Affordable Health Coverage

Affordable Health Coverage

Wed, 12/02/2020 - 15:33

A health insurance plan available through your employer is considered "affordable" if the cost to cover only the employee does not exceed 9.78% of the employee’s household income.

♦ 9.83% in 2021.

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?