The federal poverty level guidelines (FPL) are used for many purposes, including assessing eligibility for a premium tax credit for coverage purchased through the health Marketplace. Premium tax credits are available to individuals who have household income of 100% to 400% of FPL in states that have not expanded Medicaid eligibility to 133% of FPL and to those who have household income of 133% to 400% of FPL in states that have adopted expanded Medicaid – an individual who is eligible for Medicaid is not eligible for a premium tax credit.
Larger employers that do not offer affordable, minimum value coverage to full-time employees will owe a penalty on employees who receive a premium tax credit, so employers that sponsor group health plans have an interest in the FPL. FPL also may be used by employers for affordability and reporting safe harbors under the employer shared responsibility requirements.
The Department of Health and Human Services has published the 2015 federal poverty level (FPL) guidelines at 2015 Poverty Guidelines. For 2015, in states other than Alaska and Hawaii FPL is $11,770 for a single person and $24,250 for a family of four. This compares to $11,670 for a single person and $23,850 for a family of four in 2014. FPL in Alaska for 2015 is $14,720 for a single person and $30,320 for a family of four, and in Hawaii it is $13,550 for a single person and $27,890 for a family of four.
For more information on minimum value coverage, download UBA’s PPACA Advisor, “Essential Health Benefits, Minimum Essential Coverage, Minimum Value Coverage: What’s the Difference?