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Resource Guide
On Private Health Insurance Coverage & The Health Insurance Marketplace
FAQs tagged with “Employer-Sponsored Coverage”
- I got a notice that my Marketplace plan will be cancelled or terminated. What are my options?
- I have a new Health Reimbursement Arrangement (HRA) from my small employer. Can I use it to enroll in coverage if it is outside of Open Enrollment?
- 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?
- I have an offer of employer-sponsored coverage, but the premiums are too expensive and I have to pay a lot out-of-pocket. Can I get premium tax credits in the health insurance Marketplace?
- I have COBRA and it’s too expensive. Can I drop it during open enrollment and enroll in a Marketplace plan instead?
- I recently received a surprise medical bill from a doctor or hospital for services that should have been covered by my insurance. What do I do?
- I thought my employer plan couldn’t have any annual or lifetime limits on benefits but I heard that there are limits in our plan. Is that allowed?
- I thought that contraceptives were now covered, but I heard on the news that some employers don’t have to cover them. Is that true?
- I thought there was an annual cap on my out-of-pocket costs, but I’m getting billed for something that puts me well above the limit. How can that be?
- I thought there was supposed to be a cap on my out-of-pocket costs, but when I look at my plan options, it looks like there is more than one cap, depending on what health care I use. How can that be?
- I want to add my spouse and/or children to my employer-sponsored plan but I can’t afford the family premium. Can my spouse buy a more affordable plan on the health insurance Marketplace?
- I will start a new job next month with benefits. Can I enroll right away in my employer plan?
- I work and am eligible for health benefits. Do I have to sign up for my job-based plan or will my employer do that for me?
- I work for a large employer (more than 50 full time employees) but my hours vary during the year. Does my employer have to offer me health benefits?
- I work for a large employer. My employer has offered me a Health Reimbursement Arrangement (HRA), with money to buy health insurance on my own. What are my options?
- I work for a small business. My employer has offered me a Health Reimbursement Arrangement (HRA), with money to buy health insurance on my own. What are my options?
- 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?
- I work full time for a large employer (more than 50 full time employees). Is my employer required to offer me health benefits?
- I work full time for a small business (fewer than 50 employees). Does my employer have to offer me health benefits?
- I work part-time for a large employer. Is my employer required to offer me health benefits? What about benefits for my spouse and kids?
- I’m eligible for health benefits at work, but I didn’t turn in my enrollment papers on time during the company’s open enrollment, so now I’m not covered. Can I get a policy in the Marketplace instead? Can I apply for premium tax credits?
- I’m leaving my job and will be eligible for COBRA. Can I shop for coverage and subsidies on the Marketplace instead?
- I’m married. I work full-time for a large employer that offers me health benefits, but won’t cover spouses. Is that allowed? Can my spouse apply for coverage and subsidies in the Marketplace?
- I’m offered health benefits at work, but they’re not very good. I understand I may be eligible for Marketplace subsidies if my job-based plan doesn't meet a "minimum value" standard. What does that mean?
- I’ve heard that instead of offering a group health plan, I can offer my employees a “Health Reimbursement Arrangement” (HRA). What are these and should I offer them?
- Is my employer required to offer benefits to retirees?
- My employer plan covers only preventive services and a few doctors’ visits each year. I want better coverage. Can I apply for coverage and premium tax credits in the Marketplace?
- My employer won’t fill out the form that asks about the affordability of our coverage. I think my job-based plan is unaffordable and I’m not enrolled in it. Can I apply for Marketplace coverage and premium tax credits without that form?
- My employer’s health plan doesn’t cover brand-name drugs, only generics. Does that mean it doesn’t have minimum value? Can I shop for better coverage and subsidies on the Marketplace?
- My employer’s plan is grandfathered so it doesn’t cover preventive services. Can I shop for better coverage in the Marketplace if my job-based plan is grandfathered?
- My employer’s workplace wellness program increases premiums for employees who don’t participate and/or can’t meet certain targets for healthy behavior. Can I leave my employer-sponsored plan and get Marketplace coverage?
- My hours at work were cut and I no longer qualify for my employer’s plan. Do I have to wait until the open enrollment period to sign up for an individual plan?
- 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?
- My hours at work were cut back, resulting in a temporary loss of income. Can I qualify for premium tax credits?
- My large employer offers health benefits to me. My spouse works and has coverage through their job. To figure out whether my coverage is affordable, do I just count my income or do I count my spouse’s salary, as well?
- We just had a baby. Before that my husband and I were each covered under our own health plans at our own jobs, but now we want the family covered under one policy. Can we all switch to my employer plan now?
- We just had a baby. Can I add my baby to my family plan?
- What is a balance bill and how can I avoid it?
- When are you not eligible for premium tax credits?
- When can I enroll in my employer plan?