Family Glitch Question : Factor in Deductible ?

[infoseeker]

If a client is being offered health insurance through his job and wants to factor in the yearly premium to see if it exceeds the 9.5% allowable guideline can he add the deductible that he would have to meet as part of the annual cost? For ex if some one is being offered a plan through work at a cost of $200 a month that he is paying 100% and there is a $3000 deductible is the deductible counted towards his annual cost that may exceed 9.5% which equals instead of $2400 annual cost $5400

 

[Ann H]

if a client is being offered health insurance through his job and wants to factor in the yearly premium to see if it exceeds the 9.5% allowable guideline can he add the deductible that he would have to meet as part of the annual cost? For ex if some one is being offered a plan through work at a cost of $200 a month that he is paying 100% and there is a $3000 deductible is the deductible counted towards his annual cost that may exceed 9.5% which equals instead of $2400 annual cost $5400

No


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[Tkruger]

No, it's the employees share of the premium that exceeds the percentage. That is the determining factor.

 

[infoseeker]

Wow that's unfair makes no sense because they really are not covered -have No coverage until they meet the deductible

 

[Tkruger]

Wow that's unfair makes no sense because they really are not covered -have No coverage until they meet the deductible

Huh? Depending on the carriers you rep and the markets you're working plans vary. Not trying to poke here but what are you offering product wise?

I suggest you study the products and then re-evaluate what you've posted.

 

[Ann H]

Wow that's unfair makes no sense because they really are not covered -have No coverage until they meet the deductible

Dude. What's unfair is 9.5% of income is considered "affordable". And, it's based only on the employee's premium, without regard to how much it costs to add the family. That's the family glitch. The deductible is irrelevant.

 

[ameneses54]

Dude. What's unfair is 9.5% of income is considered "affordable". And, it's based only on the employee's premium, without regard to how much it costs to add the family. That's the family glitch. The deductible is irrelevant.

I have high hopes:
The Family Coverage Act, S.B. 2434
"Summary of the Family Coverage Act
Senator Al Franken
The Affordable Care Act includes a number of provisions to help millions of Americans gain access to high quality, affordable health insurance.
At the same time,there remain a number of ways to make it stronger for individuals and families.
For example, the law provides premium tax credits to help Americans purchase health insurance coverage when they do not have access to affordable job
-based coverage.
However, due to a glitch in the way the law is being interpreted by the IRS , many middle-class families are prohibited from receiving these tax credits, even when the cost of family coverage is simply unaffordable.
The Family Coverage Act will fix this glitch and help ensure that these families gain access to premium tax credits . The legislation does this by defining affordable job -based health coverage by what is affordable for a family, not just an individual employee. Unlike the current interpretation of the law, this definition is in line with what was intended by Congress, and would allow families that currently do not have access to affordable health coverage through an employer to access tax credits to buy their coverage"

 

[infoseeker]

So its calculated based on the employee portion of the premium not the premium for entire family. They factor in 9.5% of the household income Not just the employee's income. correct? if thats the case that is extremely unfair

 

[Dave020]

So its calculated based on the employee portion of the premium not the premium for entire family. They factor in 9.5% of the household income Not just the employee's income. correct? if thats the case that is extremely unfair

It's based on the employee-only "self pay" premium. Only what the actual amount the employee pays after the employer contribution. If employer pays 100% of employees premium then the employee self pay premium is $0 and the plan is considered "affordable" at any income level.

It was added to the PPACA by the Dept of Treasury to discourage jumping off of employer plans to get subsidy.

 

[infoseeker]

but is the 9.5% based on the employee income only as part of the household income or the entire household income. for ex if the household income is 50k but her income is 25k and she is the one with the employer coverage is it just her income of 25k x 9.5% or the entire household income of 50k x 9.5%?