Affordability Testing

By Chris Noffke, GBDS, CSFS, Vice President of Employee Benefits

Chris Noffke

The Affordable Care Act (ACA) brought a lot of extra work to employers and insurance companies. Whether you are pro-health care reform or against it, per the Health Affairs article, the ACA has not made insurance more affordable. Many health insurance carriers have stated the ACA, Summaries of Benefits and Coverage, machine readable files and other changes imposed added costs to insurance companies, which simply passed these costs on to employers and employees in premiums.

Insurance premium affordability is very important because it allows for more money to employers and employees and is a requirement for groups with 50 or more employees. As you may know, health care reform requires employers with 50 or more employees to offer a group health insurance option that is affordable and meets the minimal essential coverages or the employer can face a potential monetary fine (the 2022 fine was $4,120 annually per subsidized employee). Additionally, the employer should be testing to confirm the affordability requirement is being met for their employees’ premium charges. Based on health care reform’s 2023 rules, to be considered affordable in 2023, an employee cannot be charged more than 9.12% of the employee’s household income.

Do you need to test your affordability? Are you offering a plan similar to other health care companies in your areas? WisMed Assure is the only insurance agency in Wisconsin focused on health care clients and we would love to tell you more about what we can do! Please call me at 608.442.3734 or email

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