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Health Insurance FAQs

questions and answers about health insurance and employee benefits

Opt-Out Payments

Some employers offer cash to employees who decline coverage, which can affect ACA affordability. These FAQs explain opt-out payments and the rules around them.

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

HealthInsuranceFAQs, June 16, 2026June 16, 2026

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.”

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