Replacing Employer Coverage With a Marketplace Health Plan

Bad news: The New Jersey marketplace is only accessible by going through Healthcare.gov, the federal site, which is not working at well right now. It’s very difficult to create an account and actually see available plans. Our advice at the moment is to wait another few weeks to register and shop for plans, in hopes that the site will be working better by then.

Good news: The site does have a rudimentary plan preview feature that you can use to get a ballpark idea of what your unsubsidized marketplace premiums might be. I looked for plans in Bergen County, N.J., just outside of New York City. The age categories shown that are closest to you and your daughter are for individuals aged 27 and 50 (this matters because marketplace premiums vary by age). The cheapest Silver (midpriced) plan for a 27-year-old is $ 260 and for a 50-year old, $ 444, for a total of $ 704 a month. So it looks like you and your daughter could save about $ 300 a month insuring yourselves through the marketplace instead of through your wife’s job. If your income would otherwise qualify you for a subsidy, your wife’s employer would be doing your family a favor by dropping spousal coverage altogether. Employers who offer group health coverage must include dependent children, as that is a requirement of the law. But they don’t have to cover spouses. Without an “offer” of employer coverage, you would be able to get an advance tax credit that you can use right away to lower the cost of your premium on the marketplace. This family glitch was, everyone believes, simply a mistake in the drafting of the law. But apparently the only way to fix it is for Congress to enact a change. Given the events of the last couple of weeks, the chance of that happening seems pretty slim.

— Nancy Metcalf

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