Covered California and ACA related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the ACA and Covered California knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

Exchange Coverage for Spouse?

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Question: If I am currently on my spouse’s insurance can I deny insurance coverage from my current employer under new Obama health care plan? My employer is saying no that I cannot deny and would have to go t part time to avoid that.

Answer: Yes. You can drop off your spouse’s employer-based coverage and enroll in the Exchange, but you will not be eligible for premium assistance because you have access to employer-based coverage. The employer would have to exclude all spouses and children from coverage in its group plan for the dependents to be eligible for subsidized coverage in the Exchange. It is only when the insured’s employee-only cost exceeds 9.5% of income that the coverage is deemed not “affordable”, making the entire family, including the employee, eligible for premium assistance in the Exchange.

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