Health Plan Affordability Threshold Drops for the 2024 Plan Year

According to IRS Rev. Proc. 2023-29, the Affordable Care Act (ACA) threshold for determining the affordability of employer-sponsored health coverage will drop to 8.39% of an employee's household income for the 2024 plan year. This is a significant decrease from the 2023 plan-year level of 9.12%. The adjusted percentage applies on a plan-year basis, so plans will continue to use 9.12% to determine affordability in 2024 until their new plan year begins, if it does not begin at the start of the calendar year.

The affordability threshold affects employers' potential liability for ACA shared-responsibility penalties. It is adjusted annually based on health plan premium growth relative to income growth using national health expenditure data from the Centers for Medicare & Medicaid Services.

Applicable large employers may rely on one or more safe harbors to determine whether coverage is affordable. These include an employee's W-2, an employee's rate of pay and/or the federal poverty level.

Employers should review the required employee contribution for 2024 coverage if they plan to meet the ACA's affordability limit under the applicable safe harbor and check with their insurance professional or qualified tax advisor to see if this penalty may apply.

Medicare Part D Notice Coming Soon

Employers who provide prescription drug coverage to retirees and/or to Medicare-eligible employees are required to determine whether their drug plan provides “creditable coverage,” -- meaning the coverage is expected to pay, on average, as much as the standard prescription drug coverage under Medicare Part D. Employers offering prescription drug coverage must provide notices of "creditable" or "noncreditable" coverage to Medicare-eligible employees or covered dependents before the annual Medicare Part D annual enrollment period begins. Since the 2023 enrollment period runs from Oct. 15 to Dec. 7, the final day to provide this notice is Oct. 14.

We will soon be sending notices to our employer groups indicating which QualChoice plans include drug coverage that is “creditable coverage” and any that are not considered “creditable coverage.’ 

September is Prostate Cancer Awareness Month

Prostate Cancer is the most commonly diagnosed non-skin cancer in men. It is also the second leading cause of cancer deaths in men, after lung cancer. September is recognized as Prostate Cancer Awareness Month. It is designed to raise awareness about prostate cancer, risk factors, and symptoms, and to encourage men to talk to their healthcare provider about prostate cancer and early detection.

Learn more about prostate cancer and prostate health on the Prostate Health Guide website.

September is also Childhood Cancer Awareness Month and Blood Cancer Awareness Month.

Did you know that QualChoice provides a CARES Cancer Awareness Resources and Support program? The goal of this program is to provide high quality, helpful services to our members with cancer and their families. We work with our members to help them understand their illness and learn how to actively manage their own care.

Learn more about QCARE Cancer Management.

NOTE: Programs vary by employer group and benefit plan. Members should check with their benefits administrator.

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