Employer-Sponsored Health Coverage

I’m offered health benefits at work, but they’re not very good. I’m applying for better coverage and subsidies in the Marketplace. The application asks whether I’m offered job-based health coverage that meets minimum value. What does that mean?

The term “minimum value” means that your job-based plan would cover at least 60% of an average group of people’s covered health costs. In addition, employer plans must provide substantial coverage for hospitalization and for physician care to meet the “minimum value” test. Most employer plans will meet this test, but some may not. The Marketplace application includes a form with questions about job-based coverage. You should take this form to your employer and ask them to fill it out. With that information the Marketplace will determine whether the plan meets minimum value. If it doesn’t, you may be able to qualify for premium tax credits to help pay for Marketplace coverage.

While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.

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The independent source for health policy research, polling, and news, KFF is a nonprofit organization based in San Francisco, California.