The Navigator Resource Guide has not been updated for 2025 Open Enrollment. For more current information please visit:
cms.gov/marketplace/in-person-assisters/information-partners.
QUESTION

I work full time for a large employer (more than 50 full time employees) and I’m married and we have kids. Is my employer required to offer health benefits that cover my spouse and kids?

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

Your employer is not required to offer health benefits. However, employers with 50 or more employees that don’t offer health benefits to their full-time employees and to their dependent children (but not their spouse) may be liable for a tax penalty. Large employers do not face a tax penalty if they don’t offer health benefits to the spouses of their workers. If your employer doesn’t offer coverage to your spouse or children, they can apply for coverage in the Marketplace and may be eligible for financial assistance. Subsidies are calculated based on the price of available plans and household income; lower income individuals are eligible for greater subsidy amounts, and some higher income individuals may not receive subsidies. If your employer offers health benefits that are affordable to you (meaning that the premiums cost no more than 8.39 percent of your household income) and meet minimum value, you still may choose to purchase coverage through the Marketplace, but you will not be eligible for premium tax credits to help pay for the coverage. (26 U.S.C. 36B; 26 U.S.C. § 4980H; IRS Rev. Proc. 2023-29).

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