The Minimum Value Standard is a term introduced under the Affordable Care Act that determines whether an employer-sponsored health plan offers comprehensive coverage. If an employer's plan meets this standard and is considered affordable, individuals seeking marketplace coverage may not be eligible for financial assistance in the form of a tax credit.
How is the Minimum Value Standard determined?
An employer sponsored plan meets the Minimum Value Standard if it is designed to pay at least 60 percent of the total cost of medical services and cover physician and inpatient hospital services. This is sometimes referred to as a plan that is Bronze level coverage or higher.
How do I know if my employer’s plan meets the Minimum Value Standard?
Most employer-sponsored health plans meet the standard. If you are unsure, there are a few ways to check if your plan meets the Minimum Value Standard.
Contact your company’s HR department or Health Benefits Specialist. It’s recommended that you provide them with a copy of the Employer Coverage Worksheet to complete.
The Summary of Benefits and Coverage provides a concise overview of a health plan's costs, benefits, covered services, and key features for consumers to review. It is as a snapshot of what the plan offers and helps individuals understand their coverage. This document will clearly state if the plan meets the minimum value standard.
Sample Summary of Benefits and Coverage document
When is an employer’s plan considered unaffordable?
For 2024, employer sponsored coverage is considered unaffordable if the annual premium is more than 8.39%* of your total household income.
*This value is determined by the IRS