Webinar OE6: The Premium Tax Credit

In this Health Reform: Beyond the Basics webinar presented on September 13, 2018, Tara Straw, Senior Policy Analyst, provides a detailed discussion of eligibility for the premium tax credit—including how offers of employer-sponsored insurance can affect eligibility—as well as how the credit is calculated.

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

Presentation Slides

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Open enrollment 6 for coverage year 2019

Overview of the coverage landscape


Premium Tax Credit Eligibility

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Definition of the premium tax credit

Income requirements (video section, slides)

Ineligible for other minimum essential coverage (video section, slides)

  • Offers of employer-sponsored coverage

Eligible filing status (video section, slides)

  • Exceptions to the joint filing requirement


Calculation of the Premium Tax Credit

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How is the amount of PTC calculated?

  • Cost of benchmark plan
  • Expected premium contribution


  • Impact of benchmark plan cost on PTC calculation
  • Impact of expected contribution on PTC calculation
  • Impact of age on PTC calculation
  • Impact of plan choice on premiums
  • Impact of “silver loading” on premiums


Reconciliation of the Premium Tax Credit

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Reconciliation of the PTC and repayment limits

Potential issues:

  • Failure to pay premiums
  • Only Column A of Form 1095-A is completed

Overlapping coverage




Additional Resources

Resources | View resources links

Reference Guide: Yearly Guidelines and Thresholds

Key Facts:

Reference Chart: Minimum Essential Coverage

Guide: Health Assister’s Guide to Tax Rules

Webinar OE6: Determining Households and Income for PTC and Medicaid

Beyond the Basics Webinar Series | View all webinars

Key Facts About Health Reform | View all key facts

Tools and Resources | View all tools and resources

Frequently Asked Questions | View FAQs