23.04 Enrollment in eligible employer-sponsored plan

In general.64 Except as provided in paragraph (b) of this subsection, the requirements of affordability and minimum value do not apply for months that an individual is enrolled in an eligible employer-sponsored plan. Automatic enrollment.65 An employee or related individual is treated as not enrolled in an eligible employer- sponsored plan for a month in a plan year or other period for which the employee or related individual is automatically enrolled if the employee or related individual terminates the coverage before the later of the first day of the second full calendar month of that plan year or other period or the last day of any permissible opt- out period provided by the employer-sponsored plan or in regulations to be issued by the Department of Labor, for that plan year or other period. Examples.66 The following examples illustrate the provisions of this subsection: (1) Example 1. Tax filer H is employed by Employer X in 2014. H's required contribution for self-only employer coverage exceeds 9.5 percent of H's 2014 household income. H enrolls in X's calendar year plan for 2014. Under paragraph (a) of this subsection, H is eligible for MEC for 2014 because H is enrolled in an eligible employer-sponsored plan for 2014. (2) Example 2. The facts are the same as in Example 1, except that H terminates plan coverage on June 30, 2014. Under paragraph (a) of this subsection, H is eligible for MEC under X's plan for January through June 2014 but is not eligible for MEC under X's plan for July through December 2014. (3) Example 3. The facts are the same as in Example 1, except that Employer X automatically enrolls H in the plan for calendar year 2015. H terminates the coverage on January 20, 2015. Under paragraph (b) of this subsection, H is not eligible for MEC under X's plan for January 2015. 62 26 CFR § 1.36B-2(c)(3)(v)(D). 63 45 CFR § 156.145; see, also, 26 CFR §§ 1.36B-2(c)(3)(vi) and 1.36B-6. 64 26 CFR § 1.36B-2(c)(3)(vii)(A). 65 26 CFR § 1.36B-2(c)(3)(vii)(B). 66 26 CFR § 1.36B-2(c)(3)(vii)(C). Nonfinancial eligibility requirements Part 3 – Page 29 (Sec.23.00, Sub.23.05)