Affordability for Medical Coverage

Whether an employer offers affordable medical coverage impacts eligibility for premium tax credits toward individual Marketplace coverage. In addition, applicable large employers must offer affordable medical coverage if they want to avoid employer shared responsibility rules under §4980H. Therefore, it is important for employers to understand and communicate whether coverage offered under an employer-sponsored group health plan is “affordable.” We’ll dive into the details of how to calculate a medical plan’s affordability for employees and their family members to help employers when setting plan contribution rates. Additionally, for applicable large employers, we’ll address how to use the affordability safe harbors and how to report offers of coverage to avoid §4980H(b) penalties.

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