How do I figure out if health insurance through work was not affordable in 2016?
How do I figure out if health insurance through work was not affordable in 2016? If you were offered health insurance through a job, and the lowest-priced plan offered to you for just your own coverage would have cost you more than 8.13% of your household income, then it was unaffordable.
If you or your spouse were offered health insurance through a job and covering your whole family would cost more than 8.13% of your household income, it’s considered unaffordable. But if the coverage for you or your spouse individually did not cost more than 8.13% of your income, then insurance was only unaffordable for the rest of the family.
Here’s an example:
Patrick and Cecilia are married with two children, Alberto and Alicia. The family’s household income is $90,000. Patrick’s job offered him health insurance, but it would have cost a total of $20,000 to insure the whole family for 2016. To insure Patrick alone, it would have cost $5,000 for the year. Since $5,000 is not more than 8.13% of $90,000, Patrick is not eligible to get the tax penalty for going without health insurance in 2016 waived. However, since $20,000 is more than 8.13% of their $90,000 household income, Cecilia, Alberto and Alicia are all eligible to get the penalty waived.
Patrick and Cecilia are married with two children, Alberto and Alicia. The family’s household income is $90,000. Patrick’s job offered him health insurance, but it would have cost a total of $20,000 to insure the whole family for 2016. To insure Patrick alone, it would have cost $5,000 for the year. Since $5,000 is not more than 8.13% of $90,000, Patrick is not eligible to get the tax penalty for going without health insurance in 2016 waived. However, since $20,000 is more than 8.13% of their $90,000 household income, Cecilia, Alberto and Alicia are all eligible to get the penalty waived.
If you’re married without children and both you and your spouse were offered health insurance through a job, it’s unaffordable if the combined cost of coverage for both of you was more than 8.13% of your household income. But if either of you were offered a family plan that cost less than 8.13% of your household income, coverage was affordable.
Here’s an example:
Dan and Joanna are married without children and both of them have jobs. Joanna was offered health insurance through her job that would have cost 5% of her and Dan’s household income. Dan’s lowest-priced health insurance option through his job also cost 5% of his and Joanna’s household income. Joanna and Dan are both eligible to get the tax penalty for going without health insurance in 2016 waived because together, their insurance was unaffordable.
Dan and Joanna are married without children and both of them have jobs. Joanna was offered health insurance through her job that would have cost 5% of her and Dan’s household income. Dan’s lowest-priced health insurance option through his job also cost 5% of his and Joanna’s household income. Joanna and Dan are both eligible to get the tax penalty for going without health insurance in 2016 waived because together, their insurance was unaffordable.
If you were only offered coverage for part of the year, it’s OK. You can calculate whether it was affordable by multiplying the monthly premium by the 12 months of the year. If that number is more than 8.13% of your annual household income, health insurance was unaffordable.
The health insurance marketplace will follow up to confirm the details of the health insurance plan you or your spouse were offered through work.
How do I figure out if no affordable health insurance options were available through my state Marketplace?
If you were offered health insurance through a job, and the minimum amount you would’ve paid toward the premiums on the lowest-cost coverage available through the Health Insurance Marketplace would have cost you more than 8.13% of your household income, then the coverage is not affordable to you.
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In addition, if you lived in a state in 2016 that chose not to expand Medicaid and your income is below 138% of the 2015 federal poverty level for your household size, then no affordable options were available to you. (The federal poverty levels for 2015 were: $11,770 for an individual, $15,930 for a household of two, $20,090 for a household of three and $24,250 for a household of four.) This includes Alabama, Alaska, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Missouri, Mississippi, Montana, Nebraska, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming.