Are you struggling with the high cost of employer-sponsored health insurance? You’re not alone. Many people find themselves in the same situation, especially those with spouses who work for the government or other organizations with unique enrollment periods.

Employer Health Insurance vs. ACA Marketplace

Employer-sponsored health insurance is typically more expensive than plans available through the Affordable Care Act (ACA) Marketplace. This is because employers often pay a portion of the premium, which drives up the cost for employees. ACA Marketplace plans, on the other hand, are subsidized by the government, making them more affordable for many people.

ACA Marketplace Enrollment Periods

The ACA Marketplace enrollment period typically runs from November 1st to January 15th. However, there are exceptions for people who experience a qualifying life event, such as losing their job or getting married. In these cases, you may be able to enroll in an ACA Marketplace plan outside of the open enrollment period.

Your Options if Employer Insurance is Unaffordable

If your employer-sponsored health insurance is considered unaffordable, you may be eligible for financial assistance through the ACA Marketplace. Unaffordable coverage is defined as coverage that costs more than 8.5% of your household income. If your employer insurance meets this criteria, you can drop it and enroll in an ACA Marketplace plan.

Transitioning to ACA Coverage

If you decide to transition from employer insurance to ACA Marketplace coverage, there are a few things to keep in mind:

You may have a coverage gap: There may be a period of time when you are uninsured before your ACA Marketplace plan takes effect.
You may need to pay a premium: Even with financial assistance, you may still have to pay a monthly premium for your ACA Marketplace plan.
You may have a different deductible and coinsurance: ACA Marketplace plans have different deductibles and coinsurance than employer-sponsored plans. Make sure you understand these costs before you enroll.

Conclusion

If you’re struggling with the high cost of employer-sponsored health insurance, don’t despair. There are options available through the ACA Marketplace that may be more affordable. By understanding the enrollment periods and your eligibility for financial assistance, you can make an informed decision about your health insurance coverage. If you need help, we recommend consulting with a Certified Application Counselor or Navigator. They can help you navigate the enrollment process and find the best plan for your needs.