EB generic detail

ACA Affordability Rates Announced for 2022

09/06/2021 Written by: Nathanael M. Alexander, Esq

With the issuance of Rev. Proc. 2021-36, the IRS announced the 2022 indexing adjustment percentage for determining affordability of employer-sponsored health coverage under the Affordable Care Act (ACA). The percentage is adjusted annually for inflation and will be set at 9.61% for plan years beginning in 2022. This represents a decrease from 2021’s 9.83%.

Under the ACA’s provisions for plan years beginning January 1, 2022 and subsequent to that date, employer-sponsored minimum essential coverage will only be considered affordable if an employee’s required contribution for the lowest-cost, self-only coverage option does not exceed 9.61% of the employee’s household income for the tax year. Neglecting to offer affordable, minimum value coverage to full-time employees could result in penalties under §4980H(a) or (b) of the employer shared responsibility rules, commonly referred to as the “sledgehammer” and “tack hammer” penalties, respectively.

As expounded upon in IRS Notice 2015-87, employers may measure affordability of their coverage using three different safe harbor tactics (Form W-2 wages, the employee’s rate of pay, or the federal poverty line (FPL)). The affordability test applies to annual premiums for self-only coverage. If an employer offers multiple health plans, the affordability test is applicable to the lowest-cost option satisfying the requirement for minimum value. In situations where an employer offers distinct regional coverage options for employees in different states, the affordability analysis would be based on the lowest-cost option open to those specific employees. The affordability percentage is indexed in the same manner as the household income percentage.

As noted above, the adjusted percentage is applied on a plan year (not calendar year) basis, so non-calendar year plans with plan years prior to January 1, 2022 will continue to use the 9.83% standard until their new plan year begins. 

Caregiver-conscious Benefits: An Interview with the Hazelden Betty Ford Foundation
Employee Benefits07/18/2024

An organization’s overall wellness program reaches not only their employees. It reaches an employee’s loved ones, including their spouses and their dependents. This is why it is essential to think...

Pharmacy's Role in Your Small Business Benefits Budget
Employee Benefits07/16/2024

Employers across the nation are trying to find new ways to contain the rising costs of prescription drugs. For many small businesses, employee benefits can be a key way to attract and retain top...

The Relationship Between Pharmacies and Reference-Based Pricing
Employee Benefits07/09/2024

Pharmacies-and-Reference-Based-Pricing Health care costs continue to rise, a longtime trend that pushes organizations to lower expenses at every opportunity, though confronting the affordability...