📰 Kevin’s Korner 📰

Q: Do I qualify for ObamaCare subsidies if I have Group Coverage?   

A: Maybe?

That’s a great Q!  The answer is likely no and yes.  What the heck??!!  Well, YOU are likely not eligible as an employee, because your company generally pays at least half, that is 50% of your cost.  So, it is almost always considered “affordable.”  If in doubt, please call me directly and I am happy to review.  However, your DEPENDENTS, that is your spouse and kids, very well may be eligible for ObamaCare subsidies.  IF your work benefits pay little to no contribution towards your dependents, you are likely a good candidate.  Typically, most companies pay 50% for the “employee only” rate and 0% towards the “spouse plus child / children” rate.  So, often times, the employee rate is about $300ish?? And if you add on one wife and one kid, your cost could be an additional $800 to $1200 and more!  YES, those kinds of numbers can get really ridiculous!  Yet, there are tens of thousands of families paying more than they have to every year!  Here’s the not so simple formula – take your annual household income divided by 12.  Times 10% for simplicity (actually 9.12%) to get your “affordability rate.”  Then, ask HR (at job providing your coverage) “What is the monthly family rate of the cheapest plan offered?”  Many companies offer one or more health options, the least expensive option is used for this “affordability” calculation.  If the “monthly family rate” is greater than your average “monthly income x’s 10%” then you just might be able to save significantly!  Many times, I have been able to save my clients literally thousands in annual savings.  This was not the case for the first decade of ObamaCare and it was referred to as the “Family Glitch.”  GREAT NEWS, It is now fixed!  And you do not need to wait until your open enrollment.  You have the right to change your “election” such as going from “family rate” to “employee only” throughout the year.  It is required that you do indeed have established coverage with no gap.  If you feel like this is quite confusing, then you are very normal! 😊  Like always, my best advice is, “Call Kevin!” and he / I’ll be more than happy to review your options.  Sometimes, 10 minutes can save you and your family thousands! 

Best regards,

Kevin F. Gourgues

This is a new addition to the “What the Health?” newsletter that I will try to keep brief and to the point.  Hopefully, this may help shed a little light on a somewhat complex health insurance world. 

You’ve got Q’s, I hope I have your answer!  Always feel free to call Kevin most anytime.  Text or call 985-778-0072.