Client is Offered Group Coverage Through Work

[jalice1630]

I have a prospect who is being offered group coverage through his employer. He says he cannot afford the premiums through his employer. What are the rules and regulations regarding enrolling a client through the marketplace when they already have group coverage through their employer?

 

[ctg]

What he says is affordable and what the government says is affordable may be two different things. He can always get a plan through the marketplace, but not always with a subsidy.

Small group or large? Very generally speaking, with a large group, they can only charge about 9.5% of income or it is deemed unaffordable. Nearly all large groups will make it "affordable" to not be subject to the fines (or tax or penalty) our dear leader has deemed appropriate.

Small groups can play by different rules. But if they offer a plan considered affordable, no subsidy.

It all depends on what is offered by the employer.