Speak with a Covered California certified agent! Call (888) 413-3164 or Shop Online Now

Shop and Compare

California Health Insurance Plans and Rates

It's easy. Just enter your zip code.

Covered California Q&A

Covered California and Obamacare 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 Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


What is Affordable Coverage?

By on | 2 Comments

Question: I read that even if my employer offers health insurance I can buy in the health exchange if it’s not affordable. Is that right?

Answer: Right. If an employer-sponsored plan does not meet the “affordability standard”, an employee and dependents may be eligible for premium subsidies to purchase coverage from Covered California. The affordability standard, according to the ACA, is when the employee’s contribution to coverage cannot exceed 9.5 percent of the household annual income.

But the devil is in the details. Last week the IRS further clarified affordability as being based on what the employee contributes for self-coverage only, not family-coverage. In other words, the affordability of coverage will not take into consideration the portion of the annual premium the employee must pay for family coverage. Also, uninsured children will be ineligible for premium subsidies in the exchange. Bummer!

2 Comments

Are there any rumors this gliche may be remided to where it uses family premium not only self coverage?

Leave a comment

Do You Have California Health Insurance Questions?

Ask An Expert

View Previous Questions
Call Us at (888) 413-3164


© 2023 California Health Benefit Advisers, LLC
Home / About / Start Shopping / Ask a Question

“Covered California,” “California Health Benefit Exchange”, and the Covered California Logo are registered trademarks or service marks of Covered California, in the United States. This web site is owned and maintained by California Health Benefit Advisers, LLC, which is solely responsible for its content.