stop.  You do not owe a shared responsibility payment. Complete Form 8965 by checking the Yes box on line 7a.
No.  Continue...
7.  Multiply line 5 by 2.0% (0.02). This is your percentage of income amount.
 7
8.  Were you required to complete Worksheet A?
Yes.  Continue...Go to  Worksheet B. 
No. Stop.  Enter the amount from line 7 on line 2 of the Shared Responsibility Payment Worksheet and complete line 3 of that worksheet.
taxmap/instr/i8965-008.htm#TXMP2cc331a2

 Step 5   National Average Bronze Plan Premium

1.  Were you required to complete Worksheet A?
Yes.  Continue...
No.  Skip question 2; Go to question 3.
2.  Multiply $207* by the number on Worksheet A, line 8. Enter the result here and on line 4 of the Shared Responsibility Payment Worksheet. Skip question 3 and complete line 5 of the Shared Responsibility Payment Worksheet.
 2
*$207 is the 2015 national average premium for a bronze level health plan available through the Marketplace for one individual for one month.
3.  Enter on line 4 of the Shared Responsibility Payment Worksheet, the amount below that corresponds to the total number of exemptions you claimed on line 6d of Form 1040 or Form 1040A. If you filed Form 1040EZ, enter the amount below that corresponds to the number of boxes left unchecked on line 5 of Form 1040EZ. Then complete line 5 of the Shared Responsibility Payment Worksheet.
  1 exemption—$2,484
  2 exemptions—$4,968
  3 exemptions—$7,452
  4 exemptions—$9,936
  5 or more exemptions—$12,420
 
 Shared Responsibility Payment Worksheet 
  
  
      
 1.Enter the flat dollar amount1 
 2.Enter the percentage income amount2 
 3.Enter the larger of line 1 or line 23 
 4.Enter the National Average Bronze Plan Premium4 
 5.Enter the smaller of line 3 or line 4 here and on Form 1040, line 61; Form 1040A; line 38; or Form 1040EZ, line 11. This is your shared responsibility payment5 
 
Worksheet A
Use this worksheet if you were referred here from Step 1 under Shared Responsibility Payment. After completing the worksheet, go to Step 3 under Shared Responsibility Payment. If everyone in your tax household had either minimum essential coverage or a coverage exemption for every month during 2015, stop here. You do not owe a shared responsibility payment.
Complete the monthly columns by placing "X's" in each month in which you or another member of your tax household had neither minimum essential coverage nor a coverage exemption.
NameJanFebMarAprMayJunJulAugSepOctNovDec
             
             
             
             
             
             
1.Total number of X's in a month. If 5 or more, enter 5            
2.Total number of X's in a month for individuals 18 or over*            
3.One-half the number of X's in a month for individuals under 18*            
4.Add lines 2 and 3 for each month            
5.Multiply line 4 by $325 for each month. If $975 or more, enter $975            
6.Add the amounts for each month on line 5
7.Divide line 6 by 12.0. This is your flat dollar amount. Enter this amount on line 1 of the Shared Responsibility Payment Worksheet.
8.Add the amounts entered for each month on line 1. Go to Step 3
*For purposes of figuring the shared responsibility payment, an individual is considered under 18 for an entire month if he or she didn't turn 18 before the first day of the month. An individual turns 18 on the anniversary of the day the individual was born. For example, someone born on March 1, 2000, is considered age 18 on March 1, 2018, and, therefore, isn't considered age 18 for purposes of the shared responsibility payment until April 2018.
Worksheet B
caution Do not complete this worksheet unless you were directed here in Step 4 under Shared Responsibility Payment.
For each month, you must determine if the amount on line 5 of Worksheet A is less than the amount on line 7 of Step 4 under Shared Responsibility Payment * (a)(b)(c)
Enter the amount from line 5Enter the amount from Step 4, line 7Enter the larger of column (a) or column (b)
1.January   
2.February   
3.March   
4.April   
5.May   
6.June   
7.July   
8.August   
9.September   
10.October   
11.November   
12.December   
13.Add the amounts in column (c) 
14.Divide line 13 by 12.0. Enter the result on lines 2 and 3 of the Shared Responsibility Payment Worksheet. Go to Step 5 
*If the amount on line 1 of Worksheet A is -0- for any month, leave all columns of this worksheet blank for that month.
Filing Thresholds For Most People
IF your filing status is...AND at the end of 2015 you were*...THEN you must file a tax return if your gross income** is more than...
SingleUnder 65$10,300
65 or older$11,850
Head of HouseholdUnder 65$13,250
65 or older$14,800
Married Filing Jointly***Under 65 (both spouses)$20,600
65 or older (one spouse)$21,850
65 or older (both spouses)$23,100
Married Filing SeparatelyAny age$4,000
Qualifying Widow(er) with Dependent childrenUnder 65$16,600
65 or older$17,850
*If you were born on January 1, 1951, you are considered to be age 65 at the end of 2015. (If your spouse died in 2015 or if you are preparing a return for someone who died in 2015, see Pub. 501.)
**Gross income means all income you received in the form of money, goods, property, and services that isn't exempt from tax, including any income from sources outside the United States. It also includes gain from the sale of your main home, even if you can exclude part or all of it. Include only the taxable part of social security benefits (Form 1040, line 20b; Form 1040A, line 14b). Also include gains, but not losses, reported on Form 8949 or Schedule D. Gross income from a business means, for example, the amount on Schedule C, line 7, or Schedule F, line 9. But, in figuring gross income, don't reduce your income by any losses, including any loss on Schedule C, line 7, or Schedule F, line 9.
***If you did not live with your spouse at the end of 2015 (or on the date your spouse died) and your gross income was at least $4,000, you must file a return regardless of your age.