Internal Revenue Service United States Department of the Treasury
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Affordable Care Act Workout

Premium Tax Credit

Case Study 3: Employee Safe Harbor Rule

Maria is single and has no dependents. Her employer offers health insurance, but she didn't enroll because she felt it was too expensive. The Marketplace determined that the employer offer was not affordable, and Maria enrolled in Marketplace coverage and received the benefit of advance payments of the premium tax credit (APTC). At the end of the year, she received both a Form 1095-A from the Marketplace and a Form 1095-C from her employer indicating that the employer coverage was affordable.

Because of the employee safe harbor rule, Maria is eligible for the PTC because in good faith she provided the Marketplace information about her employer's offer and the Marketplace determined that the coverage was unaffordable.

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