How does having access to affordable employer coverage affect eligibility for Marketplace subsidies?

How does having access to affordable employer coverage affect eligibility for Marketplace subsidies?

• A. Having affordable employer coverage means you may not qualify for subsidies.
• B. Employer coverage has no effect on subsidies.
• C. You will automatically receive additional subsidies with employer coverage.
• D. Employer coverage guarantees eligibility for subsidies.

Answer: (A)

The main idea is that premium subsidies through the Marketplace are intended for people who don’t have affordable employer-sponsored coverage. If you have access to employer coverage that’s affordable and provides minimum value, you generally aren’t eligible for premium tax credits. “Affordable” here means your share of the employer plan’s cost for self-only coverage doesn’t exceed a certain percentage of your income, and “minimum value” means the employer plan would cover at least a baseline share of medical costs (about 60%). If both conditions are met, you may not qualify for Marketplace subsidies. If the employer coverage isn’t affordable or doesn’t meet minimum value, you may still qualify for subsidies based on your income.

The main idea is that premium subsidies through the Marketplace are intended for people who don’t have affordable employer-sponsored coverage. If you have access to employer coverage that’s affordable and provides minimum value, you generally aren’t eligible for premium tax credits. “Affordable” here means your share of the employer plan’s cost for self-only coverage doesn’t exceed a certain percentage of your income, and “minimum value” means the employer plan would cover at least a baseline share of medical costs (about 60%). If both conditions are met, you may not qualify for Marketplace subsidies. If the employer coverage isn’t affordable or doesn’t meet minimum value, you may still qualify for subsidies based on your income.