Exchange Subsidies


People with income between 100% and 400% FPL (see tables below) may be eligible for premium and cost sharing subsidies for purchasing coverage in the exchange. 

Premium Subsidies:

Premium subsidies are established such that a person pays a certain percentage of their income toward a premium (benchmarked to silver level coverage).  The person pays their share of the premium to the insurer based on their income and the federal government pays the rest of the premium directly to the insurer. 

Cost sharing subsidies:

People with household income between 100% and 400% FPL may also be eligible for cost sharing subsidies.  Certain health benefit plans at the Silver level available to those who are eligible for subsidies have higher actuarial values so cost sharing subsidies are built into the plan up front. Those eligible for subsidies will have lower out of pocket maximum amounts as well. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WHA Contact:

Joanne Alig

Senior Vice President

Policy and Research

608-274-1820

jalig@wha.org