Employer Group Coverage

Many employers or employee associations offer health insurance to their employees. In fact, the Affordable Care Act requires employers with more than 50 full-time equivalent employees to offer health coverage that meets certain minimum requirements. Smaller employers may offer insurance too. 

Employer-sponsored health insurance is selected and purchased by your employer and offered to eligible employees and their dependents.

Advantages of an employer plan:

  • Your employer does all of the work choosing the plan options.
  • Your employer often splits the cost of premiums with you.
  • Your portion of the premium may be automatically deducted from your paycheck each pay period.
  • Premium contributions from your employer are not subject to federal taxes, and your contributions can be made pre-tax, which lowers your taxable income.
  • Your employer provides policy documents and answers questions about your plan. 

Employer-sponsored health insurance is different from the kind of policy you buy with Covered California.  Employer-sponsored insurance is often a group plan – a group of employees who are insured together under an employer policy.  Covered California, on the other hand, sells individual insurance – a policy that you purchase just for yourself or your family. 

Advantages of an individual plan:

  • You can choose the insurance company, the plan and the options that meet your needs.
  • You can renew or change health insurance plans, options and health insurance companies during the annual Open Enrollment period.
  • Your plan is not tied to your job, so you can change jobs without losing your coverage. 
  • You can choose a plan that includes the doctors and hospitals you trust.
  • You may be eligible for federal or state financial help to pay for your insurance.

In most cases, if you’re eligible for employer-sponsored insurance, you aren’t eligible for financial help to buy a health plan through Covered California.

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