QUESTION

My hours at work were cut back and I no longer qualify for my employer’s health plan. I’ve been offered COBRA but it’s too expensive. Can I shop for coverage and subsidies on the marketplace instead?

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

Yes, losing your employer coverage triggers a special enrollment opportunity that lasts for 60 days. You can apply for marketplace health plans and depending on your income and the cost of COBRA, you may qualify for premium tax credits and cost-sharing reductions. Since you’re still an employee, you’ll have to show that your COBRA is either unaffordable or fails to meet minimum value in order to qualify for financial help in the marketplace. To be unaffordable, your COBRA premium for self-only coverage will have to be more than 9.56% of your household income in 2018. To meet minimum value, the COBRA plan must have an actuarial value of 60 percent or more. (45 C.F.R. § 155.420; 26 U.S.C. § 36B).

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