As of January 2023, how affordability is determined for employer- sponsored health insurance changed. Affordability is now calculated for the employee and their families separately.

For 2024, the coverage is considered unaffordable if the annual premium is more than 8.39%* of your total household income. If the employee’s coverage is affordable for themselves but not their family, their family may still qualify for a Special Enrollment Period and be eligible for a tax credit. While this may mean that your family has a policy through a different carrier, everyone will be covered by affordable health insurance.

For additional information, visit our Special Enrollment Period page.

What does this mean for employers?

Employers meeting all the guidelines on providing health insurance coverage to their employees don’t need to do anything. If the coverage that is offered to their employees and/or families is considered unaffordable, Your Health Idaho will confirm the premium(s) exceed 8.39% and calculate the amount of tax credit they are eligible for. Providing information to employees about Your Health Idaho as an option for their family’s coverage is a win for everyone. Employers benefit from not contributing to dependent coverage, and employees benefit by having affordable coverage for their families, putting money back in their pockets.

There are two times a year to enroll – Your Health Idaho’s Open Enrollment, October 15 to December 15, or during the employer’s open enrollment. We highly recommend employees confirm with Your Health Idaho that their current or offered coverage is considered unaffordable before making any decisions. Additional information is available here.

Low-Cost Options to COBRA

If you are going through an employment transition or recently lost employer health insurance, you might be eligible for a Special Enrollment Period. Health coverage at Your Health Idaho can be a low-cost option when compared to COBRA.

Why choose coverage through Your Health Idaho instead of COBRA?

    • COBRA may be expensive if your previous employer doesn’t help with premium payments or provides assistance only for a limited time.
    • Your Health Idaho is the only place you can receive a tax credit to pay for some or all of your monthly health insurance premiums.
    • You may also qualify for additional savings through Cost-Sharing Reductions, available on Silver Tier plans.

Review your options carefully. If you decide to enroll in COBRA, you will not be eligible for a Special Enrollment Period until your COBRA coverage ends or until Open Enrollment in the fall. If you would like more information on enrolling with a Special Enrollment Period for the loss of employer-sponsored coverage, please visit the Special Enrollment page.

If you have questions or would like additional help, contact Your Health Idaho at 855-944-3246 or visit the Find Help page to find a local certified agent whose assistance is at no cost.

*This percentage is determined each year by the IRS.