The ‘family glitch’ refers to the affordability standard for employer-sponsored coverage (also referred to as job-based coverage) that determines whether an employee with an offer of job-based coverage, as well as their dependents, are eligible for financial assistance (advance premium tax credits or APTC) to enroll in marketplace coverage.
(Note: The policies governing eligibility for financial assistance are set by the federal government, and not the Commonwealth of Pennsylvania or Pennie).
Job-based coverage is considered to be affordable to the employee if the employee’s share of the premium is less than 9.83 percent of the employee’s household income in 2021. If coverage is affordable and meets minimum value standards, the employee is not eligible for APTC. The employee’s family would also not be eligible for APTC because the offer of coverage meets the affordability threshold for the employee, as long as the offer of coverage was extended to the rest of the family. It does not matter if the percentage of household income to insure the entire family is much higher than 9.83 percent, the entire family is not eligible for APTC because a household member has an offer of job-based coverage that meets this affordability standard.