Job-Based Coverage

Job-based coverage (also called employer-sponsored coverage or group health insurance) is health insurance you get through your employer as part of your benefits package. Your employer typically selects the plan options and pays a portion of the premium, with the rest deducted from your paycheck before taxes.

Job-based coverage is the most common way Americans under 65 get health insurance. Employers with 50 or more full-time equivalent employees are required by the ACA to offer coverage that meets minimum value and affordability standards — or face potential penalties.

Key things to know about job-based coverage:

• You can only enroll during your employer’s annual open enrollment or within 30–60 days of a qualifying life event
• Coverage ends when you leave or lose your job (COBRA can extend it temporarily)
• If your employer’s plan is affordable and meets minimum value, you generally cannot get Marketplace subsidies — even if a Marketplace plan would cost less
• The family glitch IRS fix (effective 2023) allows family members to access Marketplace subsidies if the employer’s family coverage is unaffordable