Why could my family qualify when I do not?
The affordability test for the employee looks at the employee share of the lowest cost self only plan that meets the minimum value standard. For family members, it looks at the employee share of the lowest cost qualifying plan that covers the household members offered coverage.
If the employee offer is affordable but family coverage is not, eligible family members may qualify for Marketplace savings while the employee remains on the work plan. This is often called the family glitch fix. Marketplace savings are not available for a month someone is enrolled in the job based plan.
How can I estimate whether the offer is affordable?
Multiply expected annual household income by 10.22%, then divide by 12. Compare that monthly amount with the required employee premium, not the total premium before the employer contribution. The check below does that arithmetic on your device.
| Example | Monthly amount | What it may mean |
|---|---|---|
| Expected household income | $60,000 per year | 10.22% is $6,132 per year, or $511 per month. |
| Employee only coverage | $200 | Below the $511 estimate. The employee may not qualify for Marketplace savings. |
| Coverage for offered household members | $700 | Above the $511 estimate. Eligible family members may qualify for savings. |
The Marketplace makes the actual decision after you apply. Income, household, the particular offer, minimum value, other coverage and enrollment matter. A different type of employer offer, such as an individual coverage HRA, has different rules.
What information should I get from the employer?
Ask for the lowest cost plan offered to the employee that meets minimum value, and the lowest cost plan that covers the family members offered coverage. Get the employee share of each monthly premium and the dates coverage is available.
- Ask whether the plan meets minimum value. Generally it must be designed to pay at least 60% of covered medical costs and offer substantial hospital and doctor coverage.
- Estimate your expected household income for 2027, including income of household members required to file a tax return.
- Ask the employer to complete the Employer Coverage Tool linked in our sources. Use the information in your Marketplace application.
Does a Marketplace application automatically cancel my work plan?
No. Applying lets you see eligibility and plan prices. It does not automatically enroll you or cancel your job based coverage.
Compare the plans before declining or ending coverage. Consider the employer contribution you would lose, premiums after any savings, deductibles, doctors and prescriptions. Do not cancel existing coverage until the new coverage and start date are confirmed.
When should my family enroll for 2027?
On HealthCare.gov, choose a plan by December 15, 2026 and pay the first premium for coverage beginning January 1, 2027. Enrollment continues through January 15 for coverage beginning February 1. State marketplaces may use different dates.
Your employer may have an earlier enrollment deadline. A job based open season at a different time or a new eligibility for savings may create a special enrollment opportunity, but the Marketplace decides based on your situation. See our open enrollment dates and plan comparison tool.
How can we help compare your options?
We can help you understand the work offer, compare available Marketplace plans and check the steps for applying. Have the employer premium amounts and your estimated household income ready. An agent can explain your options without asking you to cancel a plan first.
See our Individual & Family plans
Major medical coverage for you and your household, with subsidies applied where you qualify.2027 health insurance subsidy calculator
Enter your state, household size and income to see your 2027 expected premium, your savings and whether Medicaid may apply.
Talk to a licensed agent
We compare plans, explain the tradeoffs and help you enroll. It costs you nothing.