Affordable Care Act (ACA) Affordability Threshold Rises for 2019
The percentage used to determine whether or not employer sponsored health insurance is affordable for purposes of employer shared responsibility will increase to 9.86% for 2019.
Under the Employer Shared Responsibility provisions, large employers who do not offer affordable, minimum value coverage face potential penalties if full-time employees qualify for subsidies to buy health insurance in the Marketplace. Employer-sponsored coverage is considered “affordable” if the portion that the employee is required to pay for the lowest cost, self-only coverage does not exceed a certain percentage of the employee’s household income (or a percentage of one of the three safe-harbors: W-2, rate of pay, or Federal Poverty Line for a single individual. Section 4980H(b) estimate of penalty for failure to offer affordable, minimum-value coverage will be $3,750 per employee (or $312.50 per month), up from $3,480 (or $290 per month) in 2018.
For 2019 calendar-year plans using the federal poverty level (FPL) safe harbor to determine affordability, an employee’s premium payment can’t exceed $99.75 per month, up from $96.08 per month in 2018.
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