10 Essential ACA Benefits
ACA Plan Types
Understanding the Affordable Care Act
How the Insurance Exchanges Work
Income Requirements for ACA
How Does the ACA Affect Insurance Premiums?
Government Subsidy Overview

Part-Time Employee

Unable to obtain health insurance through your employer? Don't worry, you have plenty of alternative options. Find out how the healthcare laws affect you and learn more about obtaining health insurance on your own.

2018 Open Enrollment Period

November 1, 2017 - December 15, 2017

The Government Open Enrollment period is no longer open. To enroll in a qualified insurance plan before the marketplace reopens on 11/01/2017 you must have experienced a qualifying life event.

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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Important Insurance Facts you Need to be Aware of

Employers are not required to provide health insurance to employees that work, on average, less than 30 hours per week.

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There are a number of different ways employers may calculate average hours worked for health coverage eligibility so you may need to check with your employer if you have any questions about your eligibility. However, even if you are not eligible for coverage through your employer you do need to obtain qualified coverage or you could face financial penalties.

You may qualify for government subsidies to reduce the cost of individual insurance.

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Depending on what your estimated income is for the year, you may qualify for a government subsidy, which may decrease your monthly premium if you buy your own insurance through the state or government Marketplace. To see if you qualify, check out our Coverage Calculator.

Individuals under age 30 are eligible to purchase less expensive catastrophic plans.

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Catastrophic health plans are a cost effective alternative to traditional insurance coverage and they meet the insurance mandate for people under the age of 30. Catastrophic health plans feature lower monthly premiums have higher deductibles and only emphasize coverage for hospitalization or serious illness.

If you're uninsured for more than 3 consecutive months, you could face tax penalties.

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The ACA requires that nearly everyone purchase health insurance or face potential financial penalties. The 2016 tax penalty for going without coverage is 2.5% of your income or $695 per adult and $347.50 per child. You’ll pay the higher of the amounts. In future years, the fee is adjusted for inflation.

Enrollment isn't guaranteed year-round, but affordable short-term options are available.

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The only time individuals can enroll in new public health insurance is during the government open enrollment period (the next one runs from 11/01/2016 through 01/31/2017). There are some exceptions if you have a "qualifying life event," (like a permanent move, marriage or birth of a child) which would make you eligible for a special enrollment period. Individuals locked-out until the next open enrollment period may be eligible to purchase short-term insurance to obtain some protection against unexpected medical costs, however they could still be subject to the financial penalties for failure to have health insurance coverage.

Individuals under the age of 26 may remain on their parents' health plan.

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Under the Affordable Care Act, a child can stay on his or her parent's health plan, or be added back onto it, until he or she reaches the age of 26. If you're under the age of 26, being added to your parent's health plan might be an affordable option.

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

Employers are not required to provide health insurance to employees working less than 30 hours per week. Even if your employer does not offer health care coverage to you, you are still required by law to have coverage or you will be subject to a financial penalty.

Fortunately, there are many options available to you and, depending on certain factors such as your age and income, you may even qualify for a government insurance subsidy, which can make insurance even more affordable.

It's important to explore your options in order to choose the plan that's right for you.

FAQ's

I thought the new rules required my employer to provide health insurance coverage to all employees?

No. The new healthcare rules under the Affordable Care Act require only that employers provide health insurance for employees that work, on average, more than 30 hours per week.

Do I have to purchase health insurance?

Yes. One of the elements of the Affordable Care Act was the Individual Mandate which requires that nearly everyone purchase health insurance or be subject to a penalty.

What health coverage options are available to me?

Even though your employer may not provide coverage there are a number of alternatives available. Which one is right for you depends on your situation. If you are 26 years old or younger you may be eligible to stay on your parents insurance. If you are 30 years old or younger you may be able to purchase catastrophic insurance. If none of those situations apply, you may be eligible for Medicaid or you qualify for a government subsidy to help reduce your insurance costs. To view your options, check out our Coverage Calculator.

What is Catastrophic Insurance?

A catastrophic insurance plan meets the insurance mandate for those 30 years of age and younger (and those with a "hardship exemption"). These plans cost a little less than traditional insurance as they do not provide the full scope of services and are limited to, as it sounds, protection in the case of a more catastrophic situation. These plans do cover 3 primary care visits per year at no cost and also include preventive services. Note also that catastrophic plans are not eligible for a government subsidy.

How many hours a week do I have to work to be considered a full time employee?

A full time employee is someone who works, on average, 30 hours per week, per month or who works 130 hours per month.

I just started my job, does my employer need to provide me with benefits?

No. The law allows employers to prescribe a 90 day waiting period before they need to make their insurance program available to new employees. And, as mentioned above, you must work at least 30 hours per week in order to qualify for insurance benefits.

What if I have health insurance options through my employer?

If your employer offers coverage to part time employees you have the option to get insurance through your employer or a health insurance marketplace. The choice is yours. Before you choose a plan there are some things to consider:

  • Think about the cost. Is your employer insurance "affordable?" That is, is your cost for "you only" coverage less than 9.5% of your income?
    • If it is, and the insurance meets coverage standards as required by law, you can still buy insurance through a marketplace, but you will not qualify for financial help.
    • If you can't afford the health insurance offered to you through your employer or in a marketplace, you may qualify for Medicaid, or your children may qualify for the Children's Health Insurance Program. Each state has its own eligibility requirements for these programs.
  • Think about the insurance coverage. What does your insurance "buy" you? That is, how much will you pay out of your own pocket when you use medical services?
    • How often do you expect to use your insurance? Do you see the doctor fairly often and take one or more prescription drugs for an ongoing condition, like high blood pressure or diabetes? Or do you only see the doctor once or twice a year for checkups and the occasional illness?
  • Think about the network. If you have a doctor, it is important that you continue to see him or her? You'll pay less for care you get from in-network providers. So if you want to keep your doctor and pay lower, in-network rates, make sure that he or she is in your plan's network. If you need to find a doctor, does the plan's network have a wide selection of nearby doctors for you to choose from?

I have student health insurance through my college, does that meet the requirements?

If you are covered by your school's student health plan you will be considered covered under the health care laws however, it is recommended that you confirm that this coverage meets the health care law's requirements with your student health plan.

If I am eligible for a student health plan could I still qualify for a subsidy?

Yes you may be eligible for a subsidy. Even if you have access to a student health plan you could still be eligible for a subsidy. Subsidy qualification is based primarily on income and household size.

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.