Subsidy
People who have access to affordable coverage from their employer are ineligible to receive subsidies through the Health Insurance Marketplace, also known as the Exchange. For 2017, coverage is considered affordable if the employee’s share of premium for self-only coverage is 9.69% or less of their household modified adjusted gross income.
The open enrollment period (OEP) in the individual market will begin on November 1, 2015 and end on January 31, 2016.
During this time period, just about anyone can enroll or make plan changes to coverage in the individual market.
Here are some helpful reminders as the OEP approaches:
Who is eligible for a subsidy?
There are a number of factors that affect eligibility or can disqualify an individual for a subsidy, such as:
On March 4, 2015 the U.S. Supreme Court heard oral arguments in regards to the King vs. Burwell case, which is the most significant challenge to the Affordable Care Act (ACA) since the constitutionality of the Individual Mandate was challenged back in 2012. The plaintiffs in the King vs. Burwell case argue that subsidies can only be provided by states that establish an Exchange on their own. They further argue that the federal government, which is utilized in 37 states, cannot provide subsidies to Exchange applicants.
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