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How do the health insurance exchanges affect me if I already have insurance from my employer?

  • By
  • healthinsurance.org contributor
  • March 29, 2017

Q: How do the health insurance exchanges affect me if I already have insurance from my employer?

A: The marketplace in each state consists of two parts: one for individuals, and one for small businesses (SHOP exchange). They are both collectively referred to as “the marketplace” or “the exchange.”

If you have employer-sponsored health insurance, you can largely ignore the marketplaces/exchanges unless your employer purchases a SHOP small business plan and instructs you to use the SHOP exchange site to enroll yourself and your dependents. If your employer utilizes the SHOP exchange, you may have multiple plan options from which to choose. In that case, your employer will instruct you on how to use the plan selection feature on the SHOP website.

Although small businesses can get coverage through the exchanges, the vast majority of the people who have enrolled in exchange plans have done so in the individual market; SHOP enrollment has been quite low, nationwide.

So for the most part, the people who are actively using the exchanges to compare and shop for health insurance are those who need to purchase their own individual health insurance.

If you have employer-sponsored health insurance, you can probably ignore the exchanges. Although people are allowed to decline employer-sponsored insurance and buy coverage in the exchange instead, it’s very unlikely that you’d qualify for a subsidy in the individual marketplace if you do so. And you’d be missing out on the subsidies that your employer already provides in the form of employer-funded premium contributions.

 

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