My Employer Offers a Plan, But I Have Marketplace Coverage?


I just signed up for covered Ca. bronze plan, effective 3-1-15. My monthly amount to pay is $67.00 with a subsidy amount of $162.00. I was offered insurance at my job but the premiums were $70.00 – $90.00 every pay period (twice a month) I couldn’t afford that. I am hearing a lot of rumors about this insurance and it got me thinking maybe I am not supposed to have this insurance because I was offered it at work. My question to you today is: am I going to have to pay the subsidy amount back at some time, or is my work insurance unaffordable by your standards?

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My employer had a discount plan that I purchased but it does aid me in medical expenses. Can I purchase an obama plan at the same time to cover my medical expenses after the deductible?

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So assuming your employer provides a plan that meets the basic guidelines of a health plan, you would have access to an employer-sponsored health plan and therefore not be eligible for cost assistance through healthcare.gov (ObamaCare). With that said, if you aren’t being provided such coverage, you may be able to use the marketplace and choose a marketplace plan with assistance. I’m thinking the best move here is to start with a call to healthcare.gov to run your situation by them, they can then provide you further assistance. You may also have short-term health options or options for an individual plan without cost assistance (dual coverage is possible in certain situations). It really comes down to what exactly your employer is offering, so best to get that information and contact healthcare.gov.

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My following question does not appear to be explicitly addressed here or elsewhere on this site.

My step-daughter has some health needs, but unfortunately her employer, a baptist church, only offers a “health care sharing ministry,” not actual insurance. I understand that the ministry makes her exempt from the tax fine for not having insurance (moot anyway with recent legal changes), but it does not meet the “minimum value standard” for employer insurance. My question then is, can she sign up for all the standard benefits of ACA insurance for her state and her income level without leaving the sharing ministry? Her employer is currently paying the small monthly fee for the ministry, and probably wouldn’t give her that benefit in any other form if she left it; it might also raise questions in their mind about whether she has sufficient faith or was trying to get health treatment forbidden by the religion. Neither is the case; the problem is simply that the ministry’s benefits are paltry, and she needs better coverage. But if she had to quit the sharing ministry to get ACA benefits, she might risk her job, so we need explicit guidance on whether that is the case.

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I think, but would have to double check, that since she has access to coverage through work that she wouldn’t qualify for the ACA. I’m assuming this applies to the health sharing ministry.

Since I don’t know the exact answer, I would strongly suggest contacting healthcare.gov and asking them directly!

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Hello I am employed at the rate of 20.75/ hr. I have a family of six. Me and my wife and four children. My employer offers the crap ACA, which I didn’t realize because I’m too busy making enough money for my family. But anywho the bronze ranges from 216-381. Nronze plus from 417-681. Silver from 583-1586. Gold from 755.41 – $2,383.67. And platinum from $1,041.63 – $3,129.60. This is after employee contributions of 458.00 based on me and spouse being non-smokers. My question is that from bronze to platinum the plan cost annually ranges from 6k-76k. WTF!!! Now I understand my family had no need for gold or platinum. But the in-network deductible for the lowest is 9000 for the family and 4500 individual. SERIOUSLY!!! I’m a nurse so I know bullshit when I smell it. Please explain how one goes about affording such health care. Every job I worked prior to 2003 the premium never went up past 100 a pay cycle. So now I either. Health coverage for everyone doesn’t help anyone if they can’t AFFORD it. fyi I’m in illinois. And can you please explain the 9.5% of employee gross income is the max a premium should be?

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