My employer offers health benefits to me and my family. The company pays the entire cost of my coverage but contributes nothing toward the cost of covering my family. We can’t afford to enroll my spouse and kids. Can they get coverage and subsidies in the Marketplace instead?

You can always shop for health coverage in the Marketplace. However, your employer-provided coverage is considered “affordable.” That’s because the affordability of employer sponsored coverage is only measured with respect to self-only coverage. Because your employer pays the entire cost of the employee-only coverage, you are technically considered to have affordable coverage (even though practically speaking, it was unaffordable to you.) As a result, neither you nor your spouse and children are eligible to apply for premium tax credits in the Marketplace. Sometimes this rule is referred to as “the family glitch.”

There are some other things you should know. First, depending on your family income, your children might qualify for the Children’s Health Insurance Program in your state. Check with your state Marketplace to find out if your children may be eligible for CHIP.

Second, if you find you cannot afford to get coverage for your spouse and/or children, you should know that starting in 2019, there is no tax penalty for not having health insurance.

employer health insurance

Get In Touch

Connect With Us

Hummingbird Insurance ♡ protecting what we love 

Insurance for individuals, families and employers. We specialize in employee benefits, Medicare, health, dental, vision, life & disability.

Hummingbird Insurance is an independent authorized agency licensed to sell and promote products from Blue Cross and Blue Shield of North Carolina (BCBSNC). The content contained in this site is maintained by Hummingbird Insurance. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. ®, SM  Registered marks of the Blue Cross and Blue Shield Association.
Products from Blue Cross and Blue Shield of North Carolina® (BCBSNC) are only available to North Carolina residents and employers.

Privacy Notice Statement | Copyright © 2018 | Hummingbird Insurance