UNAFFORDABLE EMPLOYER-SPONSORED COVERAGE

If your employer-sponsored health insurance is considered unaffordable for you or your dependents, you may be eligible to enroll in coverage through Your Health Idaho and apply for a tax credit.

For 2025, coverage is considered unaffordable if the annual premium of the lowest-cost plan offered to you is more than 9.02% of your total household income. For plan year 2026 the percentage threshold is 9.96%.
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There are two times a year when you can enroll:

  • During Your Health Idaho’s Open Enrollment, October 15 – December 15
  • During your employer’s Open Enrollment period 

We highly recommend confirming your employer-sponsored coverage is unaffordable before canceling your policy or opting out of enrollment. You can do this by completing the application; this does not commit you to enrollment through Your Health Idaho.

Use our affordability determination tool to check if your coverage is considered unaffordable.

      VERIFICATION DOCUMENTS

      To qualify for a Special Enrollment Period during your employer’s Open Enrollment, you must provide the following:

      • Proof of qualifying coverage from employer or insurance carrier
      • Documentation of employer Open Enrollment demonstrating an offer of unaffordable coverage

      To qualify for a tax credit and enroll during Your Health Idaho’s Open Enrollment, you must provide the following:

      • Documentation of current employer-sponsored insurance demonstrating unaffordable coverage

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