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Determine Whether Employer Coverage Is Affordable

 

This tool helps Premier Insurance Contracts agents estimate the affordability of employer-sponsored health coverage using the household’s projected annual income and the employee’s cost for individual and family coverage. It can help identify potential situations in which the employee’s coverage is considered affordable, while a spouse or tax dependents may still qualify for financial assistance through the Health Insurance Marketplace.

How to Use the Calculator

  1. Enter the estimated annual household income.

  2. Select the employee’s payroll deduction frequency.

  3. Enter the employee-only coverage cost per paycheck.

  4. Enter the family coverage cost per paycheck.

  5. Confirm whether the employer plan meets the Minimum Value Standard.

  6. Click Calculate Affordability to view the results.

Employer Coverage Affordability Analyzer

Estimate whether employer-sponsored health coverage may be considered affordable for the employee and for the employee's tax household under the 2026 affordability threshold.

$
Include the projected income of all tax household members who are required to file a federal tax return.
Threshold used for 2026 coverage.
$
Enter the employee's contribution for the lowest-cost self-only plan that meets Minimum Value.
$
Enter the employee's contribution for the lowest-cost plan covering the employee and eligible tax household members.

Employee

Annual cost $0.00
Percentage of income 0.00%
Annual affordability limit $0.00

Tax Household

Annual cost $0.00
Percentage of income 0.00%
Annual affordability limit $0.00

Important: This calculator provides an estimate only. It does not calculate Premium Tax Credit amounts, Medicaid or CHIP eligibility, immigration eligibility, or Special Enrollment Period eligibility. Final eligibility is determined through the official Health Insurance Marketplace application. Use the lowest-cost employer plan available that meets the Minimum Value Standard.

How to Interpret the Results

AFFORDABLE for the employee and family 
The employer coverage is within the affordability limit. The employee and family will likely not qualify for Marketplace financial assistance.  

AFFORDABLE for the employee, but NOT AFFORDABLE for the family 
This may be a Family Glitch case. The employee may not qualify for Marketplace financial assistance, but the spouse and eligible tax dependents may qualify. 

NOT AFFORDABLE for the employee and NOT AFFORDABLE for the family 
The employer coverage falls outside of the affordability limit. The employee and eligible household members may qualify for Marketplace financial assistance. 

Employer Plan does not meet Minimum Value Standard 
If the employer plan does not meet the Minimum Value Standard, then employee and family may qualify for Marketplace financial assistance depending on household income. Verify eligibility through the official Marketplace application. 

Disclaimer

This calculator is provided for informational and educational purposes only. Results are estimates based on the information entered and do not represent an official eligibility determination.

Final eligibility for Marketplace coverage, Premium Tax Credits, Medicaid, CHIP, or any other assistance must be confirmed through the official Health Insurance Marketplace application.

Premier Insurance Contracts is not responsible for results based on incomplete, inaccurate, or outdated information.