ACA Affordability Calculator
               
  Employer-Based Coverage Affordability Worksheet Calculator 2017        
  Enter Taxpayer MAGI to begin            
Step 1- Required Enter Taxpayer Modified AGI        
  Enter Dependent MAGI  
Total Household  
Income used for both Total Household Income      
Full year and  8.16% of Household Income  
Annualized calculation        
  Employer-Based Policy Type Self-Only Family Policy    
For full year Use to calculate full year 12 month period Monthly Premium Monthly Premium  
Step 2- Required Enter employer health coverage monthly premium  
Step 3- Review Calculated annual premium      
If Cost exceeds 8.16%,  Coverage Indicator  
enter exemption for Self  Cost of Coverage as % of Income  
or family, enter Code A        
in 8965, Part III entire year.        
         
       
Per IRS instructions, use Annualized Premium Worksheet only for partial year periods.      
       
  Annualized Premium Worksheet  Self-Only Family Policy  
Partial year Annualized Use to calculate partial year periods Total Premiums Total Premiums  
Step 2- Required Monthly premium in part-year period  
Step 3- Review Number of full months in the part-year period  
If Cost exceeds 8.16%,  Calculated annualized premium      
enter exemption for Self  Coverage Indicator  
or family, enter Code A Coverage as % of Income  
in 8965, Part III for each        
month.         
       
       
Per IRS instructions, use Marketplace Coverage Affordability Worksheet only if employer coverage is NOT available.    
         
       
  Marketplace Coverage Affordability Worksheet Calculator 2017  
Step 1- Required Enter Taxpayer MAGI to begin      
  Taxpayer Modified AGI Form 8962, Line 2a  
  Dependent MAGI Form 8962, Line 2b  
   Enter Total Household Income     
       
Step 2- Required Enter Lowest Cost Bronze Plan Premium Monthly  
  Calculated annual amount Lowest Cost Bronze Plan  
  Click here to access Healthcare.Gov Bronze Plan Premium    
Step 3- Required Enter Second Lowest Cost Silver Plan Monthly  
  Calculated annual amount SLC Silver Plan  
Enter both Bronze and  Click here to access Healthcare.gov Silver Plan Premium    
Silver Plan premium costs.      
 
     
Step 4- Verify Enter Household size 
 
     
Step 5- Verify Select Federal Poverty Line Table
 
  2017 Federal Poverty Line Amount  
Step 6- Note Percentage above Federal Poverty Line FPL Below 100% and  
  Contribution factor based upon FPL  above 400% FPL does   
  Total Household Income x FPL factor not qualify for   
  Line 9 Monthly Amount (Line 8 divided by 12)  a credit and N/A  
  Silver Plan premium minus Line 9 amount above will appear.   
     
Step 7- Review This is the required contribution per month used  
  to determine if Marketplace plan costs exceed     x 12 months  
  the 8.16% of income threshold. Note: If zero or a  Annualized Premium  
  negative amount, enter a 0. If income is greater than  
  400% of FPL, the full bronze premium amount is     
  used to determine affordability.    
     
     
  Full Year Manual Input  
  Total Household Income  
  Less: Non-taxable Social Security Benefits          
  8.16% of Household Income affordability threshold  
 
Step 8- Review Coverage Indicator  
  Coverage as % of Income  
    Automated input Manual entry  
  Total Full Year contribution Premium Costs  
  Month      
  Affordability Worksheet Threshold                                       (A)    
  For each month (B) exceeds (A) coverage is unaffordable. Coverage is affordable where (B) is less than (A).      
  (B) January                                                                                               
  (B) February                                                                                            
  (B) March                                                                                                 
  (B) April                                                                                                   
  (B) May                                                                                                   
  (B) June                                                                                                     
  (B) July                                                                                                       
  (B) August                                                                                                
  (B) September                                                                                       
  (B) October                                                                                             
  (B) November                                                                                         
  (B) December                                                                                        
       
Per IRS instructions, use Annualized Premium Worksheet only for partial year periods.      
       
Step 9- Review Annualized Annualized Premium Worksheet       
  Use to calculate partial year periods Total of Premiums Total of Premiums  
Partial Year Annualized Monthly premium in part-year period    
If the Coverage  Enter number of full months in the part-year period    
Indicator exceeds 8.16% Calculated annualized premium  
then Form 8965 Part III Coverage Indicator  
Code A exemption Coverage as % of Income  
can be taken for each   
month Form 8965 Part III  
the part-year period. This calculator is designed to be informational only.