Employer Health Insurance FAQs

Employer Coverage vs Covered California

If your employer offers health insurance, you generally won't qualify for Covered California subsidies unless the employer plan is considered "unaffordable."

However, you can always purchase a Covered California plan without subsidies if you prefer.

The Affordability Test

Employer coverage is "affordable" if your share of the employee-only premium is less than 8.39% of your household income (2024 threshold).

• Only employee-only coverage counts, not family coverage
• If unaffordable, you may qualify for Covered California subsidies
• The threshold adjusts annually

The Family Glitch Fix

Starting in 2023, the "family glitch" was fixed! Now family members can qualify for Covered California subsidies even if the employee has affordable employer coverage.

Can I Switch from Employer to Covered California?

Yes, but consider these factors:

• With subsidies: Only if employer plan is unaffordable or doesn't meet minimum value
• Without subsidies: You can always buy Covered California, but may cost more than employer plan
• Timing: Dropping employer coverage may not qualify you for Special Enrollment