The Affordable Care Act, commonly known as Obamacare, provides health insurance each year to millions of Americans who otherwise would have been uninsured.
It also offers an alternative for people and families who have access to health insurance from an employer, if the coverage is deemed unaffordable.
As the 2024 open enrollment season approaches, now is a good time to discuss whether buying health insurance through Pennie — Pennsylvania's health insurance marketplace — is a good idea for those who have high-cost, employer-provided insurance.
Who can buy health insurance through Pennie?
Pennsylvanians can apply for health insurance through Pennie even if they have an offer of job-provided insurance. The key is that they are not enrolled in the coverage, Devon Trolley, Pennie's executive director, said in an email.
The applicant would have to pay full price, however, unless the job-provided coverage fails to meet certain thresholds. Then they might qualify for tax credits and cost-sharing reductions.
"They can be eligible for financial help to reduce the cost of coverage if their offer of employer coverage does not meet the minimum value standards (60% actuarial value) or their premium exceeds a certain amount (8.39% of household income for plan year 2024)," Trolley said.
A health plan's actuarial value is a measure of the percentage of estimated health-care costs a health plan would cover. Most plans meet this threshold, Trolley said.
How has the cost of Pennie plans for family members changed?
Until plan year 2023, a family's eligibility for financial help with a Pennie plan if a person was employed was based on the premium cost of a self-only policy and not a family policy.
The average annual premium for employer-sponsored family health insurance in 2022 was $22,463, compared to $7.911 for self-only coverage, according to Kaiser Family Foundation. A family earning $100,000 would have qualified for financial help based on the family policy but not if it was based on the self-only policy.
The issue was especially difficult for families where the employer paid the entire premium for the worker but contributed nothing for their family members.
How can I shop for a plan through Pennie?
Open enrollment for plan year 2024 runs Nov. 1 through Jan. 15, though you must enroll by Dec. 15 for coverage starting Jan. 1. Applications are also accepted throughout the year for life-changing events, such as the loss of health insurance, marriage or divorce, or the birth of a baby.
You can apply for coverage through Pennie by visiting enroll.pennie.com. If you are apllying for coverage, you will need to know your annual household income, and have your Social Security number, photo ID, last four weeks of pay stubs and most recent tax return.
If your employer offers health insurance, you will also need the premium information for their lowest-priced coverage (either self or family, whichever you are seeking).
Have a consumer question you'd like us to help you with? Leave a message with David Bruce at 814-870-1736, send an email to firstname.lastname@example.org or send mail to 205 W. 12th St., Erie, PA 16534.
This article originally appeared on Erie Times-News: Affordable Care Act plans available even if job offers health insurance