Key Elements of Eligibility and Enrollment

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In this webinar presented on September 19, 2017, Judy Solomon, Vice President for Health Policy, provides a detailed discussion of eligibility for premium tax credits and explains how premium tax credits are calculated.

This is Part I in a four-part series on key elements of eligibility and enrollment.

Presentation Slides

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Overview of Upcoming Open Enrollment Period

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Shorter open enrollment

• States with extended open enrollment

 

Premium Tax Credit Eligibility

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Definition of premium tax credits

Eligibility requirements for premium tax credits

1. Enrollment in a qualified health plan (QHP) (video section, slides)
2. Income requirements (video section, slides)
3. Eligible filing status (video section, slides)
4. Ineligible for other minimum essential coverage (MEC) (video section, slides)

 

Calculation of the Premium Tax Credit

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How is the amount of the PTC calculated? (video section, slides)

• Benchmark plan
• Expected premium contribution
• Rating factors that affect the cost of the benchmark plan
• Other factors affecting premiums

Examples: Calculating the PTC (video section, slides)

• Impact of benchmark plan
• Impact of expected contribution
• Impact of age
• Impact of tobacco use
• Impact of plan choice on premiums

 

Q&A

 

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Additional Resources

Minimum Essential Coverage Reference Chart | View chart

Part II: Determining Households and Income | View webinar

Part III: Plan Design and Selection | View webinar

Part IV: Exemptions | View webinar

Key Facts: Employer-Sponsored Coverage and PTC Eligibility | View key facts

Key Facts: Premium Tax Credits | View key facts

Beyond the Basics Webinar Series | View all webinars

Key Facts About Health Reform | View all key facts