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Affordability Increasing to 9.02 Percent

In Revenue Procedure聽, the IRS聽increased聽the affordability percentage from 8.39% to 9.02% for 2025.

Background

Under 搂4980H, applicable large employers (50 or more full-time equivalents or FTEs) must offer full-time employees affordable, minimum value (MV) medical coverage to avoid potential 搂4980H(b) penalties.

Coverage is considered 鈥渁ffordable鈥� under the 搂4980H(b) requirements if the employee contribution for the lowest-cost single MV plan satisfies at least one of three available safe harbors (i.e., federal poverty level (FPL), rate of pay, or Form W-2).

In addition, individuals eligible for employer-sponsored group health plan coverage that is affordable will not qualify for a public health Exchange Marketplace tax credit that could potentially trigger an employer penalty.聽 Coverage is generally considered 鈥渁ffordable鈥� if the employee contribution for employee-only (single) coverage does not exceed a set percentage of household income.

  • Note 鈥� The 鈥渇amily glitch鈥� was removed by regulators, so coverage that is affordable to just the employee does not automatically block dependents from public Marketplace tax credits.聽 However, employers do not need to provide affordable coverage for dependents to avoid the 搂4980H(b) penalty.聽 Only single coverage is evaluated for employers under 搂4980H(b).

Required Contribution Percentage

Originally, for 2014, the required contribution percentage for determining affordability was set at 9.5%. The percentage is adjusted annually. See applicable percentages for several years in the table below, along with the dollar thresholds for single coverage to be FPL affordable those years.

202020212022202320242025
Affordability Percentage9.78%9.83%9.61%9.12%8.39%9.02%
FPL Affordability 鈥� Calendar Year Plan$101.79$104.52$103.14$103.28$101.93$113.20
FPL Affordability 鈥� Non-Calendar Year Plan$103.99$105.50$108.83$110.80$105.29TBD

Application

For calendar year plans, 9.02% applies beginning in January 2025, but for a non-calendar year plan, 9.02% applies with the plan year beginning in 2025.

ob体育 will continue to monitor regulator guidance and offer meaningful, practical, timely information. This material should not be considered as a substitute for legal, tax and/or actuarial advice. Contact the appropriate professional counsel for such matters. These materials are not exhaustive and are subject to possible changes in applicable laws, rules, and regulations and their interpretations.

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