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Premium Tax Credit Eligibility Question


peggysioux5

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Taxpayer received advanced payments of premium tax credit for 2021 (and has for several years).  Taxpayer stated she provided all information to the Marketplace stating that she told Marketplace representative that she was eligible for health insurance through employer that met MIC when she first enrolled in Covered CA.  She is not asked, nor does she provide, the cost of the employer-provided insurance to the Marketplace each year.  The instructions state:  If taxpayer provided accurate information about his employer’s coverage to Marketplace, and the Marketplace determined that the offer of coverage was not affordable, taxpayer is eligible for APTC.

The Marketplace determined she was eligible for APTC several years ago and just renews every year without determining affordability based on cost of employer-provided coverage.

So my question is this:  Is she eligible for the Premium Tax Credit? Do I mark that she is ineligible for PTC being employer-provided coverage is below 9.83% of income or being the Marketplace “determined” her eligible, she is not liable for payback of the APTC?

Input is very much appreciated.

Peggy Sioux
 

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