OE10 Webinar:
September 2022

Part II: Premium Tax Credits

In Part II of this Beyond the Basics OE10 webinar series presented on September 15, 2022, Jenny Sullivan, Director of Health Coverage Access, 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.

In October 2022, a new federal rule was issued that changes how affordability is assessed for offers of employer-sponsored coverage, making more people eligible for PTC. This new rule fixes the “family glitch.” The presentation was updated in November to reflect these changes. 

Webinar Resources

↓ Presentation Slides (PDF)

↓ Yearly Guidelines and Thresholds Guide

↓ FAQ: Rule Eliminates the “Family Glitch” 

OE10 Webinar

Jump To:

Eligibility Landscape

  • Overview of 2023 coverage landscape

Premium Tax Credit Eligibility

  • What are premium tax credits (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, including an update on the “family glitch”
  • 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

Part VIII: Tying It All Together

Reference: Yearly Guidelines and Thresholds | Coverage Year 2023 (PDF)

Enrollment Tool: PTC Subsidy Calculator

Guide: Employer Coverage & PTC Eligibility

Reference: Minimum Essential Coverage

OE8 Webinar: Health Reimbursement Arrangements (HRAs)

Key Facts:

OE10 Webinar Series (Coverage Year 2023)

Health Reform: Beyond the Basics is a project of the Center on Budget and Policy Priorities designed to provide training and resources that explain health coverage available through Medicaid, CHIP, and the Marketplace. It is aimed at navigators, advocates, state and local officials and others who help consumers get and keep their health coverage.

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Beyondthebasics@cbpp.org

Robert Wood Johnson Foundation

Support for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

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