Published October 20, 2026 · Daniel Griffin, Licensed Independent Advisor · NPN #22052447
If one of you has health insurance through work and the rest of the family is on that plan, you have probably been told the family cannot get marketplace tax credits because “you have an offer of coverage.” For 2027 that is only true if the job’s family coverage costs 10.22% of your household income or less. Above that, your spouse and children can shop the marketplace with a credit, even though the employee stays on the work plan.
This is the rule people call the “family glitch fix.” It has been in force since 2023, and most families who qualify for it have never checked.
The Test, in One Line
Take the employee’s share of the premium for family coverage on the cheapest plan the employer offers that provides minimum value. If that comes to more than 10.22% of household income for 2027, the plan is “unaffordable” for the spouse and children, and they can get a premium tax credit on the marketplace if the household is otherwise eligible.
The employee is judged differently: on the cost of employee-only coverage. If that is affordable, the employee cannot get a credit and normally stays on the job’s plan. So the family ends up split: one person on the employer plan, everyone else on a marketplace plan.
| Household income | 10.22% of it, per year | Per month |
|---|---|---|
| $60,000 | $6,132 | $511 |
| $80,000 | $8,176 | $681 |
| $100,000 | $10,220 | $852 |
| $120,000 | $12,264 | $1,022 |
If the employee’s monthly share of family coverage is above the last column, the spouse and children fail the affordability test for 2027. For 2026 the line was 9.96%.
On a spouse’s work plan? Check the family math.
Send your ZIP code. A licensed agent runs the 10.22% test on your real payroll deduction and prices the split option in your county.
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Three Things That Must Also Be True
- Household income between 100% and 400% of the poverty line. For 2027 coverage that is $27,320 to $109,280 for a family of three and $33,000 to $132,000 for a family of four. Above 400% there is no credit for anyone, whatever the employer plan costs.
- The spouse and children do not enroll in the employer’s plan. Anyone who takes the job’s coverage for a month cannot get a credit for that month.
- You file taxes jointly, if you are married. Married couples filing separately generally cannot claim the credit.
When the Split Is Worth It
Failing the test only makes the family eligible. Whether the split saves money depends on what the credit brings the marketplace plans down to in your county, against what the employer charges to add a spouse and children. Two quick checks:
- Take the monthly payroll deduction for family coverage and subtract the deduction for employee-only coverage. That difference is what the family’s coverage really costs you at work.
- Compare it with the family’s marketplace premium after the credit, and add the two deductibles you would be carrying instead of one. A split household can have two deductibles to meet.
Networks matter too: the family’s marketplace plan will use a different network from the work plan, so check the children’s pediatrician and any specialist before you move them. More on the choices for a spouse in health insurance for your spouse.
When to Do It
The marketplace side is open from November 1 to January 15 on HealthCare.gov; choose by December 15 for a January 1 start (dates by state). The employer side runs on the employer’s own open enrollment, which is often in November: drop the spouse and children at work for the same January 1 date, or you pay for both.
Two plans or one? Start with your ZIP.
A licensed agent compares keeping the family on the work plan with the marketplace split, using your real numbers, before either open enrollment closes.
Get Started Right Now →Free · No obligation · Licensed in 23 states · NPN #22052447
Sources
- IRS, Questions and Answers on the Premium Tax Credit: affordability of employer coverage for family members.
- Treasury and IRS, final regulations on affordability for related individuals, T.D. 9968 (October 2022).
- IRS, Rev. Proc. 2026-26: the 10.22% required contribution percentage for 2027.
- HHS, 2026 poverty guidelines: the 100% and 400% figures for 2027 coverage.
The table shows the affordability line only; it is not a quote. Eligibility for the credit also depends on the rest of your household’s circumstances. Nothing here is tax advice; confirm credit decisions with your tax preparer. Nothing here is an offer of coverage. Daniel Griffin is a licensed independent insurance agent, NPN #22052447, not tied to any single carrier and not affiliated with the U.S. government.