Employer Funding Versus Premium Tax Credit
Employer funding may be provided to you by your former employer or benefits provider. The Premium Tax Credit (PTC) is offered by the federal and state governments through the health insurance marketplace to those who qualify. Only one of these options can be used at a time as outlined below.
Employer Funding Benefits
If you receive funding from your former employer or benefits provider, you need to let us know if you want to use that funding. You can do this by signing into your account and choosing your employer funding or by calling Via Benefits at 1-800-822-2824 for assistance.
Advantages of taking employer funding:
Your income doesn't affect the amount of funding you get from your former employer.
You don't need to apply for the PTC when enrolling in a marketplace plan.
You don't have to provide personal details, such as income, when enrolling in a marketplace plan.
Premium Tax Credit
If you qualify, you can receive a PTC on a health insurance marketplace plan premium, which automatically lowers the premium amount. The amount of the PTC you receive depends on your estimated household income and household size.
If you choose a PTC, you must reconcile the PTC when you file taxes. If you earned more than was estimated, you may have to pay back some of the tax credit. If you earned less than was estimated, you may receive additional credits in your tax return.
Advantages of a PTC:
You receive a reduced plan premium instantly.
You don't have to wait for reimbursements.
In addition to PTC you may qualify for a Cost Share Reduction (based on household income and size) which could lower your out-of-pocket costs when using the plan.
Choosing Employer Funding Versus PTC
Call us at 1-800-322-2824 and speak with a licensed benefit advisor* to discuss the funding amount your employer may have provided. We can assist you with determining whether you qualify for a PTC and in completing your PTC application if needed. We can also assist you with determining whether employer funding or a PTC is a better option for you
Using Both Employer Funding and PTC
It’s important to know that you can’t use employer funding and a PTC together. However, you may reevaluate your options during a valid enrollment period. You can't choose a PTC if anyone in your household is using employer funding.
*Our licensed benefit advisors specialize in health insurance for retirees. They go through annual training and certification to ensure they can help you make an informed and confident decision.
