We have been looking through the fine lines of the Affordable Care Act trying to find a solution to the Family Glitch where low income employees are forced to accept the employer’s health insurance plan and end up paying 30-70% of their income to cover their family for a health plan simply because they do not qualify for assistance on the health exchange, No more; A well-educated employer can help his employees get the coverage they need at rates they can afford while saving lots work hours dealing with all the related administrative work. Talk to us today and let us show you how the numbers crunch 209-812-4026.
True story…with name changes.
I have a 50 year old hard working American Joe client. He is married to Angela a 45 year old house wife. They have one independent child .
Joe works in a plant (over 50 employees) making $18.50/ hr. Joe works 40 hours a week. And he might work few overtime here and there.
Joe’s annual household income is $38,480 a year. If Joe goes thru Covered California he can qualify for a bronze plan for $24/ year (Approx. 0.06%) after financial assistance. If he goes thru his employer it would cost him almost $8,000/yr for him and his wife Angela. (Approx. 21%) plus a $6,500 deductible for each of them.
Knowing : that the same plan for Joe alone is affordable And would cost him less than 9.5% of his gross income. And if I understood the rules correctly, Neither Joe or his wife would qualify for financial assistance because he was offered AFFORDABLE plan through his employer.
Joe does not get it, and neither do I…(his Covered California Certified Agent)
Should I write this business through Covered California and risk the IRS going after him for their money back and after my E& O?
Tell Joe Too Bad, So Sad?!
Or , I am sorry Joe, you will be penalized and still not have insurance?!
An update for that, it turns out there is a Form to Exemption to be filed for low income families , however, that is only an exemption from the Tax penalty not the subsidy requirement. In other words, you do not have to carry insurance, and you would not pay tax penalty but you can’t qualify for subsidies either. So, if you get sick. you are on your own.
Please Read it Again…and Again…
Employer coverage is considered affordable — as it relates to premium assistance from the federal government (also known as the Advanced Premium Tax Credit [APTC]) — if the employee’s share of the annual premium for self-only coverage is no greater than 9.5 percent of annual household income. Individuals offered employer-sponsored coverage that’s affordable and provides minimum value are not eligible for premium assistance.
Which means, if your employer offers affordable coverage, the government can ask /may/ probably will/ ask for their money back…
We can still review your application…if you have a question or a comment, please feel free to post it below.