Subsidies will be available for employees wishing to decline their employer sponsored health plan, and instead enroll on a plan within the health insurance exchange. However, if an employee decides to purchase a plan within the health insurance exchange but their employer offers coverage that is qualified and affordable, the employee cannot qualify for a subsidy even if their income is less than 400% of the federal poverty level.
Qualified and Affordable Coverage Definitions:
- Qualified is defined as the offered plan covers at least 60% of the employee’s health care costs
- Affordable is defined as the household’s share of the employee’s premium does not exceed 9.5% of income. This amount is solely based on the “employee only” portion of the family, and does not apply to the entire family rate.
Employers are required by law via the Affordable Care Act to provide their employee with the information needed for the exchange. This includes a written notice about the exchange, contact information, as well as their current policy so it can be determined whether or not the employer coverage is qualified. If an employee still wishes to enroll on a plan through the exchange even though their employer coverage is qualified and affordable, they risk losing any employer contributions and cannot use pre-tax dollars to cover their premiums.
More about Employer Notices in the Health Exchange Marketplaces:
Health Exchange Quote Insurance agents are well versed in all matters regarding small business plans. Let us help you and your employees find the best options for health coverage. Call us today!
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