Written by Access Health CT | Published November 29th, 2023 | Updated November 29th, 2023If you are being offered coverage through an employer, or through a family member’s employer, you may still be able to enroll through Access Health CT and get help with paying for healthcare coverage. Families with offers of employer health coverage may have new opportunities for savings, even if before they weren't eligible.
Can I enroll through Access Health CT if my employer offers health insurance?
Yes, you can still enroll in a private health insurance plan (Qualified Health Plan) through Access Health CT, however, if the employer's coverage is considered affordable and meets the Minimum Value Standard, you will not be eligible to receive financial help (a Premium Tax Credit (PTC) or Cost-Sharing Reduction (CSR)), regardless of your household income.
- Affordable: A health insurance plan is deemed "affordable" if the employee's premium contribution toward the least-expensive plan for coverage is equal to or less than 8.39% of the household's Modified Adjusted Gross Income in 2024.
- Minimum Value Standards: A health plan meets minimum value standards if it pays at least 60% of the total cost of medical services including substantial coverage of physician and inpatient hospital services.
How is Affordability calculated?
Access Health CT will use the information you provide in your application for health coverage to determine if your employer’s coverage is “affordable”.
Make sure to contact the Human Resources department at your employer to gather all information required in our application. Not entering enough information regarding your employer’s coverage offered will delay determination of your eligibility for the Premium Tax Credit (PTC) until all necessary information is provided and we can determine that you do indeed qualify. You can use the Employer Coverage Tool from healthcare.gov to gather information about your employer.
My employer doesn’t offer coverage, but my spouse’s employer does. Am I still eligible for individual medical coverage through Access Health CT?
Yes, you can enroll in a plan through Access Health CT. However, if the plan offered by your spouse’s employer is offered to you – and the plan is considered affordable and meets the Minimum Value Standard – you may not be eligible for some financial help through AHCT.
A health insurance plan is considered to be affordable for the employee, if the premium cost to the employee alone meets the affordability percentage. Under a new federal law, family members may also qualify for financial assistance now. The cost of the employer plan for additional family members (the employee's spouse and/or dependents) will now be considered as the measure of affordability for those people.
You should fill out the employer-sponsored coverage section of the Access Health CT application and answer all the questions. The enrollment and eligibility system will produce an accurate determination. If you do not know the details of your employer's (or your spouse's employer) health insurance, you should check with the employer and update your Access Health CT application with this information.
A recent job or job-based coverage loss could mean you were offered COBRA, click here to learn more.