Affordability for 2018

Posted by BAS - 21 September, 2017


The IRS released the threshold for determining affordability of health coverage in 2018.

An Applicable Large Employer must offer its full-time employees minimum essential coverage that is affordable and provides minimum value. Health coverage is considered affordable if the employee’s contribution for the lowest-cost self-only coverage is 9.5% or less of the employee’s household income. The 9.5% is adjusted annually for inflation.

Recognizing that household income is difficult for an employee to determine, the IRS established three safe-harbors that employers may use to determine affordability. These safe harbors are

  • W-2 income (the employee’s W-2 box-1 wages for the year);
  • Rate of pay (the employee’s hourly rate multiplied by 130 hours per month);
  • Federal poverty line (the annual federal poverty line for a single individual divided by 12).

In Revenue Procedure 2017-36, the IRS announced that the required contribution percentage for 2018 is 9.56%. If an employee’s share of the premium in 2018 for the lowest-cost single-only coverage is less than 9.56% of household income (or one of the three safe harbors), the coverage is deemed affordable.

Topics: Enrollment/Eligibility, Health Care Reform (ACA)

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