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questions and answers about health insurance and employee benefits

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Health Insurance FAQs
Health Insurance FAQs

questions and answers about health insurance and employee benefits

Costs & Affordability

What is the Federal Poverty Line safe harbor and how does it work?

HealthInsuranceFAQs, March 27, 2025June 16, 2025

The FPL safe harbor sets a fixed monthly max—$113.20 in 2025—for self-only coverage to be considered affordable, making ACA compliance simple and consistent across all employees.

What is the Rate of Pay safe harbor and how does it work?

HealthInsuranceFAQs, March 27, 2025June 16, 2025

Employers can meet ACA affordability by ensuring self-only coverage costs no more than 9.02% of an employee’s hourly rate × 130 hours or their monthly salary.

What is the W-2 safe harbor and how does it work?

HealthInsuranceFAQs, March 27, 2025June 16, 2025

Employers using the W-2 safe harbor must ensure employee-only coverage costs no more than 9.02% of W-2 Box 1 wages to meet ACA affordability requirements.

What is the family glitch?

HealthInsuranceFAQs, March 27, 2025March 27, 2025

The “family glitch” made families ineligible for subsidies if employee-only coverage was affordable—even if family coverage wasn’t. A 2023 rule change fixed this by evaluating family affordability separately.

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