- Calculating the net cost of coverage for the employee (second-lowest silver plan minus monthly share of QSE HRA benefit)
- Determining if employer’s benefit is affordable by comparing the net cost vs. 9.69% of the household income
- If affordable (net cost less than 9.69% of household income), employee’s household is not eligible for APTC/premium subsidies
- If unaffordable, then the APTC amount would be reduced by the QSE HRA benefit, and the employee would still be responsible for paying their share of the cost of health insurance coverage.
- defines which employees are eligible (all full-time, non-seasonal employees who have worked at least 90 days) and the QSE HRA benefits;
- inform the employee they must report the benefit amount to the marketplace or state-based exchange; and
- remind the employee that they are still subject to the individual penalty for months where they do not have coverage.
