Employers should not overlook the Affordable Care Act's (ACA's) annual inflation-adjusted shift in cost-sharing limits for group health plan coverage, as they could face potential penalties for failing to provide affordable coverage under the ACA's shared-responsibility provisions.
On May 21, the IRS announced in Revenue Procedure 2018-34 the 2019 shared-responsibility affordability percentage. Based on the ACA's affordability standard as adjusted for inflation, health coverage will satisfy the requirement to be affordable if the lowest-cost self-only coverage option available to employees does not exceed 9.86 percent of an employee's household income, up from 9.56 percent in 2018.
In determining the maximum self-only contribution amount that a calendar year plan can charge in 2019 under the Federal Poverty Level (FPL) safe harbor, the 2019 FPL of $12,140 for a one-person household is used. The maximum monthly contribution will be 9.86% of $12,140, divided by 12, or $99.75. The amounts for prior years are also included in the table below:
Calendar Year
|
Prior Year FPL
|
Affordability Percentage
|
Maximum Monthly Contribution
|
2019
|
$ 12,140
|
9.86%
|
$ 99.75
|
2018
|
$ 12,060
|
9.56%
|
$ 96.08
|
2017
|
$ 11,880
|
9.69%
|
$ 95.93
|
2016
|
$ 11,770
|
9.66%
|
$ 94.75
|
2015
|
$ 11,670
|
9.56%
|
$ 92.97
|