QUESTION

I’m offered health benefits at work, but they’re not very good. I understand I may be eligible for subsidies with marketplace subsidies if my job-based plan doesn't meet "minimum value." What does that mean?

Individuals with no coverage | Eligibility for Premium Tax Credits and Cost-Sharing Reductions
ANSWER

The term “minimum value” means that your job-based plan would cover at least 60 percent of an average group of people’s covered health costs including hospitalization and physician services. Most employer plans will meet this test, but some may not. The marketplace application includes a form with questions about job-based coverage. You should take this form to your employer and ask them to fill it out. With that information the marketplace will determine whether the plan meets minimum value. If it doesn’t, you may be able to qualify for premium tax credits to help pay for marketplace coverage. (45 C.F.R. § 156.145; 26 C.F.R. § 1.36B-6).

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