Dec 13, 2022
In October 2022, the U.S. Department of the Treasury's bureau of Internal Revenue Service (IRS) released a final rule to address the “family glitch” issue. The family glitch deemed that employer-sponsored coverage could be considered “affordable” for the employee even it was not for their family members, which disqualified those family members from eligibility for financial assistance through marketplace coverage (Advance Premium Tax Credits and Cost Sharing Reduction). The new rule - effective December 12, 2022 - extends the Affordable Care Act (ACA) affordability definition from being based solely on employee-only coverage of the tax household.
Beginning plan year 2023, if an employee must pay more than a predetermined affordability threshold percentage of household income towards the premium for the lowest cost family plan offered by their employer, the plan is considered unaffordable. Furthermore, the employee's family members may qualify for financial assistance for health coverage through Covered California. The affordability threshold for plan year 2023 is 9.12% and will be updated every year.
To help employers and employees navigate this new rule, Covered California for Small Business (CCSB) has introduced the Family Glitch Toolkit (see link below). The toolkit includes key resources, including a comprehensive FAQ document, Employer Coverage Affordability Tool, process guide, and information about common scenarios to help you better understand the fix to the family glitch and assist consumers with affordability and eligibility determinations.
Get the Toolkit:
Contact your Amwins Connect Regional Sales Manager to find the right CCSB plans for your groups.
