280 - Department of Revenue - Chapter 20 - Division of Taxation - Subchapter 55 - Personal Income Tax - Part 15 - Implementation of the Rhode Island Individual Health Insurance Mandate

Sep 19, 2026

Rules and Regulations implement Rhode Island’s individual health insurance mandate under R. I. Gen. Laws Title 44. Beginning after December 31, 2019, Rhode Island residents must maintain minimum essential coverage or face a shared responsibility payment penalty. Applicable entities must meet reporting requirements, and referenced Federal law is applied as in effect on December 15, 2017. The rules define “applicable entity” and “applicable individual,” authorize Tax Administrator authority, set application and severability standards, and describe exemption categories, including religious conscience and health care sharing ministries.

LanguageEnglish

CategoryGeneral

FormatPDF

Pages10

Reading Time4 min

AccessFree to download

15.1 Purpose

15.2 Authority

15.3 Application

15.4 Severability

15.5 Referenced Materials

15.6 Definitions

A. “Applicable entity”

B. “Applicable individual”

280-RICR-20-55-15 TITLE 280 – DEPARTMENT OF REVENUE CHAPTER 20 – DIVISION OF TAXATION SUBCHAPTER 55 – PERSONAL INCOME TAX PART 15 – Implementation of the Rhode Island Individual Health Insurance Mandate 15.1 Purpose The purpose of these Rules and Regulations is to implement various provisions of R. I. Gen. Laws Title 44 as they relate to the individual health insurance mandate. Under R. I. Gen. Laws § 44-30-101, Rhode Island residents are required, beginning after December 31, 2019, to maintain minimum essential coverage or be subject to a tax known as the shared responsibility payment penalty. Rhode Island’s individual health insurance mandate is based, in part, on the Federal mandate established under the Patient Protection and Affordable Care Act (Pub. Law 111-148) . Under R. I. Gen. Laws § 44-30-102, applicable entities providing minimum essential coverage must comply with reporting requirements and make a report whether an applicable individual maintains minimum essential coverage. 15.2 Authority These Rules and Regulations are promulgated pursuant to R. I. Gen. Laws §§ 44- 1-4, 44-30-95(a), and 44-30-101(h), which specifically authorize the Tax Administrator to prescribe Regulations for the proper administration and enforcement of tax laws, certain requirements for qualifying health insurance coverage, and the shared responsibility payment penalty. These Rules and Regulations have been prepared in accordance with the requirements of the Rhode Island Administrative Procedures Act, R. I. Gen. Laws § 42-35-1 et seq. 15.3 Application These Rules and Regulations shall be liberally construed so as to permit the Tax Division the authority to effectuate the purpose of R. I. Gen. Laws § 44-30-1 et seq. and other applicable State laws and Regulations related to the individual health insurance mandate. 15.4 Severability If any provision of these Rules and Regulations, or the application thereof to any person or circumstances, is held invalid by a court of competent jurisdiction, the validity of the remainder of the Rules and Regulations shall not be impaired or affected thereby. 15.5 Referenced Materials In accordance with R. I. Gen. Laws § 44-30-101(h), for the purposes of determining the process and procedure of shared responsibility payment penalty exemptions, references to Federal law shall be construed as references to Federal law as in effect on December 15, 2017. 15.6 Definitions A. “Applicable entity”means any of the following, as defined in R. I. Gen. Laws § 44- 30-102: 1. An employer or other sponsor of an employment-based health plan that offers employment-based minimum essential coverage to any resident of Rhode Island. 2. The Rhode Island Medicaid single State agency providing Medicaid or Children’s Health Insurance (CHIP) coverage. 3. Carriers licensed or otherwise authorized by the Rhode Island Office of the Health Insurance Commissioner to offer health coverage. B. “Applicable individual” has the same meaning as set forth in 26 U.S.C. § 5000A(d), as in effect on December 15, 2017: 1. In general. The term "applicable individual" means, with respect to any month, an individual other than an individual described in §§ 15.6(B)(2),(3), or (4) . 2. Religious exemptions a. Religious conscience exemption. Such term shall not include any individual for any month if such individual has in effect an exemption under § 1311(d)(4)(H) of the Patient Protection and Affordable Care Act (42 U.S.C. § 18031(d)(4)(H)) which certifies that such individual is: (1) A member of a recognized religious sect or division thereof which is described in 26 U.S.C. § 1402(g)(1); and (2) An adherent of established tenets or teachings of such sector division as described in such section. b. Health care sharing ministry (1) In general. Such term shall not include any individual for any month if such individual is a member of a health care sharing ministry for the month. (2) Health care sharing

FAQs

What is the purpose of Part 15 under this regulation?

The purpose is to implement provisions of Rhode Island General Laws Title 44 related to the individual health insurance mandate and the shared responsibility payment penalty.

Who has authority to promulgate these Rules and Regulations?

They are promulgated under specific authorizations in R. I. Gen. Laws, which authorize the Tax Administrator to prescribe regulations for administration, enforcement, qualified health coverage requirements, and the shared responsibility payment penalty.

What does the regulation define as an “applicable entity” and “applicable individual”?

“Applicable entity” includes employers or sponsors of employment-based plans, the Rhode Island Medicaid single state agency, and licensed or authorized carriers. “Applicable individual” uses the meaning in 26 U.S.C. § 5000A(d) and includes exclusions such as certain religious exemptions, individuals not lawfully present, and incarcerated individuals (with a limited exception).

Sep 19, 2026

Upload by Caleb Sterling