State Tax Filing

State law requires California residents to either maintain minimum essential coverage (sometimes called the “individual mandate”), pay a penalty (called the “individual shared responsibility penalty” on Form FTB 3853), or get an exemption.

While completing your state taxes, you may need to use Form FTB 3853 to see if you owe a penalty, or to claim exemptions from the state individual mandate, on your California state tax return.

The Form FTB 3853 may require you to fill out the Marketplace Coverage Affordability Worksheet to find your lowest-cost Bronze plan and second-lowest-cost Silver plan premiums. To find these amounts, use our calculator and enter the gross monthly premium payment for the lowest-cost Bronze plan and second-lowest-cost Silver plan in the form.

Step-by-step instructions and more information can be found here.

Your situation may vary, and the information above is not intended as tax advice. Please consult the California Franchise Tax Board or a tax advisor if you have questions about how to use this form when preparing your taxes, your penalty amount, or your tax return.

If you need help, please contact the Covered California Service Center. Representatives can help you calculate the lowest-cost Bronze plan and second-lowest-cost Silver plan premium amounts but cannot provide tax advice. To view the forms referenced here and get more detailed instructions for how to complete these forms, visit the Franchise Tax Board.