I saw that on 10/11 the IRS released a final rule that changes eligibility rules for the premium tax credit (PTC). Under the final rule, as of 2023 an employer-sponsored plan is affordable for family members if the portion of the annual premium the employee must pay for family coverage (the employee’s required contribution) does not exceed 9.5% (as adjusted annually) of household income. If an employer-sponsored plan’s family contributions are not affordable under this new rule, will the employer be subject to penalties, similar to penalties for employees getting the PTC due to the employer not offering employee-only coverage that is deemed affordable?
The ACA’s employer shared responsibility provisions do not require an employer offer coverage to the spouses of full-time employees and do not require that the coverage offered to spouses or dependents be affordable. The new regulations affect a family member’s eligibility for a premium tax credit (PTC) for health insurance coverage purchased through an Exchange. An employer will not be subject to an employer shared responsibility payment (ESRP) if a spouse or dependent of an employee enrolls in health insurance coverage through an Exchange and receives a PTC. However, if an employer’s full-time employee enrolls in health insurance coverage through an Exchange and receives a PTC, the employer could be liable for an ESRP.