Unaffordability
The Employer Mandate guidelines state that coverage is affordable when an employee must pay no more than 9.5% of their household income (inflation-adjusted to 8.39% for the 2024 plan year) for self-only coverage which is offered, but which employers know the household income of an employee?
The Internal Revenue Service (IRS) recently issued Rev. Proc. 2023-29 which includes information about the changes to the affordability percentage as it relates to the Employer Mandate for 2024.
The Employer Mandate guidelines state that coverage is affordable when an employee has to pay no more than 9.5% of their household income (inflation-adjusted to 9.83% for the 2021 plan year) for self-only coverage which is offered, but which employers know the household income of an employee? As a result, there are three alternative methods that an employer can rely upon when determining if the coverage they offer is affordable. These methods are explained below and some general examples of how to apply each method have also been provided.
The Internal Revenue Service (IRS) recently issued Rev. Proc. 2020-36 which includes details on the minimum required contribution percentage in determining whether employer-sponsored health coverage is affordable. In 2021, employer-sponsored health coverage will be considered affordable if an employee has to pay no more than 9.83% (an increase of 0.05% from 2020) of their income for such coverage.
The Internal Revenue Service recently released Revenue Procedure 2019-29 which included details on the affordability percentage related to the Employer Shared Responsibility provisions of the Affordable Care Act (ACA), also known as the Employer Mandate. In 2020, an applicable large employer (ALE) will be considered to offer affordable coverage to its full-time employees if the cost of coverage is 9.78% or less of the employee’s household income.
The U.S. Department of Health and Human Services (HHS) and the Internal Revenue Service (IRS) have jointly issued rules that define affordable coverage. Employers and employees still have several questions about how this affects penalty calculations and subsidy eligibility.
The following offers some insight on these key issues: