QUESTION

I have an offer of coverage from my employer, but the premiums are too expensive and I have to pay a lot out-of-pocket. Can I get financial help in the health insurance marketplace?

Individuals with coverage | Coverage for Employees of a Small Employer
ANSWER

If your premiums for self-only coverage in your employer plan are 9.86 percent or more of your household income in 2019 and your income is between 100 percent and 400 percent of the federal poverty level, you may be eligible for a premium tax credit for coverage in a health insurance marketplace. The coverage must also provide minimum value (at least 60 percent of average costs of covered services).

The application for coverage in a health insurance marketplace includes questions your employer can answer to help determine whether your health benefits qualify you for a premium tax credit. (26 U.S.C. 36B; 26 C.F.R. § 1.36B-2).

Individuals with no coverage
Individuals with coverage
Coverage for small employers
Post enrollment issues