A SIGNIFICANT CHANGE TO ELIGIBILITY RULES FOR FAMILY MEMBERS AND DEPENDENTS REGARDING EMPLOYER GROUP HEALTH PLANS IS WELCOME NEWS!
The new Family Glitch Fix rule, which will be in effect for 2023 plans, allows family members/dependents of employees that are in a group plan to be eligible for a subsidy and purchase a marketplace plan if the cost of the insurance premium to cover the entire family is more than 9.12% of household income. Previously, family members/dependents were only eligible for subsidies and marketplace plans if the employee only premium was more than 9.12% of household income, which is rarely the case. We’ve outlined a couple scenarios below that might be helpful to illustrate the change:
Scenario #1
Susan, age 31, is a teacher who makes $32,000/yr. Her husband Brad is self-employed and makes $25,000 a year. They have two kids. She has been insuring the family through her state health plan. In 2022, her family was not able to get a marketplace subsidy because the insurance premium to just insure herself was not more than 9.12% of their household income. She was paying $600/mo. to insure herself and her family through her state health plan. Under the new Family Glitch Fix rule, Susan’s husband and children will be eligible for a subsidized marketplace plan because the $600/mo. family premium is 12.6% of their household income. For 2023 Susan’s husband and children would be eligible for approx. $800 subsidy on the marketplace and purchase a great plan for $150/mo. Susan will stay insured through the state health plan and the family will save $425/mo.
Scenario #2
James is 42 and works in the parks department for the city. He makes $50,000 a year. His wife Sarah doesn’t work, and they have 2 kids. It would cost him $450/mo. to insure his entire family through his group plan in 2023. That is 10.8% of his household income for the year. Therefore, his wife and 2 kids are eligible to get a subsidized plan on the marketplace. Sarah and the kids get good health coverage through the marketplace for $170/mo. and James stays enrolled on his group plan with the city. They will save $200/mo. thanks to the Family Glitch Fix rule.
There Are Many Options For Affordable Healthcare
We represent multiple health insurance companies with different plans to provide the benefits you need at a premium you can afford. If you have questions about health coverage or how your current plan compares to what’s available…contact us! We provide consultation services at no cost to you. Our only interest is placing you in a plan that you can afford and meets your needs.
