November 02, 2022

Changes to a Family Members Exchange Subsidy Eligibility

Spotlight on Benefits Blog

Under Internal Revenue Code (Code) Section 36B, individuals are eligible for an exchange subsidy (or premium tax credit) if their employer has not offered them affordable coverage that provides minimum value. The IRS recently released two pieces of guidance with respect to eligibility determinations under Code Section 36B – Final Regulations under Code Section 36B and Notice 2022-41.  Under the new guidance, subsidized exchange coverage for family members will be based on the cost of employer-sponsored family coverage.  Plans that operate on a plan year other than the calendar year may be amended to permit mid-year election changes corresponding to the new exchange subsidy eligibility rules.

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