If you’re offered group health insurance through your employer, you’re generally not eligible for subsidies (premium tax credits) on a Marketplace plan, unless that employer coverage is considered unaffordable or doesn’t meet minimum value standards.

Here’s a breakdown:

🔹 What Makes Employer Coverage “Affordable”?

According to healthcare.gov…”a job-based health plan is considered affordable if your share of the monthly premium in the lowest-cost plan offered by the employer is less than 9.02% of your household income.”

• Note: It’s based only on self-only coverage, not family plans, even if you’re covering dependents.

🔹 What Is “Minimum Standards”?

An employer plan provides minimum standards if it pays at least 50% of the employee’s premium and meets the minimum essential health benefits.

🔸 If It’s Affordable + Meets Minimum Value:

You can still buy a Marketplace plan, but you won’t get any subsidy — you’d pay full price.

🔸 If It’s Not Affordable or Lacks Minimum Value:

You can decline the group plan and get a subsidy on a Marketplace plan, assuming you meet other eligibility requirements.

Let Us Help!  Want help figuring out if your plan is considered “affordable” or not? We can walk you through a quick calculation if you know your income and how much your job’s plan costs. Speak to one of our health agents today!