Question: … if one person in a three person family unit decides to opt for insurance without any subsidy inside or outside the exchange, do the other two automatically forfeit any subsidized insurance through the exchange because of that fact? Does it matter what the family income level is?
Answer: The eligibility for premium assistance in this scenario would be based on the income for a household of three. If the household is eligible for a subsidy, two members can enroll in Covered California while the third chooses unsubsidized coverage off-exchange. If not eligible for a subsidy, you could also enroll two members on exchange and one off-exchange, but there would be no benefit in so doing. In this case, it would be easier for all three family members to enroll off-exchange and split the enrollment among family members in any which way.