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Affordability Exemption - T/P=employer covered, Spouse=work.comp.

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    Affordability Exemption - T/P=employer covered, Spouse=work.comp.

    I have a hard time understanding the affordability exemption if the situation is a little more complicated. T/p is covered by employer (self-only), could get family coverage but this is too expensive. Spouse is on work.comp. and does not have insurance. From what I read I understand that I need to find the lowest cost for the bronze plans for each of them, minus subsidies. If that combined number is more than 8.05% of income than the affordability exemption applies. Is this right?

    #2
    No. If they have access to employer insurance, then Marketplace costs are not used at all.

    They need to find out what the lowest cost of employer insurance to cover the spouse would be. Did the spouse have access to insurance through her employer? If so, you will probably use that amount. If she works for a Large Employer, she would get a 1095-C and that amount would be on Line 15.

    If the spouse's employer did not offer insurance, then you look to the 'family plan' for the taxpayer's employer. Well, it's not not necessarily the 'family' plan, but whatever is the lowest cost plan that would cover the spouse (some employers offer a employee/spouse policy, which is lower cost than a 'family' plan which includes dependents, so you would use the cost of whichever is lower in cost). You then use the FULL cost of that plan to determine the 8.05% affordability exemption. Just to re-emphasize it, use the full cost, not the just the 'extra' cost above what the employee pays for just his coverage.

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      #3
      Thanks, Taxguybill, you might be the only person who understands this...and honestly, I feel embarrassed. I looked in the history of this board and found that I have kind of asked the same question at least twice. Anyway, the information I was looking at this time came from Intuit and doesn't seem to be right. Let's assume that one spouse doesn't have access to employer coverage whatsoever and Marketplace coverage would be 6%. This % is NOT added to the % the other spouse pays already (as you would do with two different employer plans)...Nothing has changed about this recently, right?

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        #4
        That is correct, they are not added together. It doesn't seem fair and I think that should be changed, but as of now, that is correct.

        Don't feel embarrassed about not knowing this stuff. It is a convoluted, twisted mess that they keep adding and changing the rules as time goes on. I continually need to look things up about this, but I've just looked it up enough times that I know where to look.

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