Eligibility - I’m eligible for job based coverage, can I shop around for another health plan through Stride?

If you are enrolled in or eligible for health coverage through your employer or through a spouse’s employer, this likely means you are ineligible to receive a tax credit to make your health insurance premiums cheaper ever month.

This is because most employer plans meet minimum value and affordability standards set by the government.

 

Here's how to double-check if you're eligible for a government subsidy:

  • Figure out the monthly cost to cover the employee only.
  • Multiply that number by twelve, for every month of the year.
  • Divide the resulting number by the entire household income.
    • If the resulting number is LESS than .095, you are NOT eligible for government assistance.
    • If the resulting number is MORE than .095, wahoo! You ARE eligible for government assistance.

Here's an example to help:

Cam is eligible for coverage through her employer for $50/month and estimates that she will be earning $30,000 for 2018.

  • Figure out the monthly cost to cover the employee only.
    • $50/month
  • Multiply that number by twelve, for every month of the year.
    • $50 x 12 = $600
  • Divide the resulting number by the entire household income.
    • $600 / $30,000 = .02
      • If the resulting number is LESS than .095, you are NOT eligible for government assistance.
      • If the resulting number is MORE than .095, wahoo! You ARE eligible for government assistance.

Unfortunately, because Cam's share of the premium is less than 9.56% of his income, she is NOT eligible to receive a tax credit through the Marketplace.

 

Remember, affordability is not determined by the cost of the plan if you add additional family members, only the cost of self-only coverage!

If your job based offer meets this affordability standard, then you will have to pay full price for a Marketplace plan, which is likely even more expensive!

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