10 Essential ACA Benefits
ACA Plan Types
How the Insurance Exchanges Work
How Does the ACA Affect Insurance Premiums?
Government Subsidy Overview

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Your Employer provided Health Coverage may be the best option. However, you may use this tool if you still want to learn more about the healthcare laws or investigate other possible coverage options available for your family.

2025 Open Enrollment Period

November 1, 2024 - December 15, 2024

This is the countdown until the Open Enrollment Period starts. If you have experienced a Qualifying Life Event you may still enroll and get the health coverage you need.

Are you eligible for financial assistance?

You have many health coverage options available. Use our Coverage Calculator to get your personalized coverage roadmap.

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Get Educated

Take control of your health coverage by learning everything you need to know about healthcare laws and the government subsidy program.

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Healthy new careers start with good health

If you just started your job, it may be 90 days before you qualify for health coverage.

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Employers may impose a 90 day waiting period on new full-time employees. Although not a replacement for an employer-sponsored plan, short-term insurance plans are available which can provide stopgap coverage during this 90-day waiting period.

Employers need to offer affordable insurance coverage that meets government requirements.

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The Affordable Care Act specifies that employers need to offer insurance to its full-time employees that provides minimum essential benefits and covers certain preventive care. Additionally, this coverage must be affordable, which simply means that the cost or your premiums, for self-only insurance, must be no more than 9.5% of your income.

If your employer isn't paying for health insurance you may have other options.

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Rather than offering insurance to its full-time employees, the law also allows employers to elect to pay a penalty. If your employer doesn't offer you insurance, you may be eligible to purchase individual coverage through an exchange. Further, if your employer does not offer insurance, depending on your estimated income, you might be eligible for Medicaid or a government subsidy. Check out our Coverage Calculator to see if you qualify.

Have More Questions?

Below are our lists of available resources that can help guide you through this process. We also have a thorough knowledge base of FAQ's available.

Knowledge Base

If you're a new full-time employee, you may find that you have to wait up to three months before becoming eligible for health insurance and benefits. Employers are allowed to wait up to, but no longer than, 90 days to offer you health benefits. During this waiting period, you have many options for obtaining short-term coverage.

Short-term plans generally have limited benefits and they don't overcome the potential tax penalty for being uninsured. They are, however, an important measure of protection against uninsured medical costs.

In addition to short-term coverage, full-time employees should also learn about supplemental coverage options. Supplementing an existing employer-provided healthcare plan with accident and critical illness coverage can provide an added level of coverage and an extra safeguard against medical bills.

FAQs

Do the new health care laws require that my employer pay for my health insurance?

No. Your employer is not required to pay for all of your health insurance costs. The Affordable Care Act requires only that employers provide affordable, qualified health insurance to employees that work, on average, more than 30 hours per week. Employers can still elect to not provide any coverage however they will be subject to significant financial penalties. Coverage is deemed to be affordable if the cost to you of the "self only" coverage is less than 9.5% of your income. Coverage is deemed qualified if it provides the minimum essential benefits required by law.

Can I opt out of my employer's insurance and take advantage of the government subsidies?

Generally, no. If your employer offers affordable, qualified coverage you will not be eligible for a government subsidy. If the coverage offered by your employer does not meet either of those criteria then you would be eligible to purchase insurance through the marketplace and take advantage of any subsidies you may qualify for. Check out our Coverage Calculator to see if you qualify for a subsidy.

Can I opt out of my employer's insurance and enroll in Medicaid?

Yes. Unlike government subsidies (discussed above) you can elect to enroll in Medicaid rather than insurance offered by your employer if you qualify for Medicaid.

Do I have to purchase health insurance?

While health insurance is no longer required at the federal level, there is a possibility that you will face a tax penalty for not having adequate coverage if you live in a state that has an individual mandate.

Right now, there are five states and one district where health insurance is required. You may be subject to a tax penalty if you live in one of the following areas and do not have medical insurance coverage:

  • Massachusetts
  • New Jersey
  • Vermont
  • California
  • Rhode Island
  • District of Columbia (Washington D.C.)

How many hours a week do I have to work to be eligible for employer provided health insurance?

Employers can elect to provide coverage to any group of employees regardless of how much they work however, at a minimum, the ACA requires that employers must provide affordable, qualified health insurance to employees that work, on average, 30 hours per week, or 130 hours per month.

I am working 40 hours per week but have only been employed for 6 weeks is my employer required to provide me health insurance coverage?

No. The law allows employers to prescribe a 90 day waiting period before they need to make their insurance program available to new employees. After the 90 day waiting period you should be allowed to enroll in your employer's plan. If you are looking for coverage during that waiting period you should consider the following possible options:

  • Your parent's plan (available to individuals age 26 and under)
  • Catastrophic insurance (available to individuals age 30 and under)
  • Individual insurance coverage (depending on your income you may qualify for a government subsidy)
  • COBRA coverage (if you have recently left another job and had insurance through that employer it is possible you are able to extend that coverage via COBRA)
  • Short term care options

My employer contributes to my health insurance premiums, could I elect a marketplace plan and apply my employer's contribution towards those premiums?

No. If your employer offers affordable, qualified health insurance and you elect marketplace coverage you must pay for the full cost of the premiums.

Do I Qualify for a Subsidy?

Find out if you qualify for a Government insurance exchange subsidy by completing our simple questionnaire with our coverage calculator.