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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.

Opt-Out of Employer Plan to Get Subsidy?

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Question: Can I decline my employers medical coverage and get covered California at a reduced premium rate?

Answer: Generally, you cannot receive premium assistance with Covered California coverage if you opt-out of your employer's group health plan. Only if the employer-based coverage fails the "affordability test" can you be eligible for premium assistance through Covered California. To be considered "affordable" by IRS standards, the employee-only share of the cost has to be less than 9.5% of the employee's income.

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