Required to Join the Exchanges

[Dave020]

Also ask them if the employee only has affordable health coverage through a group plan, can the spouse and kids be spun off onto the exchange and get subsidies if lower income

From the March 27th Rules filed, the dependent would still qualify for Advanced Premium Tax Credits if the coverage offered by the employer did not meet the requirements for minimum essential coverage. If the coverage offered by the employer did meet the minimum requirements and the dependent declined coverage they would not qualify for the tax credit. That being said, it could possibly change in the future.

 

[Ann H]

From the March 27th Rules filed, the dependent would still qualify for Advanced Premium Tax Credits if the coverage offered by the employer did not meet the requirements for minimum essential coverage. If the coverage offered by the employer did meet the minimum requirements and the dependent declined coverage they would not qualify for the tax credit. That being said, it could possibly change in the future.

Thanks Dave for that clarification for group plans that don't meet the minimum essential coverage requirement. The other issue is group plans that don't meet the "affordability" test. Can you tell us, from looking at the rules or other documentation that you have, if spouse and/or children will be ineligible for subsidies in the exchange, if the employer group plan meets the affordability test based on the "employee-only" premium or based on the "employee+dependents" premium. That's a big question right now.