Affordable Care Act: What Is Affordable Health Coverage?

Affordable Care Act: What Is Affordable Health Coverage?

Posted by The Propel HR ACA Team on 2/3/16 10:00 AM
The Propel HR ACA Team
Posted on: February 3, 2016

All the talk is about AFFORDABLE health coverage but what is affordable health coverage?  

If an employee’s share of coverage (for employee-only coverage) costs the employee more than 9.5% of the employee’s annual household income, then the coverage is NOT affordable.

Since we do not know an employee’s annual household income, the IRS has three safe harbors we can use instead.

Safe Harbors:

  • Form W-2 Wages – Box 1 wages on the 2015 W-2
  • Rate of pay- based on an employee’s rate of pay at the beginning of the coverage period, with adjustments permitted, for an hourly employee, if the rate of pay is decreased (but not if the rate of pay is increased)
  • Federal poverty line – for a single individual

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An employer may choose to use one or more of the safe harbors for all of its employees or for any reasonable category of employees, provided it does so on a uniform and consistent basis for all employees in a category.

Topics: Compliance, ACA

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