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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.

Is My Employer-Based Coverage Unaffordable?

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Question: I earn less than 30,000 a year. I have 2 daughters and me. I'm insured through my employer. I am paying $400 a month. Do I qualify for a subsidy?

Answer: If you pay $400/mo for health insurance that does not include your daughters, it is officially "unaffordable" because it represents over 16% of your income. The law says you can cancel your unaffordable (greater than 9.6% of income) employer-based insurance. You are eligible to buy subsidized coverage at Covered California. Your daughters are eligible for Medi-Cal. Your cost for very good insurance will be about $100 per month.

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Is the employer plan just for you, or does it include your dependents? If your job’s plan also includes your dependents then the employer may calculate the premiums with a safe harbor tool that makes the group insurance affordable for the three of you.

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