Health Insurance

The Employer “Family Glitch” has been removed!

All additional family members may now qualify for a government subsidy.

Now Get A Government SUBSIDY!

Affordable Health Insurance Within Reach for More Families

About half of the U.S. population gets their health insurance through their employer. This provides a wonderful benefit to the employee, because a minimum of ½ (50%) of the total cost of that health plan for that employee must be covered by the employer, if the employer offers group health insurance to their employees. In many cases, employers pay more than 50% of their employees’ premium, and the rest is paid by the employee.

When you combine what the employer pays, and what the employee contributes out of their paychecks, this makes the overall dollars spent on a health plan higher. This generally will give the employee a much better health insurance policy than they normally would if the employee had purchased it on their own.

Across the country, employers cover an average of 83% of the employees’ health insurance costs. Many employers, however, do NOT contribute anything towards the spouse and kids’ portion of the health insurance premium. Employers are not required to help pay for spouse and children. But because of rules, employers are required to OFFER to spouse and kids, but they are not required to PAY for spouse and kids. This makes the amount of premium the employee would have to pay to cover their spouse and kids extremely expensive! Because the spouse and kids are full price.

What Is the Family Glitch?

So, here’s the rub. Up until now, for the past few years since the Affordable Care Act was passed in 2010, if an employee was “offered” health insurance through their employer-based plan, in almost all cases, the spouse and children would be BLOCKED from qualifying for a government “subsidy” (government helps pay). It didn’t matter if the employee enrolled into the employer’s health insurance or not, they would still be blocked from a subsidy. The options for this family were: they could pay full price for their employer group plan for the spouse and kids, enroll in a private plan for spouse and kids, or enroll into a Marketplace plan for the spouse and kids (but they would be paying full price). Only a very small percentage of these Nevadan’s spouses and kids’ could qualify for a subsidy, because the employee’s plan was considered “unaffordable”. The reason they could not get a subsidy is because the employer’s health plan was considered “affordable” to the employee, and the employers affordable health plan to that employee would BLOCK their spouse and kids from qualifying for a government “subsidy”. This was the “Family Glitch”.

Time To Celebrate!

In October of 2022 the Treasury Department announced new rules to the American Rescue Plan Act, stating that starting on 1/1/2023 employees that are offered “affordable” health insurance by their employer, their family members may now qualify for a subsidy! “Affordability” is calculated in a way that the health insurance plan costs the family less than 9.12% of their household income. This household income will determine what amount of subsidy the family would qualify for, then the family can decide what health plan they’d like to enroll into. This is such a huge deal! We’ve seen so many families that desperately needed the tax subsidies, but because of this family glitch, the family members of the employee were not eligible. Many of these Nevadan’s had pre-existing conditions that really needed coverage, and this put the employee in a situation that made them think twice about their employment.

Advanced Premium Tax Credit

This subsidy is called an “Advanced Premium Tax Credit”, meaning, in advance of your premium being due on the 1st of every month, your health plan premium will be reduced in the form of a “subsidy,” which is based on factors such as your family size and income. You’ll only pay a percentage of your income for your health insurance plan. The higher the income the lower the subsidy, the lower the income the higher the subsidy. Be careful to report and state the correct and accurate income the very best you can, because you’ll have to account for your stated household income (and the overall amount of subsidy dollars you took) to the IRS, in the following year.

Who Benefits from the New Rules and gets to Celebrate?

In the past few years, if employed Nevadans that had group health insurance were super lucky, (probably less than 5% of the population) where the employee’s portion of the health insurance was considered “unaffordable”, (this means that the employee’s portion of their health insurance premium must be considered unaffordable), then the spouse and kids could get a subsidy to help pay for their health insurance, but this occurrence was very rare. Under the new rules, the affordability of employer-subsidized health insurance is based on the cost of insuring the entire family, not just the employee. There are estimates that the new rules will put affordable health insurance within reach of about a million people nationwide. The new rules go into effect for families who apply for 2023 coverage during this years open enrollment period – November 1st, 2022, through January 15th 2023.

How We Help You For FREE – Nevada Insurance Enrollment

Finding health insurance coverage that fits your needs and budget can be challenging, and ever-changing rules can make it confusing to determine what you qualify for. Our agents study the different insurance companies’ health insurance plans and options each year. They know what HMO, EPO, and PPO options are available from each insurance company. They know how the plans work, how the coverage works, what coverage you’ll have outside of Nevada, can answer difficult questions, and help with situations that may need additional research.

At Nevada Insurance Enrollment, our health insurance agents are knowledgeable, patient, caring, and can help you determine whether you may benefit from the new rules regarding the family glitch, and if you can save money by purchasing health insurance through Nevada Health Link. Our services are free to our clients. We are paid by the insurance companies to assist Nevadans into health plans that work best for them, and your insurance premiums will not go up in price one cent for using our assistance. Your plan will cost you the same with or without assistance. It only makes sense to get the help you deserve from a licensed agent. Call us today at (702) 898-0554 for an appointment in person or over the phone.

Health Insurance Subsidy Cliff

No More Subsidy Cliff for those making over 400% of the Federal Poverty Level.

For the first time, many Nevadan’s (those making over 400% of the Federal Poverty Level), may now be eligible for a health insurance subsidy! Plus, for existing members, the rate you are paying will most likely decrease.

For instance, if you were a 60 and 61 year old married couple, and your income was projected to be over $68,960 in 2021 you would not have qualified for a tax credit. Now, since the changes, that same couple making $80K per year would qualify for $1007 per month. This is HUGE!

You can now get a Government subsidy to help you pay for your health insurance premiums. Before these changes, if your income was over $51,040 for a single person in tax year 2021, or $104,800 for a family of 4, you were not eligible for a tax subsidy.

Now there is no income limit to receive these subsidies. The subsidy amount gradually slopes off to be no more than 8.5% of your household income (Modified adjusted gross – for most people, their “Adjusted Gross Income”). So, for many Nevadan’s, they’ll now be eligible for tax credits!

Also in this new law (and this is ONLY for tax year 2020), if you ended up making more than you estimated for tax year 2020, you will not be required to pay back those subsidies.

FREE or NEARLY FREE Health Insurance for any employee who lost their job and collects unemployment any time in 2021. For the tax credit, no matter how much they make on unemployment or otherwise, their income won’t be counted higher than 133% of the federal poverty level. If you are collecting unemployment for 2021, it’s most likely beneficial to apply for Obamacare than Cobra. Why? Free Cobra payments are only good for 5 months, but with Obamacare, the Free to nearly Free health plans are good all year!

These changes do not apply to those Nevadan’s that have jobs that offer insurance to their employees and their families (whether they take their employer, spouses’ employer, parents insurance or not).

Call our office, we can answer your questions, assist you with any changes to your current plan, or help you apply for these new subsidies.