Affordable coverage
In 2024, a job-based health plan is considered "affordable" if your share of the monthly premium in the lowest-cost plan offered by the employer is less than 8.39% of your household income.Â
In 2025, a job-based health plan is considered "affordable" if your share of the monthly premium in the lowest-cost plan offered by the employer is less than 9.02% of your household income.
- The lowest-cost plan must also meet the minimum value standard.
- If youâre the employee, affordability is based on only the premium youâd pay for self-only (individual) coverage.
- For coverage starting January 1, if youâre offered job-based coverage through a household memberâs job, affordability is based on the premium amount to cover everyone in the household.
- Total household income includes incomes from everybody in the household whoâs required to file a tax return.
If the premiums arenât considered affordable for the employee and the household, they may qualify for savings in a Marketplace plan. But, if the premium is considered affordable for the employee, but not for other members of the household, then only the other household members may qualify for savings.
Example:
- Householdâs monthly income = $4,083 (about $49,000 per year).
- 8.39% of the householdâs monthly household income = $343
For the employee:
- Monthly premium the employee would have to pay for the lowest-priced plan that covers just the employee = $300
- Is the plan affordable for the employee? YES. The premium the employee would have to pay to cover just themselves ($300) is less than 8.39% of the householdâs income ($343). Because the job-based coverage is affordable for the employee, the employee wonât qualify for savings in the Marketplace.
For other household members:
- Monthly premium the employee would have to pay for the lowest-priced plan that covers other members of their household = $450
- Is the plan affordable for other household members? NO. The premium the employee would have to pay to cover others in the household ($450) is more than 8.39% of the householdâs income ($343). Because the job-based coverage isn't affordable for the employeeâs household members, the employeeâs household members may qualify for savings in the Marketplace.