Is my employer health insurance "affordable"?

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Topic Author
SuperOwlXLVIII
Posts: 2
Joined: Wed Apr 29, 2020 8:23 pm

Is my employer health insurance "affordable"?

Post by SuperOwlXLVIII » Wed Apr 29, 2020 8:46 pm

The short of it, my employer health insurance is extremely unfavorable for family coverage. My conclusion when looking into the "affordability" guidelines by the government lead me to believe that because my employer pays 100% of my premiums that it's considered affordable and there would be no ACA subsidy available for the family. Staring a 20% pay cut that looks like it'll last for several years I figure it's worth asking people with far more knowledge in this area so long as I'm under these circumstances.

Subsidized ACA for myself and family would be ~$3k for superior coverage. Currently paying $12k. :annoyed

michaeljc70
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Joined: Thu Oct 15, 2015 3:53 pm

Re: Is my employer health insurance "affordable"?

Post by michaeljc70 » Wed Apr 29, 2020 9:14 pm

SuperOwlXLVIII wrote:
Wed Apr 29, 2020 8:46 pm
The short of it, my employer health insurance is extremely unfavorable for family coverage. My conclusion when looking into the "affordability" guidelines by the government lead me to believe that because my employer pays 100% of my premiums that it's considered affordable and there would be no ACA subsidy available for the family. Staring a 20% pay cut that looks like it'll last for several years I figure it's worth asking people with far more knowledge in this area so long as I'm under these circumstances.

Subsidized ACA for myself and family would be ~$3k for superior coverage. Currently paying $12k. :annoyed
If you don't qualify for subsidized ACA plans, it doesn't matter what it costs as it isn't an option. Your employer is paying 100%...so I am not clear what you are paying. For your family (excluding yourself)?

mlipps
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Re: Is my employer health insurance "affordable"?

Post by mlipps » Wed Apr 29, 2020 9:21 pm

You are correct. This is brutal gaping hole in the law, which hit my mom in the first two years of the ACA. The affordability calculation is only based on the cost of the employee policy; the offer of coverage makes you ineligible for ACA subsidies. I'm sorry you find yourself in this predicament, it's incredibly frustrating.

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bottlecap
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Re: Is my employer health insurance "affordable"?

Post by bottlecap » Wed Apr 29, 2020 9:23 pm

This is normal since the passage of the ACA. You’re actually quite lucky if your insurer is paying 100%. The most people pay $1,000 per month for employer coverage.

JT
Last edited by bottlecap on Wed Apr 29, 2020 9:25 pm, edited 1 time in total.

mlipps
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Joined: Thu Jun 21, 2012 9:35 am

Re: Is my employer health insurance "affordable"?

Post by mlipps » Wed Apr 29, 2020 9:24 pm

michaeljc70 wrote:
Wed Apr 29, 2020 9:14 pm
SuperOwlXLVIII wrote:
Wed Apr 29, 2020 8:46 pm
The short of it, my employer health insurance is extremely unfavorable for family coverage. My conclusion when looking into the "affordability" guidelines by the government lead me to believe that because my employer pays 100% of my premiums that it's considered affordable and there would be no ACA subsidy available for the family. Staring a 20% pay cut that looks like it'll last for several years I figure it's worth asking people with far more knowledge in this area so long as I'm under these circumstances.

Subsidized ACA for myself and family would be ~$3k for superior coverage. Currently paying $12k. :annoyed
If you don't qualify for subsidized ACA plans, it doesn't matter what it costs as it isn't an option. Your employer is paying 100%...so I am not clear what you are paying. For your family (excluding yourself)?
OP's employer pays 100% for themselves, but to cover their family costs an additional $1k/month. At their income, after subsidies, coverage on the exchange would only be $3k. However, there is a blindingly bad hole in the law where unaffordable coverage at work is when your premium is more than 8.16% of your gross income, but it only looks at the cost of employee coverage. In OP's situation, they do not qualify for subsidies because there is an offer on employer coverage, but they do not qualify for the affordability exemption because the coverage for the employee alone is affordable. It's a weird mess in the ACA that no one talks about and no one has bothered to fix in the last 6 years.

rantk81
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Re: Is my employer health insurance "affordable"?

Post by rantk81 » Wed Apr 29, 2020 9:26 pm

Get a divorce for ACA and tax purposes, if it is financially favorable to do so, maybe?

Topic Author
SuperOwlXLVIII
Posts: 2
Joined: Wed Apr 29, 2020 8:23 pm

Re: Is my employer health insurance "affordable"?

Post by SuperOwlXLVIII » Wed Apr 29, 2020 9:26 pm

mlipps wrote:
Wed Apr 29, 2020 9:21 pm
You are correct. This is brutal gaping hole in the law, which hit my mom in the first two years of the ACA. The affordability calculation is only based on the cost of the employee policy; the offer of coverage makes you ineligible for ACA subsidies. I'm sorry you find yourself in this predicament, it's incredibly frustrating.
Thank you for confirming. I'd be better off with no insurance offered to me. :oops:

mlipps
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Joined: Thu Jun 21, 2012 9:35 am

Re: Is my employer health insurance "affordable"?

Post by mlipps » Wed Apr 29, 2020 9:45 pm

SuperOwlXLVIII wrote:
Wed Apr 29, 2020 9:26 pm
mlipps wrote:
Wed Apr 29, 2020 9:21 pm
You are correct. This is brutal gaping hole in the law, which hit my mom in the first two years of the ACA. The affordability calculation is only based on the cost of the employee policy; the offer of coverage makes you ineligible for ACA subsidies. I'm sorry you find yourself in this predicament, it's incredibly frustrating.
Thank you for confirming. I'd be better off with no insurance offered to me. :oops:
Yep. By the way, here's my post 8 years ago, in case it's helpful as confirmation: viewtopic.php?f=2&t=128537&p=1895088&hilit=aca#p1895088

Ron Ronnerson
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Location: Bay Area

Re: Is my employer health insurance "affordable"?

Post by Ron Ronnerson » Wed Apr 29, 2020 10:07 pm

This is called the “family glitch.”

Here’s some info about it: https://www.healthinsurance.org/obamaca ... obamacare/

BruDude
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Re: Is my employer health insurance "affordable"?

Post by BruDude » Wed Apr 29, 2020 10:40 pm

You are correct, they only look at the cost of employee-only coverage. If your employer is paying 100% of employee-only premium, you will not be eligible for a subsidy.

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