Employer Health Insurance Affordability Calculator

This tool gives an estimate to see if you or your family members may be eligible for financial assistance.

General Information
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 (include wages and tips, salary, self-employment income, interest and dividends received, alimony received, Social Security payments received, and other income)
Individual Insurance
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A health plan meets the Minimum Value Standard if both of these apply:
  • It’s designed to pay at least 60% of the total cost of medical services for a standard population
  • Its benefits include substantial coverage of physician and inpatient hospital services
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Because the percentage of your household income towards your employee-only premium is larger than 9.02%, the plan is considered unaffordable. Based on this information, the employee may qualify for financial help if you apply for coverage through NY State of Health.
Family Insurance
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("Family health insurance" means health insurance that would cover the employee’s tax family, including a spouse filing jointly or a dependent. Other family members—such as adult children up to age 26 or non-dependent domestic partners—might be offered job-based coverage, but, if they are not on the employee’s tax return, they would not be considered in the affordability test and therefore the cost of covering them should not be included here).

* An employer-sponsored health plan meets "minimum value standard" if the health plan's share the total allowed benefit costs covered by the plan is no less than 60% of those cost.
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Note, employee-only coverage could be found affordable, even when family coverage is deemed unaffordable. In these cases, the employee would not be eligible for financial assistance, but family members would be.