If your employer offers health insurance, you can still shop for a Marketplace plan. But you may only get financial help (premium tax credits) if the employer plan is either too expensive or does not meet minimum standards.
When an employer plan is “too expensive”
A plan is considered unaffordable if the share you pay for coverage is more than a set percentage of your household income. For the 2026 plan year, the affordability limit is 9.96%.
The family glitch fix
In the past, affordability was only based on the cost of coverage for the employee. Now, Marketplace rules also look at the cost of coverage for your spouse and children. This means family members may qualify for savings even if the employee does not.
Other reasons you may still qualify
The employer plan does not provide minimum value (doesn’t cover enough services or costs)
The employer only offers an HRA or arrangement that isn’t considered affordable
Employer Coverage Calculator Tip
To see if you or your family might qualify for Marketplace savings:
Find the monthly premium you would pay for the lowest-cost plan your employer offers (employee-only and family coverage, if needed)
Divide that premium by your household monthly income
If the percentage is higher than 9.96% (for 2026), you may qualify for Marketplace subsidies
The Marketplace will check this when you apply, but having these numbers ready makes it easier to compare.
What to do next
Start an application to see exact plan prices and whether you qualify for savings. If you have any questions about your options, reach out to us at 855-772-2663.