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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.

Employer Penalty?

By on | 4 Comments

Question: If employer pays my premiums, but the premiums for my dependent coverage which is too expensive for me so i decline coverage and get subsidized coverage on the exchange, will my employer be fined?

Answer: If you work in a small business with less than 50 full-time your employer is not required to provide health insurance for employees, consequently there is no penalty. If you work for a larger employer, they are required to provide affordable health insurance for the employee only or face a penalty.


I only question the part of the question that was asking if he declined coverage and went to the exchange & received subsidies. I guess I was not assuming that the employers coverage exceeded the 9.5%. Your answer addressed the “will the employer be fined” but made no mention that he may or may not receive the subsidies after declining coverage. So it didn’t contradict, I just wanted clarification on the part that mention that he would get subsidy after declining coverage…maybe yes, maybe no. Thank you for your answers and keeping us informed.

No. Your understanding is correct. However, I don’t see any contradiction between your statement and my answer to this question. Am I missing something?

I thought that if the employer offered coverage regardless of size and the employee &/or dependents declined, they could go to the exchange but would not receive tax credits &/or subsidies on the exchange unless the coverage offered exceeded the 9.5% affordability rule. Has that changed?

Does this mean that an employee of a small business can decline coverage through the employer and stillget subsidies on the exchange ( if income qualified ) regardless of the 9.5% affordability rule?

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