Individuals that have access to group coverage and go through Covered CA cannot get a subsidy

Covered California is the health insurance exchange run by the state of California to administer the federal government’s Affordable Care Act. It is there to offer affordable individual health insurance to those who can’t get it from their employer or who are unemployed, disabled, or self-employed. Government subsidies may be available to help people pay the premiums for the policies they purchase through Covered California. These subsidies are based on a person’s income and may pay part or all of the premiums of the new policy.

Federal regulations governing the Affordable Care Act state that employers must ensure health insurance premiums through the group policies they offer are 9.5 percent or less of an employee’s annual household income. This is to make sure those employers who are offering group coverage make it affordable to all employees. In most cases, you will not be eligible for a subsidy from the state of California if you have affordable group coverage. You can still purchase a policy through Covered California, but you will have to pay the full price on your own.

For more information about health insurance under Covered California in the Sonoma County area, please contact Sackett & Associates.