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

If I offer coverage to my employees, is there a minimum requirement for what I must contribute to the cost of my employees’ premiums?

Coverage for small employers | Small Employer Coverage |
ANSWER

Minimum contribution requirements will vary based on where you purchase your coverage. For example, insurers offering SHOP coverage through the federally facilitated marketplace are prohibited from requiring employers to make a minimum contribution. However, outside of SHOP coverage and in some states operating marketplaces for SHOP coverage, minimum contribution rules may still apply. Minimum contribution requirements must be waived between November 15 and December 15 of each year, allowing employers that do not meet the minimum contribution requirements to access coverage. In addition, states may independently require employers offering coverage to make a minimum contribution to the cost of their employees’ premiums. (45 C.F.R. § 155.706; 45 C.F.R. § 147.104).

Related Tags

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