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Delta Dental Quoting

Employer contribution entered in Dental Contribution under Group Information affects the Delta Dental plans and rates returned. Please be aware that Delta Dental will require groups with 100% employer contribution to have 100% participation.

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ACA/Healthcare Reform

Are individuals exempt from the individual mandate if their required contribution for coverage for the month exceeds 8% or 9.5% of their household income?

There are two different affordability percentages – 8% and 9.5% (indexed annually).  These percentages are used for different purposes.

 

9.5% of household income is used to determine affordability for purposes of the large employer mandate (there are safe harbors employers can use instead of household income) and eligibility for premium tax credits and cost-sharing reductions on the Exchange.

 

8% of household income is used to determine affordability for purposes of the individual mandate.  Individuals who cannot afford coverage, meaning the individual’s required contribution for coverage for the month exceeds 8% of the individual’s household income, are exempt from the individual mandate and thus will not be subject to the penalty.