Can Spouses Receive Premium Tax Credits After Employer-Insurance Enrollment?

Many of us have experienced a change in jobs or an update to our family members’ employment status, and we wonder how the change would affect our healthcare insurance.

The Affordable Care Act (ACA) allows for spouse to obtain health insurance through their employer while the other spouse stays on their own health plan from the marketplace and receives premium tax credits, but there are some conditions that must be met:

– The employer-based coverage must not be affordable for the spouse.
An affordable plan is one that costs less than 9.12% of the household income.

– The spouse must not be eligible for other health insurance.
This includes coverage through Medicaid, Medicare, or other government programs.

– The spouse must meet all other eligibility requirements for the premium tax credit.
This includes having a household income below a certain level.

If you meet all of these conditions, the spouse can stay on their marketplace plan and receive the premium tax credit.

But how do you know if the insurance offered by your employer is affordable? Reach out to your human resource department and obtain the premium cost for employee only and employee with spouse. Take the cost for employee with spouse and multiply it by 12 to get the yearly cost, then divide it by the household income and check if the result is less than 9.12%.
If you are unable to understand the plan or the math calculation, we recommend reaching out to licensed insurance agents in your area to help you with this situation.

To apply for the premium tax credit, you must file Form 8962, Premium Tax Credit, with your tax return. You can get more information about the premium tax credit on the [IRS website]( or by speaking with a tax professional.

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