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
Starting November 1, 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.

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 2023 -  line 11 on your 1040, MAGI (Modified Adjusted Gross Income)
  • COMPLETE 2023 “ Employer Coverage Tool “  HERE  (email completed forms to dtroutinsurance@aol.com)
  • KEY Information
  • How much would the employee pay for YOURSELF ONLY
  • How much would the employee pay for ENTIRE FAMILY  

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
​For 2023, 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 2023 Plans:
     * Bronze - ZERO Premium
     * Silver - $320 - $450
     * Gold - $400 - $500 

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

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, 22, The Biden Administration announced: 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.