Question

Which of the following individuals is eligible to claim a Premium Tax Credit for 2015, assuming their household income is 100% or more of the federal poverty line (FPL), but not more than 400% of the FPL.?

Ann, single, who obtained health coverage from her employer.

Bob, single, who was on Medicare for all of 2015.

Cassie, single, who obtained insurance from the Marketplace. She was eligible for health coverage from her employer at a cost equal to about 5% of her household income. Cassie declined coverage from her employer.

Doug, single, who obtained insurance from the Marketplace. He was eligible for health coverage from his employer at a cost that exceeded 9.56% of his household income. Doug declined coverage from her employer.

Erin, her husband and 3-year old daughter. Erin’s employer offered her self-only health coverage for 2015 with a cost to her equal to 5% of her household income. The coverage offered for the entire family was at a cost greater than 9.56% of household income.

**Your answer must include the reason that the individual is or is not eligible for the credit.

Answer 1

1. Since, Ann is single and has obtained health coverage from her employer, so according to the rules regarding eligibility for Premium Tax Credit (PTC), 2015, Ann is not eligible to claim a PTC.

2. Since, Bob is single and has obtained health coverage from a government based health care plan such as Medicare , so according to the rules regarding eligibility for Premium Tax Credit (PTC), 2015, Bob is not eligible to claim a PTC.

3. Since, Cassie is single and has obtained health coverage through the Marketplace for at least one month of a calendar year in which she was not eligible for affordable coverage through an eligible employer-sponsored plan that provides minimum value or eligible to enroll in government health coverage , so according to the rules regarding eligibility for Premium Tax Credit (PTC), 2015, Cassie is eligible to claim a PTC.

4.  Since, Doug is single and has obtained health coverage through the Marketplace for at least one month of a calendar year but was eligible for affordable coverage through an eligible employer-sponsored plan that provides minimum value or eligible to enroll in government health coverage , so according to the rules regarding eligibility for Premium Tax Credit (PTC), 2015, Doug is not eligible to claim a PTC.