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People with coverage through a job

Steps to decide between job-based or Marketplace coverage

Review these steps to decide whether to pick job-based health insurance or enroll in a Marketplace plan:

1. Think about these before you decline or cancel job-based insurance:

  • The employer wonโ€™t pay part of your planโ€™s monthly premium.ย ย 
    With most job-based health insurance plans, your employer pays part of your monthly
    . If you enroll in a Marketplace plan instead, the employer wonโ€™t help pay your premiums.ย ย 
  • You may not qualify for Marketplace
    or extra savings, even if your income would qualify otherwise.ย ย 
    To qualify for savings, the offer of job-based health insurance canโ€™t meet the minimum standards. This includes whatโ€™s considered
    monthly premiums and the basic level of coverage. Most job-based plans meet these standards.ย ย 

    When you apply for Marketplace coverage, weโ€™ll check if the job-based insurance premiums are considered affordable for you (the employee) and for others in your household.

2. Get information about job-based insurance

Get any documents about job-based health insurance that has information about premium costs and who in the household can get coverage. You may be able to find this information in an online employee portal or account, a letter, email, or other document from the employer thatโ€™s offering the health coverage.
You can also ask your employer to fill out an Employer Coverage Tool (PDF, 145 KB).

3. Fill out a Marketplace application to check for savings

Include the information that your employer filled out in the Employer Coverage Tool in your application. Weโ€™ll review your application and tell you if you and others in your household will qualify for savings. Households with offers of employer health coverage may have new opportunities for savings, even if they werenโ€™t eligible before.
General rules about qualifying for savings through the Marketplace:
  • You canโ€™t get any savings for any month that you:
    • Have an offer of job-based coverage thatโ€™s considered affordable (and meets the minimum standards)
    • Are enrolled in job-based coverage
  • If the job-based insurance isnโ€™t affordable, you and others in your household may qualify for savings.ย ย 
Thereโ€™s no risk in applying
If you fill out an application, you can still choose to get job-based coverage. You wonโ€™t automatically get coverage by applying.

4. Compare Marketplace plans with your employerโ€™s job-based plan

Think about which plan will meet your needs and budget. Log in and find plans in your area. When youโ€™re logged in, youโ€™ll get prices based on any savings you qualify for.

5. Make your decision

If you choose to get a Marketplace plan:

Generally, you can enroll in a plan during Open Enrollment (November 1-January 15). If your employerโ€™s open season is at a different time of year or if you newly qualify for savings you may qualify for a Special Enrollment Period.

If you choose job-based coverage:

Accept the offer by the employerโ€™s due date, or check when you can enroll in their health coverage.
If you have Marketplace coverage now, find out how to cancel it.
Itโ€™s against the law for your employer to fire or retaliate against you if you:
  • Get a premium tax credit when you enroll in a health plan in the Marketplace.
  • Report certain violations of the Affordable Care Act to your employer or the government.