In this Beyond the Basics webinar presented by the Center on Budget and Policy Priorities on September 16, 2021, Tara Straw, Director of Health Insurance and Marketplace Policy, provides an in-depth review of eligibility rules for premium tax credits—including how offers of employer-sponsored insurance can affect eligibility—as well as how premium tax credits are calculated.

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Premium Tax Credit Eligibility

• What is the Premium Tax Credit (PTC)?
• PTC Eligibility Requirements
• Income Requirements
• Eligible Tax Filing Status
• Exceptions to Joint Filing Requirement for PTC
• Special Rule for Certain Immigrants
• Types of Minimum Essential Coverage (MEC)

Eligibility for Employer-Sponsored Insurance (ESI)

• Eligibility for ESI
• Affordability of ESI
• Minimum Value of ESI
• Health Reimbursement Arrangement (HRA)
• Reconciliation of Overlapping Coverage

Calculation of the Premium Tax Credit

• How is the PTC Calculated?
• Expected Premium Contribution
• Benchmark Plans
• Factors that Affect the Cost of Benchmark Plans & Premiums
• Reporting Changes that Impact PTC
• PTC Repayment Caps

Additional Resources

Yearly Income Guidelines and Thresholds

Employer Coverage & Premium Tax Credit Eligibility Guide

Minimum Essential Coverage Reference Chart

Health Care Assister’s Guide to Tax Rules