Affordable Health Coverage

Affordable Health Coverage

Sat, 09/24/2022 - 15:33

A health insurance plan available through your employer is considered "affordable" if the cost to cover only the employee does not exceed 9.12% of the employee’s household income in 2023.

The plan must also meet the “minimum value” standard established by the Affordable Care Act.

If your employer’s plan meets both requirements, you are not eligible for a premium tax credit if you should decide to buy a Marketplace insurance plan instead.

♦ The plan used to define affordability is your employer’s lowest priced “self-only” plan — meaning a plan covering only the employee, not dependents. This is true even if you’re enrolled in a plan that costs more or covers dependents.

• The cost is the amount the employee would pay for the insurance for him or herself.

♦ The employee’s total household income is used. Total household income does include income from everyone in the household who is required to file a tax return. (This part of the ACA is called the "family glitch." It is hoped Congress will correct this.

Related content

Affordable Coverage

• What is affordable coverage?

• How is it calculated?

• What is minimum value standard?

• Can my family buy a plan from the Marketplace if I have insurance through my company?