What happens if an individual's employer plan does not meet affordability requirements?

If an individual's employer plan does not meet affordability requirements, they may qualify for subsidies to purchase health insurance through the Marketplace. Affordability is assessed based on a percentage of the individual's household income compared to the cost of coverage provided by the employer. If the premiums for the employee's lowest-cost self-only coverage exceed a certain threshold of their income, the employer's plan is deemed unaffordable.

In this case, the individual has the option to seek coverage through the Health Insurance Marketplace. They may be eligible for financial assistance in the form of subsidies, which can help reduce the costs of premiums and potentially lower out-of-pocket expenses. This assistance is designed to ensure that individuals do not face excessive financial burdens when accessing health insurance, promoting a more equitable approach to healthcare coverage.