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2023 Premium Tax Credits & Employer Mandate Updates

Posted on August 8th, 2022

The Internal Revenue Service (IRS) recently issued Revenue Procedure 2022-34 which includes important details as it relates to Advanced Premium Tax Credits (APTCs) on Health Insurance Marketplaces and “affordable coverage” as it relates to the Employer Mandate for plan years starting in 2023.
 

Advanced Premium Tax Credits (APTCs)

 
The following table illustrates the maximum premium contribution for the second lowest cost Silver plan (SLCSP) available on a federal or state Health Insurance Marketplace.

 

 
Please note that the expanded eligibility for APTCs authorized under the American Rescue Plan Act (ARPA) expires at the end of 2022 unless Congress passes a law to extend it further. That means eligibility for APTCs will only be available to individuals and families with household earnings at or below 400% of the FPL; however, it does appear that there is a strong likelihood an extension will be passed in the coming weeks.
 

Employer Mandate Affordability Percentage

 
Coverage will be considered affordable for plan years starting in 2023 if an employee has to pay no more than 9.12% of their income for the (self-only) lowest priced group health plan available to them. This is a decrease from the current 9.61% used for 2022 plan years.
 
 
 
 

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