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Health Care Reform: Guidance for Individuals Seeking Health Insurance Premium Tax Credit

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April 2013

Beginning in 2014, eligible individuals who purchase coverage under a qualified health plan through an Affordable Insurance Exchange may receive a premium tax credit under section 36B of the Internal Revenue Code. Individuals generally may not receive a premium tax credit if they are eligible for affordable coverage under an eligible employer-sponsored plan that provides “minimum value.” The IRS issued regulations on April 30 providing guidance to individuals on how to determine whether a particular group health plan provides minimum value and whether it is affordable. Importantly, the guidance also discusses how wellness incentives may affect the affordability or minimum value measurement of a particular group health plan. 

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