<img src="//bat.bing.com/action/0?ti=5067266&amp;Ver=2" height="0" width="0" style="display:none; visibility: hidden;">
Request Demo

Small Business Employee Benefits and HR Blog

Health Insurance Tax Subsidy Charts

Beginning in 2014, significant tax subsidies will be available to help individuals purchase individual health insurance coverage through the new state-based public marketplaces.Detailed tax subsidy charts

The following charts calculate the health insurance tax subsidies and estimated premium amounts, by family size and household income.

What are the Health Insurance Tax Subsidies?

Starting January 1, 2014, health insurance tax subsidies will be available for individuals and families who enroll in "Silver" plans through their state marketplace. 

The subsidies will cap the cost of health insurance at 2% - 9.5% of household income, if household income is up to 400% above the federal poverty line (FPL).

Individuals are only eligible for tax subsidies if they are not offered qualified, affordable group health insurance through an employer.

Health Insurance Tax Subsidy Chart: 40-year old individual

This chart provides tax subsidy and premium estimates for a 40-year old individual. (Note: These are estimates only, and the premium amounts will vary by state. See sources below.)

  FPL 2013
  100%* 133% * 150% 200% 250% 300% 350% 400%
2013 Household Income  $11,490 $15,282 $17,235 $22,980 $28,725 $34,470 $40,215 $45,960
% of Income Premium Capped at: 0% - 2.0% 0% - 3.0% 4.00% 6.30% 8.10% 9.50% 9.50% 9.50%
Max Amount of Monthly Premium $0 - $19 $0 - $38 $57 $121 $193 $273 $318 $364
                 
Average Silver Monthly Premium  $321 $321 $321 $321 $321 $321 $321 $321
Average Silver Annual Premium $3,852 $3,852 $3,852 $3,852 $3,852 $3,852 $3,852 $3,852
                 
Federal Tax Subsidy (Monthly) up to $302 up to $283 $264 $201 $129 $49 $3 $0
                 
Monthly Premium Cost $0 - $19 $0 - $38 $57 $121 $193 $273 $318 $321
Annual Premium Cost $0 - $228 $0 - $456 $684 $1,452 $2,316 $3,276 $3,816 $3,852
Penalty for Individuals Not Covered
Annual Penalty 2014 $115 $153 $172 $230 $287 $345 $402 $460
Annual Penalty 2015 $325 $325 $345 $460 $575 $689 $804 $919
Annual Penalty 2016 $695 $695 $695 $695 $695 $862 $1,005 $1,149

* This amount will depend on whether your state participates in Medicaid expansion.  

Health Insurance Tax Subsidy Chart: Family of Four

This chart provides tax subsidy and premium estimates for a family of four with two 40-year olds, and two children ages 21 or under. (Note: These are estimates only, and the premium amounts will vary by state. See sources below.)

  FPL 2013
  100% * 133% * 150% 200% 250% 300% 350% 400%
2013 Household Income  $23,550 $31,322 $35,325 $47,100 $58,875 $70,650 $82,425 $94,200
% of Income Premium Capped at: 0% - 2.0% 0% - 3.0% 4.00% 6.30% 8.10% 9.50% 9.50% 9.50%
Max Amount of Monthly Premium $0 - $39 $0 - $78 $118 $247 $397 $559 $653 $746
                 
Average Silver Monthly Premium  $962 $962 $962 $962 $962 $962 $962 $962
Average Silver Annual Premium $11,544 $11,544 $11,544 $11,544 $11,544 $11,544 $11,544 $11,544
                 
Federal Tax Subsidy (Monthly) up to $923 up to $884 $844 $715 $565 $403 $309 $216
                 
Employee's Monthly Premium Cost $0 - $39 $0 - $78 $118 $247 $397 $559 $653 $746
Employee's Annual Premium Cost $0 - $468 $0 - $936 $1,416 $2,964 $4,764 $6,708 $7,836 $8,952
Penalty for Individuals Not Covered
Employee's Annual Penalty 2014 $285 $313 $353 $471 $589 $707 $824 $942
Employee's Annual Penalty 2015 $975 $975 $975 $975 $1,178 $1,413 $1,649 $1,884
Employee's Annual Penalty 2016 $2,085 $2,085 $2,085 $2,085 $2,085 $2,085 $2,085 $2,355

* This amount will depend on whether your state participates in Medicaid expansion.  

Click here for a complete chart pack.

Chart Calculations & Sources 

  • 2013 Household Income & FPL: Annual household income in 2013 and the corresponding 2013 federal poverty line (FPL) measurement. See: 2013 Federal Poverty Line (FPL) Charts.

  • % of Income Premium Cap: The federal health insurance tax subsidies will cap the amount of the premium at this percentage of income. This percentage is based on FPL and household size.

  • Max Amount of Monthly Premium: This is the monthly maximum premium amount, based on income and the premium cap percentage above. 

  • Average Silver Monthly Premium: This is a national estimate of average monthly premiums expected through the Marketplace in 2014 dollars, derived from estimates from the Congressional Budget Office. Rates will vary by state.

    Premiums are based on a "Silver" plan (plan pays 70%). If an individual purchases a plan that is more expensive than the second lowest cost "Silver" plan, he or she would pay the full difference between the cost of the second lowest cost "Silver" plan and the plan that they wish to purchase. Rates also assume non-tobacco use. Source: Kaiser Family Foundation

  • Average Silver Annual Premium: The national average of premiums, annualized.

  • Federal Tax Subsidy (Monthly): The estimated monthly tax subsidy (based on income, premium cap, and amount of premium).

  • Monthly Premium Cost: Estimated net monthly premium cost (average monthly premium minus federal tax subsidies).

  • Annual Premium Cost: Estimated net annual premium cost.

Penalty Calculations for Individuals and Families Not Covered Under Health Insurance

  • In 2014, the penalty will be $95 per person up to a maximum of three times that amount for a family ($285) or 1% of household income if greater.

  • In 2015, the penalty will be $325 per person up to a maximum of three times that amount for a family ($975) or 2% of household income if greater.

  • In 2016, the penalty will be $695 per person per year up to a maximum of three times that amount for a family ($2,085) or 2.5% of household income if greater.


Subscribe to our blog