W2 contractor employee

Asked April 17, 2014, 6:37 PM EDT

I am single with 1 dependent. I work Fulltime as a W2 contract employee. The firm I work for provides health insurance (medical & dental), however the cost for myself & 1 dependent is $915 a month. Can I opt out of the insurance and find my own cheaper insurance. I am under the impression that you have to accept your companies benefits if they are offered.

Maricopa County Arizona

1 Response

If your employer offers job-based insurance and you choose to buy a plan on the health insurance marketplace (www.healthcare.gov) instead you generally won't qualify for subsidies unless your employer coverage is considered to be either unaffordable or inadequate. Your employer coverage would be considered unaffordable if the premium for individual coverage costs more than 9.5 percent of your income. It would be considered inadequate if it doesn't cover at least 60 percent of your allowed medical costs. If you choose, you can skip having insurance altogether but, if you do, you'll owe a penalty. In 2014, the penalty for not having health insurance will be either $95 or 1 percent of your household income, whichever is greater. The penalty will gradually increase until in 2016 it reaches the greater of $695 or 2.5 percent of your income. But consider your decision carefully. If you get sick and change your mind you won't be able to buy a policy through the state health insurance marketplace until the next open enrollment period which begins November 15, 2014, for coverage to take effect January 1, 2015. There are some exceptions to that, but generally you would have to wait.
Plans in the Marketplace are offered by private companies, and every health insurance plan covers a core set of benefits called essential health benefits. You can compare your options based on price, benefits, quality, and other important features. . You can also get insurance outside the Marketplace--through a private insurance company, an online insurance seller, or an agent or broker.

You can preview Marketplace health plans and prices available in your area by using a simple tool (https://www.healthcare.gov/find-premium-estimates/). You’ll see Marketplace health plans available in your area, with premium estimates based on your income and household size. You'll also get important details like deductibles, copayments, and out-of-pocket maximums, plus links to a summary of benefits, the provider network, drug coverage rules, and customer service contacts.The premiums shown apply to people who don’t use tobacco. Look beyond the premium when figuring potential health care costs. Download the Smart Choice workbook (http://extension.umd.edu/insure ) and complete the forms to help you determine what health insurance needs you and your family have, what health care costs you may have (the monthly premium, the plan’s deductible, copayments and coinsurance, and the maximum out-of-pocket amount you could be responsible for every year), and how these costs will fit in your family’s spending plan/budget. Completing the Smart Choice workbook can help you be less confused and more confident you will make a choice that's best for you and your family's health and financial needs, wants and resources.