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Fixing the ACA "Family Glitch"

Family Glitch Fixed

IF you have a Family
AND if you receive Employer based/Group Insurance
AND if that is "Affordable" for YOU as an employee only
AND that plan was NOT affordable for the whole family
NOW you have New Options for your family
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Starting November 1, now you can compare your employer plan with a Marketplace Plan with subsidies.  You may SAVE THOUSANDS or DOLLARS. We can review options for your family’s premium subsidies and coverage through the Health Insurance Marketplace and all the insurance companies we represent in North Carolina.
2024 ACA Checklist
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What we need to get started:

  • ​You and family members: Name, Dob, Zip code
  • Income for each wage earner in the family- esp for the person with employer coverage.
  • TOTAL Family income estimate for 2024 -  line 11 on your 1040, MAGI (Modified Adjusted Gross Income)
  • COMPLETE “Employer Coverage Tool"  HERE  (email completed forms to [email protected])
  • KEY Information
  • How much would the employee pay for YOURSELF ONLY
  • How much would the employee pay for ENTIRE FAMILY  
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Family Glitch Calculator Tool

Click HERE to discover if you may be eligible for cost savings. If not, we may have other options. ​

Family Glitch Example:

Paul and Lisa are married, have two children and will file a joint tax return. Lisa is offered coverage  through her employer, Acme Anvil, Inc., and that coverage extends to Paul and the children.
  • All plans offered by Acme Anvil Inc. meet the minimum value standard.
  • Paul is not offered coverage through his employer.
  • Paul and Lisa have an annual household income of $ 75,000. 
  • The lowest-cost plan offered by Acme Anvil Inc. that would cover Lisa only has a premium of $100 per month. 
  • ​The lowest-cost plan offered by ABC Inc. that would cover Paul and Lisa and children has a premium of $600 per month
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​For 2024, we still use the self-only premium for Lisa, but the family premium for Paul & kids.  Lisa remains ineligible for APTC since $100 is less than 9.12 percent of the couple’s income. However, Paul & the kids are now eligible for APTC since $600 is more than 9.12 percent of their income (75,000 x .0912= $570)  which means Paul’s offer is considered unaffordable. 
​Let’s say that Lisa and Paul are both 45 and the children are 10 and 11 years old. They live in Buncombe county NC. 
 
The Premium discount / Marketplace subsidy would be $ 1,079 monthly for Paul & the kids. Remember Lisa is still covered on the group. Lisa has Silver Plan.  

A quick look at 2025 Plans:
     * Bronze - ZERO Premium
     * Silver - $320 - $450
     * Gold - $400 - $500 

If you are offered  a "Bronze Plan" - you may save THOUSANDS of Dollars Annually!
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Background: 

Briefly since 2014, employer coverage is deemed “affordable” if the cost for employee-only coverage would be less than 9.61% of household income. BUT NOT the premium for the whole family.   And these family members were NOT eligible for premium subsidies thru the Marketplace.  They had to pay the full price of employer plan or the ACA plan or some other coverage options .
 
On Tuesday, Oct 18, 2022, The Biden Administration announced that if a family has to pay more than 9.12% in 2023 of household income for the employer plan, they “MAY"  be eligible for premium tax credits in the Marketplace.
 
Wow -  This is A Big  *#%*#@  Deal, As then VP Biden famously said in 2010. 

Watch Dave Trout on WLOS cover the "Family Glitch" - CLICK HERE

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Get Enrolled For 2025
Trout Insurance Services

Monday-Friday
9:00am - 5:00pm & by appointment


​Visit: 29 N Main St
Weaverville, NC 28787
     
Mail: PO Box 1414     
Weaverville, NC 28787  
Ph: 828.279.4681
​
Fax: 1.888.221.4842
​

[email protected]
Trout Insurance is an Independent Insurance Agency Based in WNC. 
Privacy Notice Statement  | Privacy Policy
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“We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or call 1.800.Medicare to get information on all of your options.”
Trout Insurance is an independent authorized agency licensed to sell and promote products from Blue Cross and Blue Shield of North Carolina (Blue Cross NC). The content contained in this site is maintained by Trout Insurance. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. ®, SM Registered marks of the Blue Cross and Blue Shield Association.”
  • Insurance
    • Home & Auto Insurance >
      • Home & Auto Intro
      • Travelers - Customer Services
      • Hartford - Customer Services
      • Nationwide Customer Service
      • National General Customer Service
    • Health Insurance >
      • ACA 2025 Checklist
      • Blue Cross Blue Shield Customer Services
      • Aetna/CVS Customer Services
    • Medicare
    • Accident & Hospital >
      • Accident Plans
      • Critical Illness
      • Long-Term Care
      • Disability Insurance
    • Pet Insurance
    • Life Insurance
    • Travel Medical and Trip Protection
    • Dental and Vision
    • Employee Benefits
    • Business Owners >
      • Group Health Insurance
      • Commercial Property & Liability
      • Business Overhead Expense Disability
      • Disability for Business Owners
      • Critical Illness
    • Short Term Health
  • Trout Team
    • Our Story
    • Dave Trout
    • David Hanson
    • Idelle Davids
    • Linnea Conway
    • Jan Trout
    • Steve Dillingham
  • Resources
    • Employee Success
    • Fixing the ACA "Family Glitch"
    • Medicaid Expansion
    • Client Center
    • Newsletter
    • Thank You
    • Reviews
    • Blog
    • Articles >
      • Fine Homes WNC
      • Privacy Policy
      • Insurance Partners
      • No Income Cap
      • ACA Income Verification
      • BCBS Online Setup
      • APTC Income 2023 & Tax Form 1040
      • Prior Agents
      • Lost Subsidy
  • Community
    • WNC Strong
    • Built to Last
    • Candlelight Stroll
    • Music on Main
    • Goombay & YMI
    • Weaverville Primary Spring Fling
    • 50+ WNC Articles
    • Understanding Medicare 2024
    • Mural on Main Street
    • Alignment's 5-Star Switch
    • YMI Winter Coat Drive
    • Employer Networking w/ Just Economics
    • Blue Ridge Pride Festival
    • Medicare Seminar
    • Art in Autumn + MANNA
    • Western Women's Business Center Conference
    • Back to School
  • Contact Us