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Opt-Out Payments

An opt-out payment is cash an employer offers employees who decline its coverage. Unless structured properly, the amount can count toward the cost of coverage when testing ACA affordability.

What are opt-out payments, and how do they affect ACA affordability?

June 29, 2026June 16, 2026 by HealthInsuranceFAQs

An opt-out payment is cash an employer offers employees who decline its health coverage. An unconditional opt-out payment generally must be added to the employee’s required contribution when testing ACA affordability, which can make otherwise-affordable coverage “unaffordable.”

Categories Costs & Affordability Tags Opt-Out Payments

Health Insurance FAQs is researched carefully and believed to be accurate and current, but it is general information, not legal, tax, or insurance advice.

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