Health Care

Does My Employer Have to Offer Me Health Insurance?

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Photo illustration by Sarina Finkelstein; Getty Images (1)

Not necessarily, but Obamacare means it's likely.

In a word, no. But if your employer has at least 50 full-time workers, the company could get hit with penalties if it doesn’t offer workers and their families coverage that is considered affordable and meets “minimum value” standards under the law.

Under the Affordable Care Act, or Obamacare, health insurance is considered affordable if the employee’s share of the premium for individual coverage costs no more than 9.5% of his or her household income. (Unfortunately, there’s no comparable affordability threshold for the cost of family coverage.) Coverage passes the minimum value test if it pays at least 60% of the cost of covered benefits.

If an employer plan doesn’t meet those standards, workers can look for a plan on the health insurance marketplace, and they may qualify for premium tax credits if their income is less than 400% of the federal poverty level (about $47,000 for one person).

The catch for employers is that if even one worker buys a plan on the marketplace and gets a premium tax credit for coverage, the employer could be on the hook for penalties of up to $3,000 per employee.

Workers are considered full time under the law if they work at least 30 hours per week. Some people have fretted that employers would cut workers’ hours in order to stay under the 50 full-time employee threshold for penalties. So far, though, studies have found that generally hasn’t happened.

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