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My employer offers insurance, but I think it’s too expensive. Can I apply for a subsidy to help me buy my own insurance?

  • October 5, 2015

Q: My employer offers insurance, but I think it’s too expensive. Can I apply for a subsidy to help me buy my own insurance?

A: You are not eligible for a health insurance premium subsidy unless the insurance your boss offers would force you to kick in more than 9.66 percent of your income to cover your share of the premium in 2016 — or is so skimpy that it pays for less than 60 percent of the average employee’s covered benefits.

It’s important to note that the affordability test for employer-sponsored coverage applies only to the amount you’d have to pay to insure just yourself under your employer’s plan. If that amount is less than 9.66 percent of your income, you’re not eligible for a premium subsidy in the exchange, and neither are your family members if they’re allowed to enroll in your employer’s plan, regardless of how much it would cost to actually enroll them in the group plan. This is known as the ACA’s “family glitch,” and although some lawmakers – and countless consumer advocates – have proposed fixes, it’s still an issue for upwards of two million Americans.

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