Avoid Marketplace Penalties for ACA Plans with Smart Enrollment Choices
Beginning a new job can bring about many changes, including navigating the complexities of health insurance. If you’ve recently been hired but find your employer’s insurance costs too high, you may wonder if seeking an alternative through the Marketplace will result in penalties.
Understanding the Employer Coverage Mandate
The Affordable Care Act (ACA) includes an employer coverage mandate, which requires certain employers to offer affordable health insurance to their full-time employees. Employers must also contribute a minimum amount to the plan. If your employer meets these requirements, you are generally not eligible for ACA subsidies.
The “Family Glitch” Exception
However, there is an exception known as the “family glitch.” This loophole allows individuals to receive ACA subsidies even if their employer offers coverage, but only if the employer-sponsored plan is not affordable for family members.
For 2023, an employer-sponsored plan is considered affordable for family coverage if the employee’s share of the premium составляет менее 9.83% of their household income. If your employer’s family plan exceeds this threshold, you may qualify for ACA subsidies.
Determining Your Options
To determine your eligibility for ACA subsidies, you should:
Contact your employer’s benefits department to confirm the cost of family coverage.
Calculate your household income based on your and your child’s combined income.
Use the Marketplace subsidy calculator to estimate potential savings.
Avoid Penalties and Find the Right Plan
If you are eligible for ACA subsidies, you can avoid penalties by enrolling in a Marketplace plan. When you enroll, you will be asked to attest that you are not eligible for employer-sponsored coverage or that the coverage is not affordable for your family.
By carefully considering your options and utilizing ACA provisions like the “family glitch,” you can secure affordable health insurance coverage for yourself and your child without facing any penalties. Seeking the guidance of a licensed agent can also provide valuable insights and ensure your enrollment process is smooth and penalty-free.
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