Trying to come up with a title for this article was a tough one. As with most of my articles, the basis of this article comes from working with a client.
My client has a job that is offering group insurance. When he looked at what it would cost to insure him and his family, he just about passed out. He called me in a panic not sure what to do. He was smart to call an agent. He sent me the information for his employer plan and I started digging into the numbers. Here is what I found:
– the employer coverage for the employee-only was very good.
– the dependent children coverage was comparable to the individual market because he had 3 kids
– coverage for his wife was much higher than what was available in the open market
During my next conversation with him, I explained this. He then asked about subsidies. Unfortunately, he doesn’t qualify for subsidies. This is for 2 reasons:
1. His employer offers insurance that meets ACA requirements offering the essential health benefits
2. His employer’s coverage is deemed affordable since the least expensive option for employee-only coverage is less than 9.5% of his income.
So, what are my recommendations for this person:
– Use the employer offered insurance for you and your children.
– Get a separate individual policy for your wife.
There are a lot of assumptions here like: everyone is in good health, but this will be a common occurrence and we shouldn’t immediately criticize a company for not offering insurance to employee’s spouses. They may actually be doing you a favor depending on your income level.
Every situation is different, but the message is clear: Don’t blindly accept what your employer is offering you and your family with regards to health insurance. There may be better options for you and your family.