Does my Employer meet minimum value standard?
My managers are unable to help me answer any of these questions, I have contacted HR but I am waiting to hear back from them.
Does my Employers health insurance meets the minimum value standard (60% medical services for a standard population) Is it considered affordable in NJ?
I currently have a marketplace plan with a premium tax credit so my monthly premium is only 128 through marketplace. However now that I am being offered health insurance through my employer I have to figure out the above questions to see if I still qualify for my marketplace plan or will need to legally switch over to employers insurance.
I make 35k a year x .0912 (affordable fed rate) = 3190 maximum for annual premium payments to be considered "affordable"
Employer Insurance Options
Option A 167.99 biweekly paychecks x 26 weeks in a year = 4367.74 annual premium
TIER 1 Tier 2
Primary/Specialist Care 20/40$ 40/50$ Deductible – Single 1000$ 2,500$ Coinsurance 90% 70% Maximum out of pocket 3,500$ 6,500 RX generic/brand/preferred 15/50/75$ 15/50/75$ RX deductible 0$ 0$
Option B 127.30 biweekly x26 weeks (yearly) = 3309.80 annual premium
TIER 1 Tier 2
Primary/Specialist Care Deductible fist then 20/40$ Deductible fist then 40/50$ Deductible – Single 2000$ 2,500$ Coinsurance 80% 50% Maximum out of pocket 4,500$ 6,650$ RX generic/brand/preferred 60% 15/50/75$ RX deductible 0$ 2000$ medical deductible
The plan paper I was given makes no mention of hospital or outpatients services provided.
submitted by /u/Haunting_6772