Affordable Health Coverage

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In 2024, a health insurance plan available through your employer is considered "affordable" if the cost to cover only the employee does not exceed 8.39% of the employee’s household income.

♦ Affordability used to be determined on the cost of a "self-only" plan offered by your employer. Meaning a plan covering only the employee, not dependents.

This proved to be a big problem for families and one that came be called the "family glitch".

At the end of 2022, the Biden administration pushed through a rule change to eliminate the "family glitch".

• The rule change first took effect for coverage starting in plan year 2023.

♦ If you are offered job-based coverage through a household member’s job, affordability is now based on the premium amount to cover everyone in the household.

Example (for 2024 coverage):

Household’smonthly income = $4,083 (about $49,000 per year).
8.39% of the household’s monthly household income = $343

If the cost to insure the employee only, is less than $343 per month then the employee only plan is affordable for the employee.

If the cost to insure the employee + family members exceeds $343 per month then employer's plan that would insure the family is NOT affordable for family coverage.

• The employee’s household members may qualify for savings in the Marketplace.

The employee would not qualify for savings at the Marketplace. The employee would receive coverage through their employer.