pirsquared
Recycles dryer sheets
- Joined
- Jun 13, 2021
- Messages
- 129
Hi! I did extensive research on MEC (Minimum Essential Coverage) vs MV (Minimum Value Coverage) before enrolling in Marketplace insurance for 2021. My understanding was that MEC was enough to satisfy the mandate to have insurance, but being offered MV insurance through an employer was what would make you ineligible for Marketplace insurance subsidies. Most policies that are MEC but not MV do not cover any hospitalization, etc. A few years ago when DH was still employed, his employer insurance confirmed that my part time job's offer of MEC coverage was not MV and thus did not require me to pay extra to be on his insurance. Now DH is no longer employed and I received a 1095-C confirming that I was offered insurance that was NOT Minimum Value. I understood that this confirmed I am eligible for subsidies. However, I just started reading IRS Pub 974, which talks about MEC making one ineligible for PTC. This contradicts all my previous research and makes me very worried! Has the definition of MEC changed? What is going on?
https://www.healthinsurance.org/obamacare/will-you-receive-an-aca-premium-subsidy/
"Access to affordable employer-sponsored coverage
If your employer offers coverage that’s considered affordable and provides minimum value, you’re not eligible to receive a subsidy in the exchange. Note that the affordability test only applies to coverage for the employee; the cost to add dependents to the plan is not taken into consideration. But if the employee’s coverage is considered affordable, the dependents are not eligible for premium subsidies in the exchange – and this situation is known as the family glitch.
If your employer offers affordable coverage that provides minimum value, you already are receiving a subsidy from your employer in the form of pre-tax health insurance benefits and an employer contribution to your premiums. The exchanges offer subsidized health insurance benefits to the self-employed, the unemployed, and employees who work for a company that does not offer affordable health benefits.
Note that some employers offer coverage that is either not affordable or does not provide minimum value (by doing this, they can avoid the potentially larger penalty they would pay if they didn’t offer coverage at all). These plans, while technically considered minimum essential coverage, can be quite skimpy – and to clarify, employers are subject to a penalty if they offer these plans and their employers opt for a subsidized plan in the exchange instead. If your employer offers a plan that doesn’t meet the affordability rules and/or the minimum value rules, you do have access to premium subsidies in the exchange if you’re otherwise eligible based on your income, immigration status, etc. "
https://www.healthinsurance.org/obamacare/will-you-receive-an-aca-premium-subsidy/
"Access to affordable employer-sponsored coverage
If your employer offers coverage that’s considered affordable and provides minimum value, you’re not eligible to receive a subsidy in the exchange. Note that the affordability test only applies to coverage for the employee; the cost to add dependents to the plan is not taken into consideration. But if the employee’s coverage is considered affordable, the dependents are not eligible for premium subsidies in the exchange – and this situation is known as the family glitch.
If your employer offers affordable coverage that provides minimum value, you already are receiving a subsidy from your employer in the form of pre-tax health insurance benefits and an employer contribution to your premiums. The exchanges offer subsidized health insurance benefits to the self-employed, the unemployed, and employees who work for a company that does not offer affordable health benefits.
Note that some employers offer coverage that is either not affordable or does not provide minimum value (by doing this, they can avoid the potentially larger penalty they would pay if they didn’t offer coverage at all). These plans, while technically considered minimum essential coverage, can be quite skimpy – and to clarify, employers are subject to a penalty if they offer these plans and their employers opt for a subsidized plan in the exchange instead. If your employer offers a plan that doesn’t meet the affordability rules and/or the minimum value rules, you do have access to premium subsidies in the exchange if you’re otherwise eligible based on your income, immigration status, etc. "
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